Yesterday was a rough day for me; so I'll be uncharacteristically brief today.
As I've pointed out time and time again, these days, advocates of "complementary and alternative medicine" (CAM) don't like it so much anymore when their preferred quackery is referred to as "CAM." Now the preferred term has--shall we say?--evolved to a happy term designed to paint their woo as being co-equal with real medicine: "integrative medicine" in a way that the term "CAM" does not. After all, CAM is "complementary," which implies that it's subsidiary, the icing on the cake so to speak, and it's "alternative," which implies (correctly, I might add) that it's not real medicine. What was once rightly considered quackery has "evolved" to become first "complementary" and now "integrative," the latter of which implies that co-equal modalities are being "integrated." This evolution has occurred in less than 30 years, so now we even have a branch of the National Institutes of Health, the National Center for Complementary and Alternative Medicine (NCCAM) promoting magic, not to mention very wealthy foundations promoting the infiltration of quackery into academic medicine to produce quackademic medicine.
I've been pointing out time and time again that "integrative" medicine is largely nothing more than "integrating" quackery and magic with scientific medicine, at least when integrative medicine is not concerned with co-opting areas of scientific medicine, such as nutrition, exercise, and the like, as being somehow "alternative" to be "integrated." Leave it to my good bud Mark Crislip to come up with the perfect analogy for this "best of both worlds" propaganda:
If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.
And if you integrate quackery with real medicine, you do not produce better medicine. Instead, you turn quackery into medicine and medicine into quackery, which is exactly what's happening in medicine right now. Much of integrative medicine represents a return to the past, and not in a good way. Rather, it's a return to the past where the four humors qi determined health and disease, miasmas unspecified and unknowable "toxins" were responsible for many diseases, and praying to God (or the gods) for healing energy healing and reiki was the order of the day. That's what we're "integrating" into scientific medicine.
Remember Mark Crislip's pithy 34-word maxim any time you hear someone like Dr. Oz or his many lesser minions use the term "integrative" medicine. It might even be worth memorizing to throw back in their faces.
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Maybe I missed something in Orac's "34 words" blog this morning, but I'm not seeing the 34 word definition cited in the title. (Maybe my night of insomnia is clouding my mind). So, please, someone clue me in on these 34 words.
It's these 34 words: If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.
Here you go, kurt:
Hope that clears it up for you.
34 Words:
kurt:
The 34 words are in the blockquote. It's not a definition, it's an analogy, and an appropriate (and amusing) one.
Hope you get some sleep tonight.
Leave it to Mark Crislip to come up with a humorous yet concisely accurate phrase to describe the situation. That's going straight into my quotefile.
A wonderful analogy, Orac. Sorry yesterday was rough. May today be better. More apple, MUCH less cow.
Last night I went down alongside the river where there are interesting shops, restaurants and a theatre, the fellow with me wanted to buy some "healthy biscuits"** at the vitamin store so we went there and I spied a little booklet about homeopathy, which I took.
Over dinner, he asked innocently, "What's homeo-P, D?" So I told him. He replied, after laughing uncontrollably for several minutes: " If that were true, we could be billionaires!" and outlined a plan wherein we would dilute expensive commodities with cheaper commodities ( i.e. water) and sell the new, stronger ( i.e. diluted) product at top price- imagine oil, orange juice, gin, vodka, perfume- and of course, we would be the enlightened beings who would have thought of this first!
I can only add: diluting real things doesn't make them stronger or better, it only means that there are less of them: integrative medicine dilutes SBM with crap- a much cheaper commodity.
**bizarre concoctions of oats, nuts and seeds he keeps in his desk drawer so he doesn't eat what's in vending machines- you know what's in vending machines.
Speaking geneally, those sub-consciously sensing uncomfortable change a-coming, in their more consicous manifestations, tend initially to become still more agressively identified with their ever-weakening position.
Integrative medicine is the beginnings of a movement which has yet but started where doctors themselves are beginning to understand much of what certain quality "CAM" practitioners have been saying for some time. That's all basically about prevention, quality natural nutrition, stress minimisation and avoidance of toxic patented pharmaceuticals
The CAM label was about "us" and "them" thinking; a denigrating label favoured of course by the orthodoxy.
Folk like you will struggle with this. Your logic reminds me, in another realm, of how those most irate about any sort of criticism of even the most blatantly indefensible aspects of Israeli foreign policy like to brand non-Jewish critics as "anti-Semites" and incredibly, critics who are Jewish as, yes, "self-hating Jews"! Your piece here smells the same. Dr. Weil and his like are "self-hating or self-deluding doctors", correct?
@ Denice Walter: You are reminding me of a conversation I had with an infection control nurse at a local hospital, during the mailing of anthrax spores, soon after 9-11.
We were discussing how people were purchasing Cipro from off-shore pharmacy internet sites and how thousands of people, with absolutely no exposure to anthrax, were calling local health departments to get anthrax vaccine. Hundreds of these same people showed up in hospital emergency rooms with the hope of getting anthrax vaccine (just as a "precaution").
We devised a "plan" (scheme) to sell "vaccine" on the internet, by selling pre-loaded syringes filled with isotonic 0.9 % normal saline water. We further finessed our business "plan" (scheme) and decided to fill the syringes with hypotonic injectable sterile water. Sterile water burns like hell and our "patients" (marks) would think that they were getting the real deal.
It only goes to show 'ya...that intelligent people are prone to bouts of hysteria when it comes to their health and that they will fall for any scheme.
Which (aside from the fearmongering "toxic") is what science-based medicine has been saying since it existed. In no way is any of that the least bit "complementary," "alternative," or "integrative." Completely standard science, harped upon ad nauseum by physicians across the world.
Alright Conner, only 11 posts and someone already tries to Goodwin the thread.
The only uncomfortable change is when the folks believing this crap finally find themselves facing a real illness that will require medical intervention after their beetroot and magic water cures fail them.
"That's all basically about prevention, quality natural nutrition, stress minimisation and avoidance of toxic patented pharmaceuticals."
Conor S., that's not even word salad you've got there. Particularly when CAM often deals with anything but what you describe:
- prevention (cough Wakefield cough, plus anti-pasturisation movements)
- natural nutrition (going off on bizzare food combinations not even remotely reflective of human diets in the past several thousand years)
- stress minimisation (by putting the onus of illness on the sick? yeah, right)
- patented pharamceuticals (when most CAM modalities are nothing but low-cost/high-margin patent medicine with some condescending talk)
CAM is nothing new, and that's the problem; it harkens back to the bad old days when homeopathy really was competitive with the medicine of the day because at least highly-filtered water won't harm patients. I'll stick with modern medicine, myself; I like infant mortality rates in the single-digits-per-100k, keeping my teeth into my golden years, and the absence of epidemic smallpox.
-- Steve
Oh, not sure if anyone here brought it up, but anything in the right quantity is toxic. A few years ago in the states we had a woman die from drinking too much water(radio contest) horribly sad but true.
I never really got the toxin thing. Everything has the potential to be a toxin on some level. Please new-agers, try to at least produce some modicum of data to back up your claims. Can we please have that?
Conor: "Integrative medicine is the beginnings of a movement which has yet but started where doctors themselves are beginning to understand much of what certain quality "CAM" practitioners have been saying for some time. That's all basically about prevention, quality natural nutrition, stress minimisation and avoidance of toxic patented pharmaceuticals"
Let's see - prevention, good nutrition and stress minimization are all well-established components of mainstream evidence-based medicine, for which CAM falsely claims credit. CAM does promote "avoidance of toxic patented pharmaceuticals" in favor of toxic and/or ineffective "natural" remedies, so I'll have to grant you that one.
By the way, I don't think you can "Goodwin" a thread unless you go off on a Nero Wolfe tangent. :)
imagine oil, orange juice, gin, vodka, perfume
I still giggle at the 'homeopathic lager' at the end of Mitchell and Webb's new age emergency room sketch.
@Kuruth - the dose makes the poison. (Even when it isn't actually a 'toxin,' one of those words that alties love to abuse.)
As Conor informs us: we are on the brink of Paradigm Shift, wherein our opponents riding the tsunamic wave of Enlightenment shall righteously overwash the miasmically encrusted Corruption that we have enabled to reign upon our fair Planet and that has enriched us in worldly goods and unnatural Power: it shall be no more!
There will be a new Order arising based upon spirituality and freedom while the present powers evanesce into the gloom of Night: even memory of them shall fade like a bad dream. A new City shall arise from the cleansing floods, sparkling and brilliant in the noonday sun- a beacon of hope to the millions newly freed from the dark slavery of science! And in that new day in that new bastion new wise leaders will rise up to lead the lost children to Truth, Nature, Purity and Goodness. Our Time has passed.
Hi Steve,
I see my one typo, "not even word salad", nevertheless provided you with a nice meal to dine out on ...
The trouble with what you call modern medicine is that it's not in fact about quality data at all: it's about whatever research studies get into whatever text books that inform the medical industy as a whole, which text books are funded as "gifts to medicine" by the Phrama boys precisely and only because they act as advertising material for the particular drug company funding the given literature. I know. My family used to be involved is just this business: medical publishing. The studies in text books aren't made up but they're always about 1 amongst several competing options, authored by 1 of several experts with varying views and the higgest bidder gets to pick the content of the medical textbooks they fund ... It's just like how internet adverising is sold ...
And so, our good doctors all over the world have been in the main acting as the street dealers of Big Pharma for years and years. Which reminds me, which modality is it again that kills hundreds of thousands of folk every year in the US alone ... CDC figures, not mine ... It ain't the homeopaths anyhow :)
I myself practice nutritional therapy, based on the kind of RCTs folk like you just might respect, championned by the best brains in "modern medicine" at the Institute for Functional Medicine in the US. "CAM" is not a single church and only the laziest of minds play that card (woo-woo crystals yadda yadda). The only reason it's taken so long to get quality research on say cinnamon, tangerine peel, rosehips, bromelain etc etc is because there's never been much research dollars flung at discovering that our ancestors had most of it all worked out way back when Pharoah was in short pants ..
Hope you keep them teeth! CoQ10 is good for that by the way!
I don't think you do. SBM promotes not using drugs (whether patented or not, and coming from a lab or a plant) unless the benefits outweigh the risks and there are no better alternatives available. I'd say that qualifies as intelligent avoidance.
In programming circles, the metaphor is "If you put a teaspoon of sewage in a barrel of wine, you get a barrel of sewage."
I love the analogy but then, I love Mark Crislip with a passion!
@Conor S.
Others have already dealt with your attempts to misappropriate science-based medicine for CAM, so I'll deal with a couple other things.
Well, yes, the CAM label was about "us" and "them" thinking. CAM practitioners came up with the term, themselves, as a way of playing up the beneficent "us" as compared to the cold, heartless "them" (real doctors).
No, I'm sure that Dr. Weil and those like him are quite enamored of themselves and that they know very well that the nonsense they're peddling is snake oil. In short, I'm sure they are quite pleased at the money they rake in acting like frauds.
Well I might like to reply to some of you fine people but my last mail didn't make it to the site whereas the first one did instantly.
In my experience of web forums (considerable), either moderation is in place or it isn't. Moderator? Did I foul up or offend or what?
Funny, that's exactly the opposite of what me and my "orthodox" "allopathic" friends typically believe about it: The idea of "orthodox" and "alternative/complementary/integrative" medicine is a marketing tool invented by quacks to instill that "us versus them" mentality. It's used to deflect criticism of quacks by claiming that the "brave maverick doctor" is being suppressed by a monolithic, shadowy group of villains and thus should be given a free pass, rather than address criticism of the poor quality of his evidence.
"CAM" and those other labels are a foundational part in indoctrinating consumers into an anti-science culture, because it allows them to practice a double-standard: The in-group doesn't have to prove anything, while "The Other" can be dismissed out of hand, even if they've got decades worth of rigorous studies on their side.
A common joke among us so-called "orthodox" "allopathic" people: "What do you call alternative medicine that has been proven to work? Medicine."
I call quacks and their supporters "alties" because, among other things, they assert that there really is such an entity called "alternative medicine" or whatever label is fashionable at the moment, and that treatments that belong in this group are, for some strange reason, exempt from science. This is a ridiculous false dichotomy. As far as I'm concerned, there is medicine that has been proven to work, treatments that have not been proven to work, and quackery which has been reasonably proven not to work.
When I thought about how the pies would be labeled--for full and accurate information that is always demanded by alt-med types, I thought that there wouldn't be legit claims on the alt-pie label.
You know, it didn't strike me until right now how funny the "label it" donations by Mercola are. He and his minions are harassing a California journalist for complaining about Mercola's contributions to political activity from out of state, demanding food labels: http://www.sacbee.com/2012/02/25/4289321/gmo-foes-should-rebut-morain-n…
So far, nobody on this thread has managed to show any signs of getting the sea change that is going on ...
Wake up boys and girls! The old mediccal model is dying on its feet. These labels or "modern medicine" "Versus" "CAM" etc. no longer apply. Whether any of us like this or not, it's happening!
CAM was the equivalent of the Reformation; what is now beginning is the medical establishment's Counter Reformation. Selfishly, it doesn't suit me as another decade what I practice will have been subsumed by the medicacl orthodoxy within a decade or so. So if this scares some of you here, I sympathise
Why do any of think Big Pharma is spendind endless funds on trying to bully various power blocks into outlawing herbs, requiring regulation for stronger vitamin dosages etc. (Vote on this coming soon in EU ...)
The Pharma people are much smarter than the docs: they've anticipated the change and are making plans accordingly.
Have you?
"Integrative medicine is the beginnings of a movement which has yet but started where doctors themselves are beginning to understand much of what certain quality "CAM" practitioners have been saying for some time."
I'm curious, Conner: who exactly do you consider representative of those "certain quality "CAM" practitioners"?
I issued the 'wake-up call' above but it seems to be in moderation: evangelism ain't what it used to be.
Our entire medical system is broken primarily due to 1 fact: Big Pharma only make big dollars from selling patented "new to nature" molecules which substances, de facto, are alien to our systems and thus sooner or later are likely to cause harm to the body. Hence the mounting death toll ... Hence the fact that each decade's blockbuster is the next decade's class action ...
In answer to your question, the practitioners I continue to admire are those who accept as a tenet that "new to nature" molecules are inherently dangerous, de facto. If the moderator hadn't stopped an earlier post, you'd know already that I hitch my wagon to the Insitute for Functional Medicine as a paradigm with a healthy respect if less knowledge of other ancient systems also, Chinese, Ayurvedic etc
If you mix the ability to write with a person of low intelligence you end up with people writing crap like this story.
Got any science-based arguments for your comments, Conor...I see your name links to a natural food site.
Oh...are you are "nutritionist"?...that explains it.
The mounting death toll that has resulted in a steady increase in life expectancy over the last century?
Idiot.
@Connor. You seem to think that all drugs are somehow synthetic? When in actuality, quite a bit has been learned from nature, and those drugs are more purified and potent applications of the same natural products.
And god forbid that we would ask for the same types of testing and regulations for so called natural products as we would any pharmaceutical.
"The old mediccal model is dying on its feet. "
It was; and then we found something better than cupping, leeches, purgatives, noxious diets, and prayer. CAM *is* the old medical model.
Evidence-based medicine (or science-based medicine, if you prefer) is the new medical model, the one that's knocked the old model off its plinth and by doing so has led to better health and longer lives for more people than all that old quackery ever did. EBM/SBM isn't perfect, but it beats everything else we've tried... and unlike CAM modalities, it tries to learn from its mistakes and improve itself rather than pretend it's perfect and eternal.
This isn't a matter of opinion; this is concrete fact, available to anyone who wants to look up the records. (Or walk through an old cemetary and read the headstones, for that matter.)
-- Steve
Connor, stop lying about what we believe.
And moderation is started by a machine. The computer saw certain words or the number of links or something, thought it was spam, and put it on hold until Orac tells it to allow the post. This happens to me, too, and I'm a regular.
Oh, yeah:
1. You're being terribly, terribly naive about human nature and "Big Pharma." Some people join pharma corporations because they believe in the quality of their products and want to help the world. Some do it to make money. Some do it out of sheer curiosity about what the research will reveal. We use regulations, the global scientific community, and watchdog organizations to make sure the products work, and to monitor the risks. Everything is subject to scientific scrutiny from across the globe. Pharma corporations simply don't have the power to suppress everyone in the information age. The real world is not a black and white cartoon melodrama. Humans have individual desires and motives. You can't split everything into two "camps."
2. A lot of drugs come from nature, just refined to purity standards, so that we don't get the unnecessary or dangerous stuff that might come with the raw form. They can extract the pure active ingredient from the natural source, or to artificially recreate that natural chemical. You can still have a patent on a more efficient purification process, by the way.
3. There are ways to make money without a patent. They still sell aspirin, even though the patent has long ago expired. It's just a matter of how much it costs to produce, and if you can sell it for more than the cost. Basic economics.
4. You have a very naive, Disneyfied view of nature. Nature does not exist to benefit humans. Nature is not subservient to human desires. Nature can be quite nasty to humans. It often is. Likewise, assuming that artificial chemicals are inherently bad demonstrates fallacious black-and-white thinking. It depends on the chemical's properties, not how new or old it is, nor how natural or artificial it is. Evolution is probably still churning out "new to nature" novel proteins and other chemicals as we speak, and inside living organisms, possibly to their benefit.
5. Ancient is not inherently good, either. Humans easily fool themselves, no matter the era. Science is about preventing self-deception, and it's still relatively new to humanity. Why should we assume ancient humans were inherently less prone to self-deception? Also, since I suspect you may very well end up going there: It's racist to treat "East" and "West" differently. We're all human, and we're all at risk of self-deception.
Conor S. and (possibly) leo:
I'd advise you to study up on Pablo's first Law of Internet Discussion before writing much more...
Conor S:
You have made a serious error in your attempt to denigrate the "old medical model".
The "old model" is the suite of quackeries and practices called CAM: practices justified solely by assertion, or by anecdote, or by faith alone, or by distortions of English and scientific jargon. This "old model" prevailed among humans for a very long time.
Only over the last few centuries has a new model of medicine, based on robust empirical inquiry, emerged and then prevailed, culturally and institutionally. Modern conceptions of this newer model are called 'evidence-based medicine' and 'science-based medicine' (EBM/SBM).
The recent rise of "CAM" is, IMO, more likely the result of two factors:
(1) The success of "new model" medicine has, ironically, made it seem less succesful, as people forget the scourges of ages past and become more aware of the diseases and disabilities which follow from an enormously larger, older, and more affluent population.
(2) Built-in cognitive biases and heuristics which make rational-empirical thinking difficult and emotional-magical thinking easy - biases & heuristics which serve humans well in some circumstances (especially in the past) but quite badly in others (increasingly so in the present).
Your allusion to the Reformation/Counter-Reformation is correct in one key respect and very wrong in another.
Correct in that it was more a political struggle than a religious one - just as the attempt by apologists for quackery are engaged in a socio-political struggle to bring the patina of scientific legitimacy to baldly unscientific practice more than trying to adequately justify their claims using robust empirical/experimental methods.
Incorrect in that whereas the Reformation and subsequent struggles were between factions of a religion over doctrinal/dogmatic disputes - thus suggesting neither side had any inherently superior position, the CAM/integrative "Reformation" is an attempt to smuggle in obsolete, useless practices in with those which have an empirically-validated history of success.
What advocates of SBM wish for is the same, stringent standard of empirical/experimental validation be applied to all medical practices and products - whether they be the fruits of decades of research and millions of taxpayer or Sanofi-Aventis (or whatever) dollars, or the fruits of Joe Herbalist mixing various plants in his basement, or anything in between - and those practices and products which fail the test be jettisoned.
On this view there is no preference for "Big Pharma" of necessity, save that the size of large pharmaceutical companies makes it easier for them to fund research and development even in the face of high failure rates, easier for them to manufacture products at large scale (e.g. to meet the requirements of mass societies of tens or hundreds of millions of people), and easier for them to be subject to regulatory oversight (while acknowledging that it can be easier for them to try to fight such oversight or subvert it - against which precautions must be taken).
Apologists for CAM, such as yourself (so it appears), apparently, wish for a somewhat lower standard of validation - at least for those practices and products you favour.
Hey, Conor, mind explaining to me why the website your name links to contains howlers like this:
"The mechanism is understood: milk products tend to raise the acidity of the body which the system must work against to maintain blood at the proper pH. This it does by a number of means, prncipally [sic] leaching calcium from the bones."
1. Do you have the slightest clue by what means and how tightly the body regulates blood pH?
2. Do you have any idea what the body uses calcium for? Free clue: it has nothing to do with pH whatsoever.
Once you have figured the answers to these questions out, you might understand why I call that quoted statement (of yours?) a howler.
lilady@29
Yes, I noticed that too - it's promoting "healthy eating" classes for the Dublin/Wicklow area in Ireland. Paleo-type recipes with complementary supplement woo.
There's also a Facebook page with lots of approving links to articles on the Wretched Hive and other founts of nutrawoo -need I say more?...https://www.facebook.com/SmartEaters
And Big sCAM makes their money from selling whatever junk somebody decided to pull some claim for out of their nether regions. Without any form of evidence that they're effective, or safe.
No more so than "old to nature" molecules. In fact, they're LESS dangerous since somebody has actually gone to the trouble to find out (a) that they work, (b) what the effective dose is, (c) what the risks and side effects are.
Herbs are either untested and highly contaminated drugs, or salad.
Edith,
It appears you've mastered both the art of the hyperlink and reading, although in the latter case, not correctly it seems
Yeah publicity! My plan has worked!
Wretched Hive ?!? In your bonnet perhaps ...
Sorry, that couldn't resist that one !
Lilady & Denice: After the tsunami last winter I suggested we make up our departmental budget shortfall by peddling fake Prussian blue. I was only half-joking (if we'd been in California we'd have made a killing, no pun intended).
My hyperlink fail still doesn't make your nonsense true. You may think what you're doing is cutting-edge, but it's actually firmly rooted in the 19th century (and refusing to budge). Here's another link just for you: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1139856/pdf/medhist00063-00…
And that recipe for spelt soda bread might make a good doorstop, but I can't imagine anyone eating it voluntarily.
BTW, Wretched Hive is shorthand for "Wretched Hive of Scum and Quackery," which is what the Huffington Post is called 'round here. It's like the Weekly World News of health reporting.
What exactly is a "new to nature" molecule? Could you provide relevant examples, and indicate what evidence demonstrates that "new to nature" molecules must uniformly be inherently dangerous?
So we're talking the standard diet, nutrition, overwhelming-environmental-toxins brand of woo, informed by a primitive 5 elements (earth-air-fire-water-sky) worldview?
Yur use of the word 'qualified'--I don't think it means what you think it means.
Thanks Edith.
Your use of the "'round here", in-neologisms for sites you dislike etc. confirm my suspicions of an inward looking group, small in a number of ways. Fine. Good luck with that.
Thanks for the site hits y'all
Got some healthy kids to feed now: the world's first Paleo doorstop bread !!
C
You know, after some thought I think i have identified one class of "new to nature" moelcules--syntheitc polymers such as nylon. Somehow I don't think these are what Connor's having a problem with.
BTW, Wretched Hive is shorthand for "Wretched Hive of Scum and Quackery," which is what the Huffington Post is called 'round here.
Further, it's a Star Wars reference: Obi-Wan Kenobi described Mos Eisley Spaceport as "a wretched hive of scum and villainy." (I'm sorry, but how could you not know that?! It's probably only one of the most-quoted-online movie lines ever.)
So, not only are you deluded, but you're uncool, too.
My first thought was plutonium. Which is not without its problems, but probably not what was meant.
My sympathies to the children.
Also Conor, I find it quite interesting that you're engaging with my (admittedly) light-weight gibes but not answering any of the far more substantial criticisms from other commenters.
Hi Edith,
So, you'd rather I didn't respond to you but responded to more worthy contributors? No keeping some folk happy huh?
The only individual who tried to call me on matters medical specifically, Steve was it, appears unaware that the body uses 3 primary mechanisms to maintain blood pH within the narrow homeostatic range, one being available calcium from bone if necessary ...
So, Edith, if you want to up your level of banter, sure, let's talk turkey. But spare me the dumb resorts to in-clique chuckles about "woo" etc.
Here's something you should read very carefully, Connor.
I consider Big Pharma a necessary evil. Despite what slander you've likely been taught about us, the average skeptic is not in love with pharmaceutical corporations. They are an ally of convenience, not a part of our identity. I do not approach this as "orthodox" medicine versus "alternative medicine." Despite your explicit claims to the contrary, you still use the same fallacious rhetoric I've heard from people who try to convince me that those are real labels.
What this is really about is science versus individual treatments, and you don't seem to get that. We want treatments to be judged by certain standards before they're offered to the public, as well as monitoring standards after they've been used, to catch problems that didn't show up in testing. The real problem is that "alternative medicine" and other labels are consistently used as excuses to avoid scientific scrutiny. It's a line in the sand, and it keeps changing. I'm interested in the science, not the "alternative" brand name.
If my doctor prescribes me a medication, I'll take it because I've come to trust her judgement. That trust is made based on what I've come to understand about medicine and all the mechanisms involved in getting a treatment approved for use, as well as what doctors have to go through to prove their competency in the field of medicine. If I have questions, she'll answer them. If I question a decision she makes, I'm free to look up my prescription on PubMed and look at the scientific journals.
Where so-called "alternative medicine" and pharmaceutical companies come in is what they've done to prove their worth. Which product is better?:
A) A car model that's gone through extensive, government mandated crash tests with good results, won independent awards for its performance, and built by a company with an established reputation for practicing good customer service as determined by an independent consumer rights group
or
B) Some go-kart hastily slapped together according to the builder's interpretation of grandpa's illegible blueprints, never been test driven, and when you ask about a warranty, the builder goes off on an Ayn Rand-inspired rant about how it's the buyer's job to evaluate every product they'll ever buy for themselves, and that the seller is never at fault. And he asks for as much or more money than the "conventional" car.
I know you don't want to hear this, but that's what the field looks like: A lot of pharmaceutical products are on the market and succeeding because they've been tested by medical researchers who actually care about safety and efficacy tests. Every treatment labeled "alternative," aside from the bait-and-switch ideas like proper diet and exercise (which the science supports), fails to meet my standards. It doesn't help that people like you come in and live up to the used car salesman stereotype. Pharma companies have problems, but they're nowhere near as bad as their competition. Pharma companies at least have to convincingly jump through hoops whenever they release a new product. "Altie" quacks and their supporters argue that I should blindly trust them, and that the hoops are never necessary.
And here's one thing that might shock you: There are some products I am biased against, that are manufactured by pharmaceutical companies: Vitamin cocktails, herbal supplements, and things like that. Why? Because in America, herbal supplements and such are exempt from a lot of drug regulations because someone drew an arbitrary line in the sand and made it into law. As it stands, just about anyone can grind some not-very-poisonous plants into pill form and sell it without testing to see if it can do what they advertise it for. All they have to do is slap on the Quack Miranda about how it's (allegedly) not intended to diagnose, treat, or cure anything. Easy profit. And that's how many self-proclaimed "alternative/complementary/integrative medicine practitioners" do it, too. That way is wrong.
JGC,
A "new to nature" molecule is the expression used in internationl patent law as being the fundamental requirement to secure a patent on a drug and therefore poentially enjoy super-normal profits on sales until the patent expires. Justification for the practice is to allow companies secure a fair return on fron-loaded reearch funding, many of which dollars invested result in drugs where the problems show up sooner and thus don't make it to market at all. The aim is a laudable one: a fair return for labour. Problem is that many of these molecules cause havoc in the body, sooner or later, precisely because of their artificial origin ...
I'm starting to feel patronising now but it's clear that you and others didn't get that bit yet ... (nylon, plutonium etc.)
The posts submitted by Conor S. remind me of the rants I see from true-believer chiropractors. Is Conor S. in fact a "doctor" of chiropractic?
Just curious...
@ Denise #17
Now I have recovered from choking on my morning cup of tea, I am left with that Annie Lennox song in my head - the one from Lord of the Rings when all the Elves sail away in boats. Don't "evanesce into the gloom of Night", diminish into the West!
No Kurt, I'm suspicious of that whole discipline myself. In that realm, my sympathies lie with osteopathy, Tuina massage and preventatively, yoga. Scary to think I could be confused for one of those boys: I'd have earned about a grand by now surely .. :)
I should add it's 9am in my part of the world.
In 2009, Prometheus proposed calling alt.med/"integrative medicine" Traditional Victorian Medicine:
Perhaps we should heed him.
Conor S wrote:
[citation needed]
@ Shay: Excellent suggestion about stockpiling and marketing bogus drugs, treatments and supplements to make up for our "departmental shortfall". Perhaps,you should speak to our beloved Lord Draconis to have your suggestions put on the agenda for our next *meeting*. We could store huge quantities of phony Prussian Blue in a warehouse like this:
http://www.cdc.gov/phpr/documents/DSNS_fact_sheet.pdf
Conor, isn't it time for you to get on the internet for your "nutrionist's" sound advice appointments?:
"For this reason, SmartEaters offers 2 types of personalised therapeutic consultations which involve taking a detailed health and medical history and customising an entirely bespoke nutritional wellness plan. These basically function in the same way but one is delivered in person and the other using phone and/or web conferencing software (Skype)."
How, exactly, how does artificiality make a molecule inherently bad? I was under the impression that the toxicity of a molecule is related to its chemical properties, and how those properties make it interact with a person or the environment.
If I were to artificially burn some hydrogen gas in an oxygen environment to produce water vapor, condense that vapor into liquid form, would that "artificial" water be more poisonous than "natural" water?
Let's say I grow a never before seen protein in a lab. At the same time, by coincidence, a bacterium in another part of the world receives a natural mutation caused by a natural 'malfunction' in mitosis that causes it to naturally produce that same protein. Is my protein more toxic than the bacterium's chemically identical protein?
Liz Ditz,
Here you go: US Government data
http://www.aapcc.org/dnn/NPDSPoisonData/AnnualReports/tabid/125/Default…
Download any year in the past many and you will see deaths due to pharmaceuticals used AS PRESCRIBED top 100,000 annually in the US alone; in other words, that doesn't count the unforunate Whitney Houston style misue deaths, another issue which alone is now killing as many as on US roads, (36,000+ I believe for the last year for which stats are in according to a recent piece in the Economist ...)
On the other hand ....
There was not even one death caused by a dietary supplement in 2008, according to the most recent information collected by the U.S. National Poison Data System. The new 174-page annual report of the American Association of Poison Control Centers, published in the journal Clinical Toxicology, shows zero deaths from multiple vitamins; zero deaths from any of the B vitamins; zero deaths from vitamins A, C, D, or E; and zero deaths from any other vitamin.
Additionally, there were no deaths whatsoever from any amino acid or herbal product. This means no deaths at all from blue cohosh, echinacea, ginkgo biloba, ginseng, kava kava, St. John's wort, valerian, yohimbe, Asian medicines, ayurvedic medicines, or any other botanical. There were zero deaths from creatine, blue-green algae, glucosamine, chondroitin, melatonin, or any homeopathic remedies.
Furthermore, there were zero deaths in 2008 from any dietary mineral supplement. This means there were no fatalities from calcium, magnesium, chromium, zinc, colloidal silver, selenium, iron, or multimineral supplements. Two children died as a result of medical use of the antacid sodium bicarbonate. The other "Electrolyte and Mineral" category death was due to a man accidentally drinking sodium hydroxide, a highly toxic degreaser and drain-opener.
No man, woman or child died from nutritional supplements. Period.
61 poison centers provide coast-to-coast data for the U.S. National Poison Data System, which is then reviewed by 29 medical and clinical toxicologists. NPDS, the authors write, is "one of the few real-time national surveillance systems in existence, providing a model public health surveillance system for all types of exposures, public health event identification, resilience response and situational awareness tracking."
Over half of the U.S. population takes daily nutritional supplements. Even if each of those people took only one single tablet daily, that makes 154,000,000 individual doses per day, for a total of over 56 billion doses annually. Since many persons take more than just one vitamin or mineral tablet, actual consumption is considerably higher, and the safety of nutritional supplements is all the more remarkable.
If nutritional supplements are allegedly so "dangerous," as the FDA and news media so often claim, then where are the bodies?
Those who wonder if the media are biased against vitamins may consider this: how many television stations, newspapers, magazines, and medical journals have reported that no one dies from nutritional supplements?
End of quote
Establishment enough for you or no?
I think it's time to start defining CAM as competent allopathic medicine. A little bit of google optimization, and any other meaning will disappear down the memory hole.
Conor,
As someone who has measured more blood pH (and calcium) levels than you have eaten Palaeolithic dinners, acid base myths irritate me.
The claim was that pH homeostasis is achieved by "principally leaching calcium from the bones" which is nonsense. Osteoclasts which break down bone to maintain blood pH are activated at pH of under 7.0. The only patients I have seen with blood pH that low have been in the intensive care unit, or on their way there.
The bicarbonate buffering system and respiratory compensation take care of all but the most extreme challenges to blood pH. Leaching carbonate from bone is a last resort if those mechanisms fail, certainly not the principal mechanism.
So, it appears we're getting places as now the "new to nature" bit is perhaps understood.
Now, studying anything at all bout our Universe, literally any discipline from archaeology to zoology must surely lead to at least some understanding of the delciate balance that exists throughout and how all currently existing quasi-independent organisms exist in a state of fluid and fragile harmony with their environment from where they draw their particular sustenance and to which they return "waste" nutrients etc. Such applies to food and air and some say other finer energies. Who knows?
Intuition would suggest that to suddenly begin only since the last World War, after countless thousands of years of human existence, for humanity to swallow back totally previously unexisting potent bio- and psycho-active chemicals to "fix" us, is a dangerous project to say the least.
But never mind inutition. Where's the evidence.
It's here:
http://www.aapcc.org/dnn/NPDSPoisonData/AnnualReports/tabid/125/Default…
over 100,000 deaths in the US every year due to pharmaceutials USED AS PRESCRIBED ... Another estimated 36,000 deaths due to overdose ...
So inutition AND evidence pointing the same way? And I'm the know geting told what EBM means ?!?
Krebiozen,
So we agree! I said 1 of 3 mechanisms if necessary, you misquoted attributing "principal mechanism" to me but agree that leaching Ca from bone does occur as a last restort (your words)
I also dislike the systemic acidosis, "alkylise or die" sub-division of naturopathy. Not because it might not be true, but only because there is no evidence for any of it, even in thier own books.
Osteoporosis and heavy acid load diets is the exception here, which is why this idea is on its way to being mainstream
Conor S:
I think Steve's implication was that *you* are unaware that the body regulates blood pH very tightly, so much so that drinking milk will have no measurable effect on it. In fact, as far as I know, calcium is not involved in buffering the blood's pH. If you have evidence to the contrary, I'd love to hear it.
The body does leach calcium out of bones, but not to alter blood pH; it uses the calcium for something else, something so critical that hypocalcemia can cause rapid death, and not from blood acidification. Do you happen to know what?
@ Bronze Dog
It's all about the Intent. You see, the natural molecules have all of Nature's (note the capital letter) good intention behind them, while the artificial molecules have that nasty profit motive as their main intention. Chemists, being unattuned to Nature can't detect the difference. Only someone at one with the Universe can sense it.
Conor's just another fanboi. "We're going to bury you" is so tiresome -- I've heard it a million times before and it's never come true. Replace "allopathic medicine" with "mainframe computers" and "CAM" with "PCs" and it's the same old song. At least PCs have some value to them.
Conor needs to spend some time in reality, rather than the straw man battle between what he fears traditional medicine is and what he wishes alternative medicine was. Both are fantasies.
Nylon was the only molecule I could think of off the top of my head that does not and could not occur other than as the result of directed synthesis. But I understand now that new-to-nature is a legal term, not a scientific term, and in fact one that is applied to molecules that are in fact not new to nature (e.g., taxol, rapamycin, tacrolimus, etc.)
As the term is used with respect to patent law it doesn't denote molecules that are artificial in origin: it simply denotes molecules that have not previously been offered for patent registration.
Further, the potential for 'havok'--i.e., adverse effect--isn't a function of a molecules origin, artificial or natural, and that potential is rigorously addressed by estenisve mandatory preclinical and clinical testing which characterize the drug's saety and efficacy, continuing post-approval surveillance, etc., all of which allows for accurate and continuous evaluation of a drug's risk versus benefit.
Interesting; it appears Kreboizen has actually answered my question for you, Conor, before I even posted it. I have a high school level education in biology, so I didn't know about leaching calcium carbonate from bone as a last-ditch effort to neutralize blood pH.
But Conor, I'll note that he did not misquote you. Steelclaws (sorry, it wasn't Steve, it was Steelclaws) was quoting your own website. You did say "principally". (Well, actually your website spells it "prncipally".) It's right here, and you claim it's a major cause of osteoporosis:
http://www.smarteaters.org/conditions/osteoporosis/articles/osteoporosi…
Conor S (#51):
If this is the case, how did they ever manage to market Taxol (paclitaxel)? It's extracted from the bark of the Pacific Yew and isn't "new to nature" in any sense of the phrase. Perhaps "Conor S" isn't as well-informed as he thinks.
What do the following substances have in common: aconitine, alpha-amanitin, orellanine, gyromitrin? They are all molecules of completely natural origin (the first is a toxin found in wolfsbane; the others are mushroom toxins) that "cause havoc in the body, sooner or later" (some up to weeks after ingestion).
In contrast, there are a number of compounds that are of completely "artificial origin" that are pretty much inert in the human body (e.g. HDPE, nylon 6) or have properties that are indistinguishable from "natural" compounds (e.g. Humulin, rHGH). In short, "Conor S" is grossly overgeneralising when he claims that the artificial origin of a molecule can determine its effect in the human body.
Of course, "Conor S" has been spouting a lot of nonsense about how "alternative" medicine is anything more than the leavings and cast-offs of real medicine. Just because "alternative" medicine is currently popular doesn't mean anything more than the popularity of Justin Bieber.
Prometheus
Likewise, I am very curious what Connor's reasoning is behind the idea that novel or artificial molecules are inherently bad. Herbal medicines have all sort of things in them that were never in our body before we took them. To think that nature produces wonderful, or at least benign chemicals that are ok to introduce into our bodies but that anything we create is awful and inherently more dangerous is rather strange. Perhaps it is because many people have this very odd idea that herbs contain compounds that are for us, rather than realizing they are simply there, used for other purposes by the plant, and that we discover they are useful for us.
Calli,
The carbonate and phosphate salts in bone act as a long term supply of buffer especially during prolonged metabolic acidosis.
The important role of bone buffers is often omitted from discussions of acid-base physiology4.
Bone consists of matrix within which specialised cells are dispersed. The matrix is composed of organic [collagen and other proteins in ground substance] and inorganic [hydroxyapatite crystals: general formula Ca10(PO4)6(OH)2] components. The hydroxyapatite crystals make up two-thirds of the total bone volume but they are extremely small and consequently have a huge total surface area. The crystals contain a large amount of carbonate (CO3-2) as this anion can be substituted for both phosphate and hydroxyl in the apatite crystals. Bone is the major CO2 reservoir in the body and contains carbonate and bicarbonate equivalent to 5 moles of CO2 out of a total body CO2 store of 6 moles. (Compare this with the basal daily CO2 production of 12 moles/day)
CO2 in bone is in two forms: bicarbonate (HCO3-) and carbonate (CO3-2). The bicarbonate makes up a readily exchangeable pool because it is present in the bone water which makes up the âhydration shellâ around each of the hydroxyapatite crystals. The carbonate is present in the crystals and its release requires dissolution of the crystals. This is a much slower process but the amounts of buffer involved are much larger.
How does bone act as a buffer?
Two processes are involved:
Ionic exchange
Dissolution of bone crystal
Bone can take up H+ in exchange for Ca++, Na+ and K+ (ionic exchange) or release of HCO3-, CO3- or HPO4-2. In acute metabolic acidosis uptake of H+ by bone in exchange for Na+ and K+ is involved in buffering as this can occur rapidly without any bone breakdown. A part of the so called âintracellular bufferingâ of acute metabolic disorders may represent some of this acute buffering by bone. In chronic metabolic acidosis, the major buffering mechanism by far is release of calcium carbonate from bone. The mechanism by which this dissolution of bone crystal occurs involves two processes:
direct physicochemical breakdown of crystals in response to [H+]
osteoclastic reabsorption of bone.
Conor S.,
If this is true - that your work is based on the current best available science and you don't claim things that aren't science based - I don't see how anyone can have an issue with that.Is it true?
Conor,
I disagree, I think it is becoming clear that increased urinary excretion of calcium in those on high protein diets is due to increased calcium absorption, not to calcium leaching from bone. For example this study using calcium isotopes showed that a high protein diet increased absorption of calcium and actually reduced osteoclast activity, though it was not statistically significant, the opposite of what you suggest.
This is also supported by epidemiological evidence that shows lower bone density in vegans and vegetarians (who eat less protein than carnivores) as compared with meat eaters (see for example this meta-analysis).
Some science on bon as buffer :
"
The carbonate and phosphate salts in bone act as a long term supply of buffer especially during prolonged metabolic acidosis.
The important role of bone buffers is often omitted from discussions of acid-base physiology4.
Bone consists of matrix within which specialised cells are dispersed. The matrix is composed of organic [collagen and other proteins in ground substance] and inorganic [hydroxyapatite crystals: general formula Ca10(PO4)6(OH)2] components. The hydroxyapatite crystals make up two-thirds of the total bone volume but they are extremely small and consequently have a huge total surface area. The crystals contain a large amount of carbonate (CO3-2) as this anion can be substituted for both phosphate and hydroxyl in the apatite crystals. Bone is the major CO2 reservoir in the body and contains carbonate and bicarbonate equivalent to 5 moles of CO2 out of a total body CO2 store of 6 moles. (Compare this with the basal daily CO2 production of 12 moles/day)
CO2 in bone is in two forms: bicarbonate (HCO3-) and carbonate (CO3-2). The bicarbonate makes up a readily exchangeable pool because it is present in the bone water which makes up the âhydration shellâ around each of the hydroxyapatite crystals. The carbonate is present in the crystals and its release requires dissolution of the crystals. This is a much slower process but the amounts of buffer involved are much larger.
How does bone act as a buffer?
Two processes are involved:
Ionic exchange
Dissolution of bone crystal "
Krebiozen,
Not at my books here but didn't Dr T Colin Campbell and son make millions with the "largest ever epidemiolgical study on nutrition and health" or whatever the claim was proving just the opposite? Meat eaters having weaker bones?
About buffering from bone:
Two processes are involved:
Ionic exchange
Dissolution of bone crystal
Bone can take up H+ in exchange for Ca++, Na+ and K+ (ionic exchange) or release of HCO3-, CO3- or HPO4-2. In acute metabolic acidosis uptake of H+ by bone in exchange for Na+ and K+ is involved in buffering as this can occur rapidly without any bone breakdown. A part of the so called âintracellular bufferingâ of acute metabolic disorders may represent some of this acute buffering by bone. In chronic metabolic acidosis, the major buffering mechanism by far is release of calcium carbonate from bone. The mechanism by which this dissolution of bone crystal occurs involves two processes:
direct physicochemical breakdown of crystals in response to [H+]
osteoclastic reabsorption of bone.
The involvement of these processes in buffering is independent of parathyroid hormone. Intracellular acidosis in osteoclasts results in a decrease in intracellular Ca++ and this stimulates these cells.
Travis,
It makes perfect sense if you believe the Bible literally and is quite a pervasive idea. For example the doctrine of signatures, that says that God put plants on the earth as medicine for us, and made them look like the part of the body ailments of which they cure so we would know. So lungwort, whose leaves vaguely resemble a lung, are prescribed for lung conditions etc.
Of course this also leads to the idea that plants contain a cocktail of compounds that act in a beneficial synergy that pure, isolated chemicals cannot duplicate. The truth is that plants often contain chemicals that do no good and cause unwanted side effects. Many of the chemicals in plants that we use as medicines have been designed by the plants to poison predators, and our bodies have evolved detoxification mechanisms to deal with them. The same detoxification mechanisms are often effective at dealing with synthetic molecules that are "new to nature".
By the way I remember a heated discussion with a person who insisted that ascorbic acid is not the same as vitamin C. Natural vitamin C that occurs in citrus fruit, for example, includes bioflavonoids that act in synergy with the ascorbic acid to promote human health they said. I asked this person why animals that synthesize ascorbic acid don't synthesize bioflavonoids to work in tandem with them. A long silence ensued.
I'd rather trust something made by humans, for human needs, tested by humans who care about other humans. Humans can even consider the impacts on other species on their behalf if they care. Not perfect, but nothing is.
Nature, on the other hand, doesn't care. To nature, we're all just self-replicating piles of food for other self-replicating piles of food, and it doesn't matter which transitory types of piles survive.
Just so we are all clear... The random recombination process used to make antigen receptors for B cells and T cells in your body results in unique proteins. In other words, Conor, every lympocyte in your body or that of your patients/victims is "new to nature" in the sense you were shooting for. Oops, your body is the villain now.
Heh. Nice one, Jay.
That's the problem with black-and-white thinkers like Connor. The world is full of grays and colors that need to be judged individually, not according to arbitrary absolutist metaphysical "sides."
Conor: "The Pharma people are much smarter than the docs: they've anticipated the change and are making plans accordingly."
Yes, but not in the way you think. While drug companies continue to invest in and develop plant-based pharmaceuticals for evidence-based medicine, they're also eagerly pursuing profits in CAM. Here's an example of a big-money partnership in China:
"Tasly is one of China's largest pharmaceutical companies and is China's 2nd largest producer of TCMs, which are derived from plants. Its lead drug, Tasly Cardiotonic Pill, is the #1 selling TCM in Chinafor the past seven years. Up to September 30th2011, Tasly recorded YTD revenues of 4.8 billion RMB with a 10 year compounded growth rate in excess of 20%. Tasly also has operations in the United States, Africa, South East Asia, and the UK...SemBioSys is a health and wellness company that utilizes its renewable, patented plant seed-based oilbody and plant-based protein expression technology platforms to develop and produce high-value proteins and oils to make nutritional products and drug candidates."
ht_p://www.4-traders.com/news/SemBioSys-and-Tasly-Pharmaceutical-to-participat…
Woo is big-time business, Conor - a multi-billion dollar industry in the U.S. alone and growing all the time. With far, far less regulation to worry about and customers who prefer conspiracy theories to actual medicine, the sky's the limit!
Regulars here (this is not meant to un-include you, Conor) will recall the famous Quack Miranda Warning that CAM sites feature ("This product is not intended to treat or cure any disease..."). The above-described Chinese partnership announcement was accompanied by a CAM Investment Miranda Warning:
"Forward Looking Statement and Disclaimer
"This press release contains certain forward-looking statements, including, without limitation, statements containing the words "believe", "may", "plan", "will", "estimate", "continue", "anticipate", "intend", "expect" and other similar expressions which constitute "forward-looking information" within the meaning of applicable securities laws. Forward-looking statements reflect the Company's current expectation and assumptions, and are subject to a number of risks and uncertainties that could cause actual results to differ materially from those anticipated."
:)
Nylon's not all that "new to nature" anyway. It's a polymer formed from a 6-unit amide, the 4- and 5- unit versions of which do occur in nature, and are called "putresceine" and "cadaverine" respectively. If you've ever smelled burning nylon, you know why.
MESSAGE BEGINS-----------------------
Shills and Minions,
Once again, another rebel has uncovered our eeeeevil plans for world dominion and it's evidently "starting to feel patronising." My superior reptilian brain, pulsing with deadly, new-to-nature molecules, tells me this rebel crossed that line with "hello."
You all seem to have things under control here. I'm on Glaxxon Prime at present at the investiture of the Grand Vitara, and as I predicted, it is a grand as it is tedious. At least we can finally get XKCD here.
Yours in PPE (Pure PharmaEeeeeeeevil)
Lord Draconis Zeneca, V7HIL
Forward Mavoon of the Great Fleet, Pharmaca Magna of Terra, Subjugator General With The Mostess.
Glaxxon Subjugation Ministry | Glaxxon Prime
0010101110100111010101001
------------------------MESSAGE ENDS
I repeated it on Twitter, but had to boil it down to 20:
Mixing fantasy with reality doesn't instantiate reality. Mixing cow pie with apple pie doesn't make cow pie better; it makes apple pie shit.
@ Hinterlander:
While I'm sorry if I caused you to waste a good cup of tea, I *do* sincerely thank you for your kindness: I wasn't exactly aiming for JRRT but generic visionary weirdness - an updated Wm Blake, perhaps ( in truth, I was hanging around his prints Saturday at a museum). However, re-reading my words I get a glimpse of the drowning of Numenor. I guess most visionaries get caught up in images of floods and symbolism involving light/dark and fading away like a mist or suchlike: comes with the territory.
I find the blind faith in so-called evidence-based medicine in this forum and the level of abuse hurled at proponents of natural medicine (e.g. foods, high-dose nutritional supplements, herbal extracts) exasperating and anything but rational.
Here are some more reasonable lines of argumentation that I hope might open the minds of the worst offenders I refer to:
The rigid, so-called EBM model is flawed. A good starting point for getting acquainted with its principles and downsides might be Steve Hickey & Hilary Robert âs book: âTarnished Gold: The Sickness of Evidence-based Medicine.â
These links further explore the concept of evidence based medicine and how it may (not) apply to the various modalities of natural medicine â e.g. how do you control for massage treatment?
Article: Circular instead of hierarchical: methodological principles for the evaluation of complex interventions by Wallach et al, BMC Medical Research Methodology 2006, 6:29
http://www.biomedcentral.com/1471-2288/6/29
Article: Deconstructing the evidence-based discourse in health sciences: truth, power and fascism, by Holmes D. et al
Int J Evid Based Healthc 2006; 4: 180â186
http://dcscience.net/holmes-deconstruction-ebhc-06.pdf
Evidence-based medicine and naturopathy:
http://epubs.scu.edu.au/cgi/viewcontent.cgi?article=1092&context=hahs_p…
Calli Arcale: "The body does leach calcium out of bones, but not to alter blood pH"
See this link for an explanation how calcium in bone may be used as a metabolic buffer:
http://www.anaesthesiamcq.com/AcidBaseBook/ab2_2.php
Also, this general comment may be of interest:
"Overall, the evidence leaves little doubt that excess acidity will create a reduction in total bone substance. This is normal physiologyânot pathology. This is a mechanism of Homo sapiens to protect himself against acidosis."
http://jn.nutrition.org/content/128/6/1051.full
Witch:
You're using the infamous "microfascism" paper as a reference?
Bwahahahahahahahaha!!!
@84, Witch -
If you don't believe in evidence based medicine, you believe in medicine with no evidence behind it. It's that simple.
If that's ok for you then go for it, but realise you're peddling magic, not medicine, and stop trying to convince other people to whom evidence matters - it just makes you look stupid.
To nastylittlehorse:
It's quite possible you didn't understand the articles provided under the links; it's absolutely certain that you don't understand holistic medicine.
Excellent. We have, in one series of posts from Conor, the "Big Pharma Shill" gambit, a hint of the "quantum physics/"there are more things in this word, Horatio" gambit, and the "I have a degree in X, which also makes me an expert in unrelated Y" gambit. A veritable delicious stew of CAM delights!
And in addition to Conor's main course, we have the side dishes of Witch: "Natural medicine is better than evidence-based medicine!" "Your disagreement means you don't understand!" My meal of woo is complete tonight.
A pro po medicine without evidence... flu vaccines don't work, yet are peddled agressively by doctors - see:
http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD001269/fr…
Kolga and the other lot: Just so you won't get indigestion and to end the evening on a hilarious note, here's something you might like - it's your favourite topic: Snake oil.
"For many centuries the Chinese used snake oil as a treatment for joint pain, arthritis and bursitis. They brought this folk remedy with them when they arrived in the US in the mid 1800's to build the Transcontinental Railroad. That was hard work you know. Aspirin, while having been invented, was not a readily available item at that time. When the Chinese workers offered the remedy to Westerners as a palliative it was likely perceived to be a "primitive" form of "quackery" by the medical experts of that time. Hence the origin of the derogatory meaning of the word "snake oil."
The funny thing about modern "snake oil," i.e. petrochemically-derived and patented synthetic chemicals - is that they often have considerably less value than a placebo and in certain cases may not even compare in therapeutic value to ACTUAL snake oil. Here are four studies on the potential medicinal value of sea snake and boa constrictor lipids for inflammation and infection......"
http://www.greenmedinfo.com/blog/snake-oil-traditional-and-evidence-bas…
Dear Conor S., in #61 you state "No man, woman or child died from nutritional supplements. Period." Are you forgetting the 1,500+ consumers who became seriously ill and the 27 who died in 1988-89 from botched L-Tryptophan? How about the folks like Anne Marie Capati who was killed when she took the ephedra that was suggested to her despite high blood pressure and she ruptured blood vessels in her skull? What about the huge amounts of toxic heavy metals in many supplements (Arsenic 46,400 ppm in a sample of An Kung Niu Huang Wan, Mercury 3590 ppm in a sample of Ansenpunaw, higher amounts in many raw materials and ayurvedic preparations)? What about the 17 people who died from listeria contamination of probiotic supplements over the last five years? Look dude, I know you are a true believer but I was the director of QC for one of the largest "pure and natural" supplement makers before I quit the sham and went back to grad school for an Immunology Ph.D. - some of the products are good, most are placebo, many are contaminated with heavy metals and are borderline toxic with repeat/continuous use. You haven't found evidence of harm because you did not look. Shame on you. The number of contaminants and adulterants in "natural products" is astounding and having been in that industry I can tell you that I'd much rather give my daughter a "synthetic" drug made under GMP conditions than some crap herbal formula mixed from powdered vegetation bought from China on faith and a COA that says whatever you wanted it to say.
For anyone who wants to look at what we know about dangers of supplements and herbal products please see: L.G. Miller, Herbal Medicinals: Selected Clinical Considerations Focusing on Known or Potential Drug-Herb Interactions, 158 ARCHIVES INTERNAL MED. 2200 (1998) or ANDREA PIERCE, PRACTICAL GUIDE OF NATURAL MEDICINES (1999). The EU has done much more research, try THE COMPLETE GERMAN COMMISSION E MONOGRAPHS (M. Blumenthal ed., 1998).
How about pertussis vaccine? Tetanus? Diptheria? Measles? Mumps? Rubella? Polio? Or did you just mean flu vaccines don't work/ Could that be because you don't understand statistics and herd immunity? How would you prevent these diseases that used to kill hundreds of thousands of people a year? With your wand and some henbane?
Witches don't work that way; they only cause diseases...and sometimes have delicious residences serving as attractive nuisance to nosy local kids. Kinda unfair witches got all the bad publicity, when evil warlocks avoided scrutiny?
@92, Witch
You were educated about how wrong that link on Flu Vaccines is in the last thread you pposted in. Clearly you don't learn.
And re: post 89 - the links are irrelevant. If you don't believe that an evidence basis is required for medicine (and anything else) then you're just peddling magic and magical thinking. You fundamentally operate on a different level of knowledge to other people - you consider your feelings and intuitions to be more important than actual facts.
As I said, that's fine, but admit it to yourself and stop pretending otherwise.
Oh really?
Flu vaccination provides a 50%-75% reduction in the number of cases, depending on how well the match is, according to the review. I've noticed that you have lied about the contents of a number of studies. Why are you lying?
Note that if the Cochrane Review's numbers are correct, up to 9 million cases of influenza each year could be prevented, if everyone in the US got a flu shot, though more often it would 'only' be 5 million cases prevented. And that's not including herd protection effects. Ineffective?
@Conor:
That's called the naturalistic fallacy.
@Witch:
It's very likely that you don't understand the word "holistic".
Witch @86,
No one is disputing that calcium will leach out of bone during "prolonged metabolic acidosis" as your first link says. What many people don't understand is that prolonged metabolic acidosis is not something we see in people who simply eat the wrong diet. It is something we see in people with serious illnesses like kidney disease. A number of nutritionists have argued that we do, as exemplified by your second link, but the evidence I have seen (and I have gone into this very extensively) suggests that they are wrong.
See the links I gave above showing that a high protein (acidic) diet leads to increased calcium absorption and lower bone breakdown than a low protein (alkaline) diet, and the lower bone density in vegans. The increased urinary calcium excretion that some people have claimed shows that a high protein diet breaks down bone is actually due to increased calcium absorption. Your body maintains calcium homeostasis, so excess calcium is excreted in the urine.
Roadstergal, thanks for clearing up what I said. You're correct.
Those interested in dietary protein, metabolic acidosis and bone health may find this article of interest.
Thank you, Krebiozen, for educating those of us without any post-high-school biology education. ;-) I was only familiar with normal pH buffering, not that found in dire, near-death conditions.
I'm still curious if Conor or Witch knows the *main* reason the body tries to leach calcium out of bones. It doesn't normally need to do that to maintain pH, but it does need calcium very urgently for something else. I'm curious if they know what it is. (If they want a hint, they can google Abubakar Tariq Nadama, who died of hypocalcemia.)
Witch @ 85
Whoa! Stop right there. Blind faith?
Confidence in the safety and efficacy of evidence based medicine doesn't derive from subjective personal faith but instead from large bodies of actual evidence (including but not limited to extensive pre-clinical and clinical testing).
See, it's right there in the name: evidence based medicine. How'd you miss that?
@ JGC:
Hey, hold on there now, Mr ( Ms)! But *those* SBM studies, *those* mountains of journals filled with research, *those* textbooks are all IN-admissable because they are *tainted* by the contaminating pollution of corruption: sponsored by pharma, conducted in compromised universities by untrustworthy university-educated, establishment-trained and governmentally-approved agents of the orthodoxy and printed in pharma-controlled journals and discussed in paid-for mainstream media. DON'T believe it!
( lord almighty, I'm starting to be able to produce woo-screed without actually thinking!)
Doesn't it mean "full of holes"?
#94 Jay Chaplin
Thanks for posting that information.
How many near misses I wonder?
One rather memorable example was Gary Null's overdose on his own Vit. D supplement.
A controversial alternative health guru is suing after a taste of his own medicine nearly killed him.
#94 Jay Chaplin
Thanks for the references.
A link sent my post into moderation. Just had to add a mention of Gary Null's overdose on his own Vit. D supplement. While no fatality eventuated, a rather memorable event all the same.
A simple version of Mark Crislip's statement:
Prometheus
Somebody pass me that paper bag-- I need it to hide my own head now.
As someone who is a cultural Wiccan, I just want to point out that really, truly, there ARE witches out there who are capable of rational thought, and even of properly understanding statistics, biochemistry, and how to read a scientific study.
Does anyone know where the claim "100,000 deaths a year from drugs used AS PRESCRIBED!!!!!!!!!!" comes from? I checked the CDC mortality statistics for 2009 and found drug-induced deaths numbered at 39,147 (here, page 28). As far as I can tell, that is total drug deaths, not just deaths due to properly prescribed drugs.
I also checked the link Conor provided, and couldn't find it there. It looks like that link is just supposed to show that vitamins don't kill people. I used RI search to find the 100,000 deaths claim as well. Does anyone have the source for this claim?
Melissa G:
My best friend is a witch and sounds very much like you. She is a college instructor in Residential Health Care and takes great pains to be current on evidence-based health science. Of course, she strongly recommends vaccination (including flu vaccines).
What I would say to "Witch" (with credit to Lloyd Bentsen):
"Witch", I know a real witch, a real witch is a friend of mine. "Witch", you're no witch.
Does anyone have the source for this claim?
Usually, it's Lazarou et al., although I seem to recall Emily the Natural Hygienist eventually producing a slightly earlier cite.
I may like the Prometheus version (@110) better, since some of us nerds have biases about what we want "instantiate" to mean. We want to keep it for ourselves.
Ben T,
An execrable article by Gary Null titled 'Death By Medicine' is a common source of that figure; it quotes Lazarou et al among others. Lazarou's figures, BTW, were mostly from the 60s and 70s and extrapolated to 1998 IIRC.
Being a foreigner (from your perspective), I am having a bit of difficulty in translating "instantiate". It is not in my dictionary, and google translate is....err...google translate. I also kind of like Prometheus (#110) version. but I am dying to find a Danish word for "instantiate". Guess it will keep me awake all night.
JLI: easiest way to think of "instantiate" is as "create an instance of". dictionary.com provides
to provide an instance of or concrete evidence in support of (a theory, concept, claim, or the like).
But since that is about 5 seconds of Googling away, you're probably trying to make a point...?
BenT: start your trail of mud on "100000 deaths" here. Even more telling is the first link that comes up when you Google "100000 drug deaths".
JLI,
I don't know a Danish equivalent for "instantiate" (there may not be one, as it is a relatively recent word), but a definition in English would be:
I hope that helps.
Prometheus
Stu -- give the guy a break; English isn't his native language.
In computer science, it's a very important word. I don't encounter it much outside of that. In, for instance, Java, there are all sorts of different kinds of objects defined, and you can create your own definitions of new object types, but they don't really exist until you *instantiate* them, which causes memory to be allocated to hold them. For instance:
String foo = new String("bar");
That declares an object of the String class, names it "foo", and initializes it with the value of "bar". "foo" is an instance of the class String.
Thank you fellows. I have an idea of what it means. I guess we just don't have a good word for it in Danish. English is much more elegant in this respect.
I just noticed some posts from Conor have emerged from moderation, but they all refer to bone buffering in chronic metabolic acidosis. You don't suffer chronic metabolic acidosis from eating too much cheese; as I have said before, kidney disease is the most common cause. The article I link to at #104 explains things very clearly.
Conor wrote:
If you mean 'The China Study' I don't recall much in there about bone health. Campbell set out with the aim of proving that animal protein is a killer, and cherry-picked his evidence to support that. There's a good refutation of Campbell here.
Maybe you are referring to Campbell's article 'Dietary calcium and bone density among middle-aged and elderly women in China'? It found a strong correlation between dairy intake and stronger bones. It concluded that:
Dairy is a rich source of animal protein and in this study resulted in better bone health.
I have found an article referring to studies done by Campbell looking at urinary calcium excretion and protein intake which made the erroneous assumption that high protein leads to net calcium loss, but I have failed to locate them.
I'm still curious if Conor or Witch knows the *main* reason the body tries to leach calcium out of bones. It doesn't normally need to do that to maintain pH, but it does need calcium very urgently for something else.
Pregnancy?
I guess that's reason #2...
I find the blind faith in so-called evidence-based medicine in this forum...
Translation: Who are you gonna believe? Me, or your lying eyes?
@ Herr Doktor
I believe calcium is needed by the heart to keep functioning.
Calcium is needed by every cell in the body to keep functioning, it is THE primary second messenger for signaling in eukaryotic cells. That doesn't mean that calcium buffers anything - folks ought to learn some basic chemistry. THis is an equilibrium effect and not a "stripping calcium carbonate from the bone to buffer blood pH" effect. Honestly, go back to freshman chemistry class.
More light reading on the "natural and therefore supersafe" supplements that have never caused any harm:
http://www.nytimes.com/2007/01/16/health/16diet.html?_r=2&adxnnl=1&oref…
http://query.nytimes.com/gst/fullpage.html?res=9E01E1D9173EF93BA35757C0…
@ Krebiozen:
@ Ben T:
The excrable *article* is also available in book form and has recently premiered as an *award-winning 'documentary'*( i.e. the documentation of ridiculous, fear-mongering ideas dreamt up to bilk followers out of their excess cash).
The death-by-drug figures are usually quoted as you say, K, but the 'money quote' is the 600K: the sum total of death by drugs, by doctors, by hospitals et al. ( see Gary Null.com/ Progressive Radio Network.com for this and other bilge-water).
Thanks, Jay. ;-)
Herr Doktor -- well, it's needed in pregnancy, yes, but for the same reason everything else is needed in pregnancy -- the baby's body needs it just as desperately as the mother's body. Calcium is critical to life. Feddle mentioned the heart; when little Abubakar Tariq Nadama died, this is why -- chelation therapy, an alternative treatment for autism offered by an "integrative" physician (hey, this comes back around to the topic of the thread!), was administered without any of the appropriate safeguards or, indeed, any sense whatsoever. The chelating agent, disodium EDTA, promptly stripped the calcium from his bloodstream, much faster than any natural process could replace it. Among other things, calcium ions are critical in the contraction of muscle fibers. All muscle fibers. His heart became physically incapable of beating, and he died; even a defibrillator would have had no effect.
Ah, yes, excuse my limited memory of physiology class. I only remembered that fluorine exposure usually kills a person by striping calcium out of their bones and bloodstream and causing a heart attacks.
#126 Jay Chaplin
Great.
I lost all my bookmarks a few months back so I welcome these links.
Here's one I still have on file..
Undercover government employees received consistently false information when shopping for supplements, and analyses show most supplements contain trace amounts of contaminants
@Conor:
Problem is that many of these molecules cause havoc in the body, sooner or later, precisely because of their artificial origin ...
That's called the naturalistic fallacy.
Posted by: Mojo | February 29, 2012 7:07 AM
... more like iatrogenesis
Witch
You speak Thinglish?
Merriam-Webster Dictionary:
Just a few comments on the above posts since yesterday.
Low level, chronic metabolic acidosis does indeed exist on a massive scale in populations on the typical western diet....
Apart from a last resort attempt at buffering acids (in renal failure or in chronic, low-level metabolic acidosis), calcium may also leave bone due to parathyroid disease.
As a closing contribution, here's an article I'm sure you'll all enjoy - your favourite topic - snake oil:
Snake Oil: Traditional and Evidence-based Medicine Converge
http://www.greenmedinfo.com/blog/snake-oil-traditional-and-evidence-bas…
Witch, have you learned to actually read the papers you cite? I was highly amused that you said a vaccine did not work in women who were already infected, plus you did not know which vaccine was used in that study.
@Witch #133
"Low level, chronic metabolic acidosis does indeed exist on a massive scale in populations on the typical western diet...."
Perhaps you would be kind enough to provide a citation for your claim.
Witch,
Not true. Elderly people do have a tendency to mild compensated metabolic acidosis due to mild renal impairment, not because they eat too much animal protein. There is no convincing evidence that an "acid diet" causes bone loss. Read the article I linked to #104 and this one which concludes:
You also wrote:
That's true, but has nothing at all to do with diet or acidosis.
Jay,
True, it's the carbonate and phosphate that does the buffering.
Freshman chemistry class won't help you much with bone biochemistry. Despite dozens of lectures and case presentations, hours of study and exams passed, I still have to go back to the textbooks to be sure I have the roles of PTH, calcitonin, vitamin D, IL-6, osteoblasts, osteoclasts etc right, and that's just the basics. You can get deeply into cathepsins and metalloproteinases and other esoteric stuff too. It's not my favorite area of biochemistry.
As a matter of fact it's not just an equilibrium effect, low pH activates osteoclasts to break down bone, releasing carbonate and phosphate to buffer blood pH.
Thanks for the links, Narad, Krebiozen, Stu. Interesting reading. I had seen that 100,000 deaths claim a few times and wondered if there was anything behind it. It is easier to deal with claims when you have citations.
I am sympathetic to the argument that if a therapy works and is evidenced-based, it should not be called "alternative."
I am also grateful to the skeptics here for continuing to demand evidence and keep medicine grounded in science, and challenge us to know our sources and use critical thinking.
I am also planning on incorporating elements of yoga - poses, breathing exercises, meditation, etc., into a primary care practice, not in place of allopathic medicine, but alongside it.
Is it wrong to call a practice like this integrative? I am not trying to be difficult, I just want to hear your perspectives.
Jay@126
The linked NY Times article against supplements' safety record could be considered a disingenuously retracted attack considering the Correction article that followed, linked at the end. Acknowledging "exposures" are not "adverse reactions" pretty much guts the basis of the original article.
Trying to find the 2005 paper Hurley refered to in Clinical Toxicology, I saw an old 70s fatality referenced, the lowest ferrous sulfate fatal overdose recorded was coingested with a high level of phenobarbitol and methampthetamines...
SC@139--
I think there is fairly good evidence that yoga and its associated components can have beneficial effects on health. I wouldn't call that alternative; I'd call it patient-centered and progressive. You could call it integrative if you like, but the problem is that the people looking for an "integrative" practice would probably have a different idea about what that term encompasses, and would probably be disappointed that you weren't also prescribing homeopathy, accupuncture, and other woo-ology.
SC,
I don't think it's wrong, but be aware you will be allying yourself to people who believe in magic. By 'magic' I mean imaginary energies, undetectable meridian systems and that diluting a substance until none of it remains makes its effects stronger. As Cynical Pediatrician said, some people will expect magic from you too.
SC (#139):
Why call it anything? As for the term "integrative", the word has picked up certain connotations that you may or may not want associated with your practice.
If you want people to think that your practice mingles evidence-based and fantasy-based therapies, then "integrative" is an appropriate term. If, on the other hand, you see yoga as a form of low-impact exercise and stretching, a good way to relax and decompress emotionally, then you way want to avoid the term "integrative".
Words pick up extra layers of meaning from their usage, like the way "allopathic" (originally coined by Hahnemann to describe all non-homeopathic medical therapies) has picked up an taint of insult. The term "integrative" has become yet another "code word" or euphemism for fantasy-based (or magical) pseudoscientific therapies, much the same as the words "alternative" and "complementary" in conjunction with medical practice.
So, if you are an "alternative" practitioner (i.e. you believe in fantasy-based therapies), the term "integrative" would attract the type of patients you seek. If you aren't an "alternative" type practitioner, some people attracted to the "integrative" label in search of magic cures will be terribly disappointed.
Prometheus
Too right you are, Krebioz: "low pH activates osteoclasts to break down bone, releasing carbonate and phosphate to buffer blood pH." ( as well as releasing calcium from bone, since bone is formed from calcium-phosphate). Therefore, low pH is one of the reasons for loss of calcium from bone, regardless of the mechanism.
Again I refer to this link http://www.anaesthesiamcq.com/AcidBaseBook/ab2_2.php
I only mentioned the loss of calcium link to parathyroid disease bit because someone above asked about some of the reasons for calcium loss from bone, not as an explanation for anything relating to a net acid load diet.
How did you all like the Snake Oil link http://www.greenmedinfo.com/blog/snake-oil-traditional-and-evidence-bas…
As you can see, there is emerging evidence that many disparaged traditional medicines are, in fact, effective medicines. Why is everyone so afraid? Why can't herbalists / nutritionists (naturopaths), yoga teachers, acupuncturists, to name a few, work alongside of conventional doctors as part of an integrative medicine alliance? Patients will soon know if a therapy works or not.
Witch,
Low pH is not an important reason for the loss of calcium from bone. Look at the risk factors for osteoporosis and you won't see metabolic acidosis, acid diet or even high protein diet listed there.
You keep referring to material I don't think you understand - did you notice that bone buffering only occurs "In prolonged metabolic acidosis" according to your link? I have personally measured blood gases (that include pH, CO2 and bicarbonate) on thousands of people, and I can promise you that those with metabolic acidosis sufficient to cause bone loss were not walking around ordering Big Macs. I know there are thousands of websites that claim that we all accumulate acids due to our poor diet and lifestyles, but they are wrong. It is a prevalent and widely believed myth.
If something happens to make our blood more acidic, we ingest some acid-generating food, or we take some vigorous exercise for example, the major buffering systems in our body deal with it. You can see what these are in the link you provided. In the most important, the bicarbonate buffering system, acid combines with bicarbonate to form carbon dioxide and water. The carbon dioxide is exhaled and normal pH is restored. This is why people with metabolic acidosis hyperventilate, as their body rids itself of excess carbon dioxide. It is a very characteristic way of breathing, a sort of deep sighing, that you see in very sick people. It is only when these buffering systems are insufficient to bring blood pH back within the normal range that bone will be broken down.
Metabolic acidosis sufficient to lead to bone loss is rare and is due to underlying disease, not simply due to eating an "acid diet". As your link says "the body has a HUGE buffering capacity, and this system is essentially IMMEDIATE in effect" (their emphasis). Consider a marathon runner. Running generates a huge amount of metabolic acids, as much as 320 mEq/hour (note this is in addition to the volatile acids that are eliminated as CO2 through respiration). A marathon runner will generate about 1000 mEq of hydrogen ions if they run for 3 hours. This will induce an impressive metabolic acidosis. I have done metabolic profiles on blood samples from marathon runners and if I hadn't known I would have assumed they has suffered a massive heart attack. However, by the next day their acidosis has vanished. Some people have run marathons on consecutive days over a period of a year or more without succumbing to acidosis.
Compare this to the acids generated by food. The most acid generating food is hard cheese (PMID 7797810) which generates about 30 mEq of acid for every 100g (about 4 ounces) eaten. You would have to eat 7 pounds of hard cheese to produce the same amount of organic acids a marathon runner does.
If marathon runners can easily deal with the 1000 mEq/day of organic acids generated by running multiple marathons without their skeletons dissolving into a calcium soup, why would our bodies be incapable of dealing with the tiny fraction of this that eating acidic foods generates? It doesn't make sense, and is not supported by experiments or by epidemiological data. Check out PMID 21248199 which concludes, "a high-protein diet has no adverse effects on bone health".
I see why you mention parathyroid disease, but I think you miss Calli's point. Maintaining blood calcium levels is essential for life. Low calcium can rapidly lead to fatal cardiac arrhythmias.
I appreciate the irony of snake oil turning out to have therapeutic properties. Some folk medicines have proved to be effective. They are tested, the active ingredients isolated, and if they prove to be effective they become science based medicine. The majority of folk remedies that have been tested have been found to be inert, ineffective or dangerous. I don't see how this supports your assertion that "many disparaged traditional medicines are, in fact, effective medicines". I think that most aren't. Does anyone know what percentage of traditional remedies that are tested turn out to be useful in pharmacognosy?
I don't think anyone is afraid exactly. I just don't want to see proven science based medicine mixed up with superstitious nonsense. Not only is it ineffective but it encourages people to believe in nonsense, and that can't be good for anyone.
Because most of the treatments they use have been proven not to work and they often propagate misinformation about health and disease.
Unfortunately that's not true. Humans are very bad at assessing therapies, which is why dangerous treatments like bloodletting were popular for thousands of years, and doctors were convinced they were helping their patients. It was only when these treatments were subjected to careful scientific study using clinical trials that it was proven they were dangerous.
Witch re: snake oil
The website you link to re: Chinese snake oil wouldn't seem to support a claim that 'integrating' principles of traditional Chinese medicine with evidence based medicine would lead to improvement in health care.
First, recall what illnesses snake oil prescribed to treat in traditional Chinese medicine: joint pain, arthritis, and bursitis.
The four studies the article cites, however, doesn't look at outcomes re: joint pain, arthritis, bursitis: one looks at antimicrobial activity against s aureus and s pyrogenes, one looks at effects on plasma glucose in diabetic mice, one looks at lactate production and clearance in smooth muscle, and one looks at effects on fibroblasts which may reduce keloid scarring.
Finally, note that two of the studies involved 'oil' harvested from boa constrictors, which are not indigenous to Asia.
By my reading we've got preliminary indications that compounds isolated from two species of snake may be of medicinal value, but no indication that they'd have value in treating the complaints traditional Chinese medicine prescribes snake oil for. Instead, they may be of use in treating different ailments which have been identified by standard evidence based scientific investigation.
@141-143
Thanks for your comments. Since over 90% of Americans believe in God, I'm not too worried about allying myself with people who believe in magic. It seems fairly ubiquitous. The trick, it seems, is to balance that belief in magic with a reverence for science and a reliance on evidence. I'd wager that the majority of physicians have some religious affiliation, but it is part of their duty not to let that interfere with evidenced-based medicine. A doctor might recommend prayer to his patients, for example, but he/she would not recommend it in place of medical therapy, but rather, perhaps as a way to help patients manage their illness if faith is part of their background.
It seems from what I'm reading that this is a primary concern with integrative medicine - a fear that belief will overtake evidence, and that this will negatively impact how a physician acts. I think this is a valid concern, and I'm glad there are people on the lookout for this kind of departure from best practices. I do not believe in an external God myself, but I certainly have beliefs that can't be proven (woo is on a spectrum, after all), so as my practice takes shape, I will be sure to be careful about how my beliefs might be effecting my practice, and whether that is to the potential detriment of my patients. Thanks for reminding me to be aware of that.
I could boil integrative medicine down to three words: absolute f*cking bullshit!
How did you all like the Snake Oil link
Anyone who links to the same site three times is a spammer.
I did not really click on that link because I figured it was a pointless article by someone who is clueless. I checked, and yep, I was right. If was by the same person who declared vaccines are transhumanism. Pure dreck.
TBruce @ #114, thank you, and a virtual Hi5 to your friend the witch! :D Tell her I got my flu shot last month!
I would like to report that it gave me superpowers, but so far only super immunity. Which, really, compared to our not-too-distant ancestors IS a superpower, now that I think of it.
Patients will soon know if a therapy works or not.
By which time it may be too late for them to get treatment that, you know, actually does something.
You will love this one. There is a cancer article on HuffPo, and I encountered one of the usual luddites. They were saying all cancer treatments are bunk and only alternative medicine will work.
So I wrote.
âThen give an example of an alternative treatment and what it is used for. Cite peer reviewed sources showing its rate of effectiveness vs conventional treatments. Compare the outcome statistically to conventional treatments. Good luck.â
They wrote back....
âRead Suzanne Sommers' book "Breakthrough." Chemotherapy does not help most cancers. It does help some but the majority it DOES NOT. Most people, even after treatment, are left with broken bodies that have been poisoned by this treatment. There is no energy. Cells on a cellular level are destroyed. Western medicine only knows chemotherapy/radiation. That's it. The body is capable of being healed but only with the right protocol. Chemo is not a one size fits all treatment for cancer. Why do you think there is no cure for cancer? It brings in too much revenue for the pharmaceutical companies and oncologists that have absolutely no clue in treatment other than chemo/radiation.â
I am confused. Can you use a Thighmaster for lung cancer?
...If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.
Sounds like a prescription for America. Maybe you'll finally stop using that (cr)apple pie for your sugar fix and keep your pie hole a little less carb abused.