Evidence-based medicine: More than a "coin flip"

One characteristic of cranks, quacks, and pseudoscience boosters is a love-hate relationship with science. They desperately crave the respectability and validation that science confers. In the case of medicine, they want to be seen as evidence- and science-based. On the other hand, they hate science because it just won't given them what they want: Confirmation and validation. The reasons, of course, are obvious; their preferred ideas about disease and modalities to treat it are not rooted in science. Rather, they're usually based in either prescientific concepts of how the human body works and how disease attacks it (i.e., vitalism or miasmas), or they are based in completely unscientific belief systems, or both. It's not surprising, then, that science either tells them that their ideas are nonsense right from the start (i.e., for homeopathy or distance healing) or finds when it tests treatments based on those ideas that they do not perform better than placebo.

All of this explains the propensity of quacks and apologists for quackery to attack medical science, to try to convince people that it is unreliable or even dangerous. We see this when people like Gary Null try to convince you that medicine kills 600,000 people a year in the US, a number, which, if true, would make medicine roughly tied with heart disease as the number one cause of death, if not the number one cause of death. It would also mean that more than one in five people in the US who die each year die due to medical treatment. It's utter nonsense, but it feeds a narrative in which medicine is not just ineffective but downright dangerous in comparison to, of course, the lovely "natural" cures that are much safe. The unspoken and unadmitted reason that such treatments are often safer is because they are also ineffective placebo medicine, the way homeopathy is water, but that is never mentioned.

Such were my thoughts as I encountered yet another example of this sort of demonization of medicine. It's a post by Sayer Ji. We've met Ji before when he tried to argue that vaccines are transhumanism that somehow subverts evolution and attacked the Bill and Melinda Gates Foundation. This time around, he's trying to convince you that evidence-based medicine is completely uncertain, even going so far as to entitle his post "Evidence-based medicine": A coin's flip of certainty. It's a veritable cornucopia of antiscience fallacies aimed at medical science. In fact, as I read Ji's little screed, I began to get the image of Mike Adams. There is more than a passing resemblance to Ji's bad science and misunderstanding of evidence-based medicine and Mike Adams', beginning with the attempt to convince readers that most research is not just false, but patently false:

The very life's blood of 'evidence-based' medicine -- peer-reviewed and published clinical research results – which legitimizes the entire infrastructure and superstructure upon which conventional medical knowledge and practice is erected, has been revealed as mostly and patently false.

Case in point: in a 2005 essay, "Why Most Published Research Findings are False," and which is the most downloaded document of all time on PLoS, the Public Library of Medicine's peer-reviewed, open access journal, John P. A Ioannidis explains in detail how "It can be proven that most claimed research findings are false." And that "for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias."

The Atlantic published a piece on Ioannidis' work, back in 2010, titled "Lies, Damned Lies, and Medical Science," well worth reading, and which opened with "Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors - to a striking extent - still drawing upon misinformation in their everyday practice?"

Cranks love John Ioannidis, and so do I. Of course, we love Ioannidis for different reasons. I love Ioannidis' work because it demonstrates very clearly the limitations of clinical trials and suggests how we can overcome them. Cranks, on the other hand, love Ioannidis because he gives them material with which to attack evidence- and science-based medicine. Unfortunately, they completely don't understand Ioannidis, who is not at all saying that EBM is no better than a coin flip as to whether it's accurate or not. What he is saying is that you can't look at just individual studies, because any single study is more likely to be wrong than it is to be correct. However, the preponderance of studies will over time converge on effective treatments.

Ioannidis is also most definitely not friendly to cranks, contrary to what Ji thinks. As I've described before, the problem of false positive studies becomes more serious the lower the prior plausibility of the hypothesis being tested. That's why testing something like homeopathy, which involves diluting substances to the point where it is incredibly unlikely that even a single molecule remains, can produce so many seemingly "positive" studies, even though science tells us that what is being tested is nothing but water. Moreover, Ioannidis' observation that perhaps 1/3 of highly cited papers ultimately turn out to be wrong indicates that, contrary to what the cranks tell us, science really is self-correcting and will be more likely to get it right over time, discarding false hypotheses and dead ends. It is true that the process is messier than we might like, that it often takes longer than we might like, and that it produces more dead ends than we might like, but science also demonstrably works better than anything the quacks can come up with. It also eventually unloads and abandons therapies demonstrated to be ineffective, something "alternative medicine" virtually never does.

Oddly enough, Ji almost starts to make sense at one point in a criticism of the hierarchy of evidence in EBM, something I've criticized myself from time to time. Almost:

Evidence-based medicine (EBM), of course, is founded upon an epistemological power structure arranged hierarchally like a pyramid. The 'quality of evidence' determines whether or not something can be said to be true. On the lowest tier, the 'base' of this pyramid, is the Anecdote, considered worthless, encompassing many folk medical systems employing food and plant medicines and still used by the majority of the word as their primary care system, followed by: Cell Studies > Animal Studies > Human Studies > Clinical Trials > Meta-Analyses and Systematic Reviews of Clinical Trials.

Indeed, time and time again, I've pointed out how the hierarchy of evidence in EBM is defective in that it vastly undervalues basic science studies. The point is not that basic science is enough to establish the efficacy and safety of any given treatment. It's not. Clinical trials still need to be done. However, basic science can be enough to close the door on the question of whether a treatment is efficacious and safe. The example of homeopathy comes to mind. Huge swaths of physics and chemistry would have to be not just wrong, but spectacularly wrong for homeopathy to work; basic science alone is enough to declare homeopathy so implausible as not to be worth testing in randomized clinical trials.

Ji also can't resist attacking the straw man that anecdotes are considered "worthless." They are not. However, they are the lowest form of evidence, and quite rightly so given how easily anecdotes can lead us astray. They are considered hypothesis-generating, rather than hypothesis-testing. Ji does, however, realize why EBM is so threatening to him, as he recognizes that the vast majority of evidence in support of his favored modalities are all anecdotes and that these are how most folk medical systems are supported.

That's not the only straw man argument that Ji gleefully tries to set aflame with burning stupid:

This model assumes, in the characteristically Napoleonic style, that what it does not officially confirm as being true, is not true. Herbs and vitamins, for instance, are almost never considered to be "evidence-based" and credible because they have not run the gauntlet of prerequisite clinical trials required for them to be verified as therapeutic within this model. The fact that our bodies, for instance, require vitamin C in order to be alive, is not evidence enough to support the concept that it may be valuable to take it supplementally at doses beyond the recommended daily value (which may keep you only a few milligrams above starvation/deficiency values).

No, the model assumes that what has not been tested and confirmed to be true is unproven, not that it isn't true. His "logic," such as it is, is ridiculous, as well. It does not follow from the observation that vitamin C is required in the diet that using it as a supplement in megadoses (which, let's be blunt, is what is meant by "taking it supplementally at doses beyond the recommended daily value") is useful therapy. As I said before, observations an anecdote are not enough. They can be a starting point. They can be hypothesis-generating. They can also be profoundly misleading to the unwary, the ideologically blinded, and lovers of pseudoscience. Like Sayer Ji.

Of course, with this long, drawn-out lead up, you know we're fast approaching the climax, and, if you're familiar with cranks like Ji, you know what that climax probably is going to be. I can't say I was too surprised when I came upon that climax:

Ultimately, Ioannadis' findings reflect an inborn and potentially fatal error at the very heart of modern science itself: namely, a tendency towards scientism.

Scientism is the idea that natural science is the most authoritative worldview or aspect of human education, and that it is superior to all other interpretations of life. Furthermore, scientism accepts as real and valid only those things which it can confirm empirically; those things it does not or cannot confirm it is skeptical about, e.g. homeopathy, the existence of the soul, an innate intelligence in the body, or worse, outright denies as unscientific, or "quackery."

That's right. If you can't prove your woo works through science, accuse your critics of "scientism"! Works every time. Well, not really. It's one of the oldest, most transparent gambits in the book. It's also hilarious in that it is clearly designed to cut science down a notch or two, to make it just one of any other "ways of knowing." So how do cranks do that? They liken science to a religion! Yet they blather on and on about "soul," "innate intelligence of the body," and other spiritual, mystic, or outright religious concepts that they value. Oh, sure, Ji and his ilk gussy them up with the language of science, throwing around terms like "quantum," non-locality, faster-than-light communication, to make his woo sound like science. In this, Ji is nothing more than a cut-rate Deepak Chopra.

A Deepak Chopra who sees fascists under his bed:

This is how we arrived at our present day pseudo-scientific medical dictatorship. I say pseudo- because insofar as science means an attempt to discern the truth without bias, it is a human faculty, a yearning of the soul, a constant challenge we must meet each and every moment we try to figure something out. Science is not a "brand," a "possession," an exclusive faculty of a caste of scientific elite, dispensed solely through monolithic institutions. It can not claim to deny anything and everything it does not explicitly confirm without being an organ and instrument of fascism, control, divisiveness and institutionalized and compulsory ignorance and myopathy.

Help, help, I'm being repressed by microfascists wearing microjackboots and microtruncheons! Big shock, Ji thinks it impossible for "natural medicine" ever to achieve legitimacy "within the present power structure." Of course, the "power structure" has nothing to do with it. It couldn't possibly be because these "natural cures" are rank quackery unsupported by science, evidence, or even convincing anecdotes, could it? Perish the thought.

In the end, Ji's little screed is nothing more than a massive case of special pleading. Because his favorite woo can't meet the standards of science, Ji wants different standards. Same as it ever was.


More like this

If I understood this correctly, he says that scientists and science based medicine are bad because it tries to impose a scientific world view on everything.

Scientism is the idea that natural science is the most authoritative worldview or aspect of human education, and that it is superior to all other interpretations of life.

And then goes on to contradict himself by endorsing science as the most important world view with:

science means an attempt to discern the truth without bias, it is a human faculty, a yearning of the soul, a constant challenge we must meet each and every moment we try to figure something out.

[Emphasis mine]

"they hate science because it just won’t given them what they want: Confirmation and validation."

Nonsense, we know scientific papers are unreliable and science is a fraud! Here's a scientific paper that PROVES it!!! And another paper that proves my woo works!!!

By Dangerous Bacon (not verified) on 16 Nov 2012 #permalink

"I love Ioannidis’ work because it demonstrates very clearly the limitations of clinical trials and suggests how we can overcome them."

Indeed. If anything, Ioannidis' work is an argument for *more* SBM, not less, because it states that findings based on low prior probability are more likely to be wrong than those rooted in a sound scientific context.

In other words, Ioannidis pretty much argues that you can forget the odd positive homeopathy or acupuncture trial because they lack any solid foundation. Truly ironic. :-)

How the quacks don't see that eludes me.

Oh wait, it doesn't: They're too religious about their pet theories to get the point.

Sayer Ji sounds like the name of a character from Star Wars.

I feel like that is about as relevant a statment as pretty much everything he wrote in his attack on EBM.

By Composer99 (not verified) on 16 Nov 2012 #permalink

Yes, their love-hate relationship with science:

it seems to me that their aping of the superficial features of science- decorating their websites with ersatz doctorates, using terms like "clinical trials", "statistical analysis", " current research", translating materials into " lay language" for their enraptured audiences- often displays a remarkable lack of depth that is revealed when they attempt to explain HOW some of their cherished therapies work as well as HOW their hypotheses' validity is assessed and HOW this related to other data. Tell me how it all works.

For example, a woo-meister pontificates about a mental illness or an ASD/ LD, reeling out a line about how SMI is unrelated to "chemical imbalances" and how autism is the the result of "brain damage" caused by vaccines; then the confabulation begins that reveals the paucity of their knowledge; of course, if their audience knows nothing they might be impressed with a parade of science-y sounding terms, although they are, to my ear, malapropised and mispronounced . Here's a clue: if a person mispronounces "synapse", "hippocampus" and "amygdala" and stumbles over "serotonin", chances are he hasn't studied physiology: instead he probably looked up bits and pieces and glued a few of the more exotic-sounding terms together *en pastiche*- however since the audience, like him, never darkened the door of a classroom, they wouldn't recognise the errors and the shoddy hack job. But I do.

When they run out of ideas they resort to talking about the 'soul" and "energy"**: apparently, these remedy all ills as well as their theories' lacks. Faith moves mountains and can also clear out blocked arteries ( with a little help from chelataion) and stop the proliferation of malignancies ( with some help from green juices). Mike Adams says that science neglects the soul. Right, it's supposed to,

They mimic science but their envy and hatred of consensus science suggests that they perhaps aimed at becoming fabled paradigm shifters themselves and never made it past the university door so they had to satisfy their ambition with mail-order degrees and make believe research. However, their paying customers are real.

Unbelievably, I have heard Ben Goldacre's name mentioned*** as a critic of science , as though he's on their side of the fence, HOWEVER the prevaricators carefully edit his writing to leave out the parts where he acknowledges the great utility of pharmaceutical products and SB research: like Ioannadis, he wants to make SBM better.

-btw- the BMJ will start monitoring studies submitted by requesting access to data ( January 2013).

** if you scratch woo, you'll find religion.

*** Gary Null brought BG up as did RI commenter Marg- on the thread that is rapidly approaching its demise ( IIRC, Tuesday).
Yes, the thread continues, struggling on towards its final day, going "gently into that goodnight"- at least I hope so.

By Denice Walter (not verified) on 16 Nov 2012 #permalink


"Sayer Ji sounds like the name of a character from Star Wars."

To which I mis-quote...
"No. Prove not. Woo. . . or Woo not. There is no proof."

A hypothetical contest: I will let you flip a coin and if it comes up heads, you win a prize. You can choose between these 2 coins:

1. The science-based medicine coin. This has been specially weighted to make it more likely to come up heads based on mechanical calculations. Among a variety of possible formulations, we picked a weighting that gave more heads than tails in 3 separate trials of 10 tosses each. Then, in a large trial of 1000 tosses, it came up heads 800 times.

2. The woo coin: This has been embedded with frequencies (that cannot be measured) that interact with the tosser's energy field (that cannot be measured) to make heads come up. I have a long list of people who have tossed this coin and wil tell you it came up heads. One time we tossed it 10 times and got 8 heads. We can't do a large trial because the coin interacts with the individual energy field and large trials are too expensive for natural coins.

Which coin do you pick?

By way of rejecting Ji's framing, I might add that, given medicine is done by humans, a 50/50 toss-up of a treatment is better than what quackery offers. Not just better, but orders of magnitude better.

By Composer99 (not verified) on 16 Nov 2012 #permalink

"an instrument of fascism ...compulsory ignorance and myopathy."
Does he mean an instrument of mitochondrial myopathy? Inflammatory myopathy? Hereditary myopathy? Metabolic myopathy?
I always knew that science was bad, but I never knew that it destroyed your muscle fibers!

By Ed Whitney (not verified) on 16 Nov 2012 #permalink

"The reasons, of course, are obvious; their preferred ideas about disease and modalities to treat it are not rooted in science."

Or might the reason be that they're in the sales and marketing business, not the practice of medicine business?

By Spectator (not verified) on 16 Nov 2012 #permalink

Sayer Ji sounds like the name of a character from Star Wars Firefly.

Fixed that for you.

By herr doktor bimler (not verified) on 16 Nov 2012 #permalink

The difference between woo and science is something like the story of the blind men and the elephant. Woo promoters are like the blind men of the story - they touch some small part of the elephant and assume they now know all there is to know about it, and while they may even get a tiny bit of truth, they have learned nothing useful, or true on a fundamental level. But those blind men were lazy. With a coordinated and systematic approach (and a very patient elephant) there is no reason they could not develop a reasonably accurate and useful model of an elephant.

By Old Rockin' Dave (not verified) on 16 Nov 2012 #permalink


the tosser’s energy field...

I see what you did there. :)

By Julian Frost (not verified) on 16 Nov 2012 #permalink

@ Ed Whitney:

He probably means 'myopia' but not being too familar with anatomy gets things mixed up.

@ BKSea & Julian:

Which tosser is that? There are so many in woo.

By Denice Walter (not verified) on 16 Nov 2012 #permalink

an organ and instrument of fascism
So asking someone for evidence before accepting their whimsy-based theory is "fascism"?
No wonder the Gestapo in the old movies are always shouting out "Show me your papers!"

By herr doktor bimler (not verified) on 16 Nov 2012 #permalink

Science is not a “brand,” a “possession,” an exclusive faculty of a caste of scientific elite, dispensed solely through monolithic institutions.

AKA another whiny wooster with something to sell and covets the requisite education he doesn't have.

By Science Mom (not verified) on 16 Nov 2012 #permalink

I think about "plausibility" in the context of the Moneyball post the other day.

Note that Oakland relied heavily on in-depth statistical analysis to determine the value of players. This has incorrectly been interpreted as them just using stats. It isn't true. Keep in mind that all the players they evaluated by using their statistical approaches were already identified as potential candidates for being major league baseball players. They didn't just randomly grab people off the street and have them bat. They required a plausible reason to expect that these people could succeed.

This is just like what happens with science based medicine. We don't test every possible cause X with every possible outcome Y. We actually require that there is some reason to think X will work, and then we do extensive study of potential major leaguers, not random people off the street.

By Marry Me, Mindy (not verified) on 16 Nov 2012 #permalink

Apparently, someone is pissed off at Orac’s post and say we’re all crank

Ah, good old Cliffy. I'd truly like to see the leash he's on as part of Wakefield's legal team.

Alain,That article is really rather sad, though it's nice to see that Cliff (or perhaps John) pays attention to Orac's writing.

Science Blogs Pseudo-Skeptics Crave Scientific Respectablity [sic] They Cannot Have

I've got news for you Cliff, we've already got scientific respectability, through study, qualifications and experience, and through agreeing on the whole with scientific consensus. It's you who is the blog equivalent of a lunatic shouting in the street.

By Krebiozen (not verified) on 16 Nov 2012 #permalink

@ herr doktor bimler:
Well, you know, the first thing the Nazis did was set up the Cochrane Database of Systematic Reviews!

By Ed Whitney (not verified) on 16 Nov 2012 #permalink

Curious that a supporter/ legal adviser of Wakefield who appears to accept Null's trumped up b#llsh!t should discuss respectability.

Alain, thanks for the link: it's a harsh world, we all need a laugh now and then.

By Denice Walter (not verified) on 16 Nov 2012 #permalink

It’s you who is the blog equivalent of a lunatic shouting in the street.

Careful, he may be forced to produce a graph showing that you've already ceased to exist.

You mean that's clifford miller? oooh, glad that Orac's post twisted his panties....


I finally recall about the child health blog as some random lunatic posting links and stories inline with AoA which I put in feedreader for entertainment value but then I did not know it was cliffy and stone :D. gotta keep an eyes on it.


@ Alain: Stone is associated with JABS...the anti-vaccine organization that referred autistic kids and their parents to Richard Barr (the lawyer who was fixin' to sue Merck for MMR autistic enterocolitis/the lawyer who paid Wakefield $ 750,000 USD for his *expert testimony* even before he saw the autistic kids). Richard Barr then sent the parents and their autistic kids to Wakefield.

Becky at "JABS Loonies" tracks Stone and the JABS crowd...


(I'm going offline now....catch you later)

...if their audience knows nothing they might be impressed with a parade of science-y sounding terms, although they are, to my ear, malapropised and mispronounced . Here’s a clue: if a person mispronounces “synapse”, “hippocampus” and “amygdala” and stumbles over “serotonin”, chances are he hasn’t studied physiology...

This reminds me of the time I thought I had completely finished headdesking over the various idiocies of the late L. Ron Hubbard. Then I heard a recording of him explaining our past lives out among the stars, and discovered this man who supposedly knew so much didn't know that "galaxy" is pronounced with the stress on the first syllable, not on the second.

Randall Munroe did a somewhat relevant XKCD comic about "frequentists vs. Bayesians" not too long ago. Usually Munroe hits the target dead-center; in this case I think he should have "unpacked" the analysis a bit more, so I'll take the liberty of presenting my own thought-experiment based on Munroe's scenario.

Suppose we have an instrument that is constructed to do just two things: a) detect a very, very rare event, one that only occurs with a frequency of 1/100,000,000; and b) report to us whether that event was detected or not, which it does accurately with a frequency of 99/100, giving a false positive the other 1/100 of the time.

If we were to get a positive from the detector, it would be ridiculous if we were to consider only the 99/100 accuracy of the reporting in trying to assess whether the underlying event had indeed really occurred. When you get a positive result and have to decide whether it's a true positive or a false positive, it makes no sense to decide that based on the fact that false positives are rare in comparison to negative reports. You have to consider the probability of a true positive to get any sort of realistic evaluation.

But that's pretty much what EBM-as-opposed-to-SBM does. The rare event every woo-monger wants to detect is their woo turning out to be 100% real and the foundation of a whole revolution of the entire medical field. The instrument for detecting it is the clinical trial, which actually does much worse in terms of generating false positives than our thought-experiment instrument that only produced false positives with p=0.01. It was silly in our thought experiment to consider ONLY the detector's low rate of false positives and NOT the underlying event's much, MUCH lower rates of true positives, but that's exactly what woo-sters do, and want us to do.

By Antaeus Feldspar (not verified) on 16 Nov 2012 #permalink

I have a question I know will sound rhetorical and hence trollish, but believe me, I am honestly trying to learn this and figure out how to apply it in debates with anti-vaxer acquaintances.

So here goes: Given that they can't do a large-scale "vaxed-vs-unvaxed" study for ethical reasons, what exactly is the basis for the reccomendation of the current vaccine schedule?

I feel like this is a sort of ultimate stumper but I know it isn't, so how can I answer that point?

@ Alain,

Seeing you raise the subject of people poking at science bloggers - while I don't rank up there with Orac (heh!), the local anti-vax group have decided in their "wisdom" to write an open letter aimed in part at me. It's mostly targeting Darcy, but they seem to want to rope me in for good measure:


It's a silly damn thing. They cite an article of mine, but I'd say they've not read it, as it actually has a paragraph explicitly asking readers to not hassle them and spells out that the focus of that article was on encouraging them to live up to what they claim to represent (‘informed choice’).

I’d try clarify this and other points on their Facebook page, but I'm not sure I'm able to comment there (no comment boxes are showing, yet others clearly are able to comment).

@ Grant,

Congrat for making it to the hall of fame :), I wish my tiny blog would live up to that standard. Someday maybe.

@ Antaeus Feldspar

I had a good introduction to bayesian probability theory but still, I tried to mentally parse your statistics and the context does not compute but still, I can see where you're getting at regarding clinical trial.


@ Antaeus:

It illustrates that they have never formally taken courses in the area in which they claim expertise. I have heard the same idiot -who also claims expertise in arts and letters- mispronounce the names of well-known artists and writers.
It is, needless to say, quite hilarious. Unfortunately his fans don't know the difference.

The fact that semi-literate idiots manage to find an audience seemingly hungry for information- although they're looking in the wrong places
- is encouraging to me. I think that his audience is trying to learn general information in science and arts in small,palatable doses. Adults work, have family responsibilities and worries and often can't take
a course at a local university so they seek information through the internet and find the marshy swamplands of unreason that I survey, treading carefully through the quicksand of alt media and foetid pools of vegetative,
intellectual detritus.

Sceptics' task involves pointing out the warning signs of quacks and cranks. Perhaps the great flashing road sign of bad information is warning the audience about how experts are not to be trusted: if it is an offiical organisation, governmental agency or mainstream media, it is automatically suspect. They usually follow with a long, conspiratorial novella that implicates all the aforementioned parties into an intricate plot.

Lately, alt media seems to talk more about the conspiracy to the neglect of so-called medical information.

By Denice Walter (not verified) on 16 Nov 2012 #permalink


I'm not a scientist, so can't offer a real answer. As a placeholder, it might be some of the following:
- One can compare an older cohort. e.g. study people born in 1950, 1960, 1970, and 1980 and their outcomes (who got what disease later) with those who did get z vaccine.

- Occasionally, populations do this study to themselves. There was a region controlled by fundamentalists (mulsims this time) who held that vaccines were a conspiracy and such, so they stopped polio vaccination. Shortly after that, there was a polio epidemic in exactly the area where vax was prohibited. Neighboring countries with the same living conditions did not have the epidemic.
You can get a better answer from someone who works in a related field.

By Spectator (not verified) on 16 Nov 2012 #permalink

@ Lenoxus: You could start here...to learn about the prevalence of each vaccine-preventable disease, before vaccines were developed and available.:


Then you could check each chapter of the current CDC Pink Book, which provides statistics (morbidity and mortality) for each vaccine preventable disease...before and after vaccines were developed and available:


And of course we have to deal with comments like this on other blogs

"I would say one would be remiss to suggest trusting the medical and pharmaceutical industry. They don’t have our best interests at heart. Their only goals are to keep you alive long enough to get all your money, and sell as many drugs as possible in the meantime. So the more drugs they can prescribe the better and not necessarily ones that actually help. Sadly, MANY people are unable to see that fact, and many have lost their lives due to that ‘trust’. Did you know that doctors and their drugs are the third leading cause of death in the US, killing over 22,000 people, 106,000 of those from *non-error* (in other words, correctly prescribed) negative effects of drugs, with another 7000 in medication errors.



There's more, but I'm just to appaled to quote the rest.

There’s more, but I’m just to appaled to quote the rest.

I'm not. Here's some more,


Or if it’s an ‘auto-immune’ disease, usually there are parasites involved. The body isn’t attacking itself, it’s attacking the parasites which the medical industry doesn’t seem to recognize or even acknowledge.

They, like us, are trained to think we wonderful 1st worlders are somehow immune to having parasites, although we don’t do anything to divest ourselves of them. That’s what the cod liver oil and caster oil were for, in the more recent past. To kill parasites.

Nowadays with all the toxins accumulating in our bodies, it allows parasites, like the pancreatic sheep fluke, to live their entire life cycle in the human pancreas, instead of having to go back to the sheep for some of it. Hence the upsurge in diabetes, which I’ve gotten rid of thru deparasiting and detoxing. So, here we go even further outside the ‘medical industry’ propaganda.

If the eye condition persists even after the rue-fennel, you might consider doing a parasite clease. I can send you information about a good one if you want, or you can reference Dr. Hulda Clark’s work although you might have to google her using the word zapper, since most search engines have her name blocked.

Diabetes is caused by parasites? So, if she didn't have an accumulation of toxins, would her parasites migrate, emerge from her body to go feed off some sheep, only to return later?

The really sad part about her claims is that there are licensed doctors teaching(selling) patients this garbage. I still don't quite understand how such apparent malpractice is being tolerated to the degree that it is allowed to continue. I note an increase in antiscience awareness and it's negative impact on the practice of medicine. I only hope that enough of this awareness makes it way to the patient population, as the more ill patients are oftentimes unable to follow the media and blogosphere.

Yipes! That stuff you are reading will rot your brain.

Thanks for the laughs.

Just a note for those who didn't go to the source link for the quotes above - the comments were not made by the lovely and talented Ms. Cherryh herself, but by someone with they 'nym "Dragonrider Gal".

By Mephistopheles… (not verified) on 17 Nov 2012 #permalink

Yipes! That stuff you are reading will rot your brain.

Thanks for the laughs.

@lilady, you better get on the ball then, 'cause there are docs in your home state teaching patients this garbage. :-) Your work is never done, but it much appreciated nonetheless. I know you understand this, but as far as the laughs, it's not so funny when you're the patient and finally realize how misled, exploited and endangered you had become.

IAS and Cherryh remind me of this quotation:

“Two things are infinite: the universe and human stupidity; and I'm not sure about the universe.”
― Albert Einstein

By Krebiozen (not verified) on 17 Nov 2012 #permalink

the comments were not made by the lovely and talented Ms. Cherryh herself, but by someone with they ‘nym “Dragonrider Gal”.

Yah, and I'm thinking the Myspace (really?) version is one and the same. This one is firing on all crank cylinders.

cod liver oil ... To kill parasites.
Vitamin D kills parasites? Good to know.

By herr doktor bimler (not verified) on 17 Nov 2012 #permalink

@herr doktor bimler:
"cod liver oil … To kill parasites.
Vitamin D kills parasites? Good to know."
I dunno - it's fashionable among woo-titioners to take Vit D in megadoses, and they don't seem to be dropping dead more often.
Also, does anyone know if cod get liver parasites?

By Old Rockin' Dave (not verified) on 17 Nov 2012 #permalink

To answer my own question, according to this Wikipedia article (https://en.wikipedia.org/wiki/Anisakis), "The areas of highest prevalence" of anisakiasis spreading to humans from consuming fish "are Scandinavia (from cod livers)..."
So cod liver oil can't even kill parasites in cod livers; another woo bites the dust.

By Old Rockin' Dave (not verified) on 17 Nov 2012 #permalink

So cod liver oil can’t even kill parasites in cod livers; another woo bites the dust.

Excellent! You guys are sharp. This is why I love this blog.

Marvel at this:
you can reference Dr. Hulda Clark’s work although you might have to google her using the word zapper, since most search engines have her name blocked.

The vast conspiracy to suppress Clark's parasite / cancer discoveries include Goggle &c, who are blocking her name, but as always with cartoon supervillains they have left an elementary flaw in their scheme, by neglecting to block the name of the discovery itself.

By herr doktor bimler (not verified) on 17 Nov 2012 #permalink

Needless to say, you can zap right on over to Google and turn up lots of wonderfulness by searching Hulda Clark - including the first four websites on the search list, which are pro-Clark.

Codex is all-powerful, but the Powers Of Clark are even mightier.

I'm still working on my unauthorized biography of Hulda. Possible titles: "No Fluke: The Hulda Clark Story" and "Batteries Included".

By Dangerous Bacon (not verified) on 17 Nov 2012 #permalink

I have an online acquaintance who has been using her zapper for 13 years. She is so delightfully whacko, I gotta love her. 13 years, daily!! Do you think her oncologists surgery and chemotherapy might have cured her, or that the vaccine clinical trial she was in may have played a role? no, no, it must be the zapper or the flax and cottage cheese diet.

"...Did you know that doctors and their drugs are the third leading cause of death in the US, killing over 22,000 people, 106,000 of those from *non-error* (in other words, correctly prescribed) negative effects of drugs, with another 7000 in medication errors.…”

Does this part of the quote not add up, or is my arithmetic bad?

...22,000 people killed...106,000 of those from non-error...another 7,000 from medication errors...?

Or is this just an example of Woo-based arithmetic? :)

Or, are the evil medico-industrial complex's errors so heinous that 22,000 of those deaths are actually equal to 113,000 (106,000 + 7,000) regular deaths? :)

Needless to say, you can zap right on over to Google and turn up lots of wonderfulness by searching Hulda Clark – including the first four websites on the search list, which are pro-Clark.

I find that if I include "zapper" with "Hulda Clark," these search results are somewhat different in sentiment.

I find that if I include “zapper” with “Hulda Clark,” these search results are somewhat different in sentiment.

The Google software probably thinks you have misspelled the name of the musician.

By herr doktor bimler (not verified) on 17 Nov 2012 #permalink

Thanks, Spectator and lilady. I'll be sure to check those out. One problem is that anti-vaxers often get schizoid about this, presenting different arguments in different contexts -- they act like "vaccines" in general are unsafe, but when it comes to something like polio, they know their only real argument for what happened to the disease is one that sounds insane to most people, namely, a conspiracy of deliberate misdiagnosis. (Or, that it went away on its own or something.) So they simply move the goalposts — of course the polio vaccine worked, duh, we're not stupid. It's all these "new, untested" ones that are bad.

Then what they ultimately ask for is a large-scale "vaxed vs unvaxed" study to demonstrate that the new ones work. I sometimes unthinkingly wonder if it would be a good thing because it would ultimately result in more kids getting vaccinated — but I know perfectly well that in reality, no study with a "pro-vaccine" result would get listened to by these folks, so all that would happen is more kids dying for no particulary good reason. Argh.

@ Lenoxus: A vaxed-vs-unvaxed study is unethical, but we know from epidemiology studies of measles outbreaks, that deliberately unvaccinated children are the indexes cases. And, they transmit measles to other deliberately unvaccinated kids and babies who are too young to have received the MMR vaccine.

Here's one of Orac's posts on Dr. Bob Sears' patient who was the index case in a San Diego measles outbreak:


Here's the MMWR about the measles outbreak 2011, Minneapolis where the index case was a Somali youngster who was deliberately unvaccinated. The "back story" in this outbreak is that Andrew Wakefield met with Somali parents at least two times (that we are aware of), before the outbreak...and one additional time during the outbreak...to advance his latest *theory* of higher prevalence of autism within Somali populations, following MMR immunization.


A while back, Vox Day made a similar case; his argument amounted to saying "Even with the most rigorous efforts not to allow human frailties to lead to error, error still sometimes occur. The obvious solution: Give up rigorous error-checking...

I was thoroughly convinced by his logic - not.

I don't know if I've ever stated this - I'm an IT worker in the health industry. Of all the projects I've been involved in over the years, one I'm most proud of has been working with an orthopaedic clinic, working with older fracture patients, who were trying to prevent/alleviate osteoporosis in older patients. My role was to develop a database to help them manage treatment and track outcomes.

One of the most significant outcomes they have shown? That well-formulated calcium, magnesium and vitamin D supplements have a significant role in alleviating the possibility of further fractures in many patients with the early stages of osteoporosis. Doesn't do as much for advanced osteoporosis, but even there the supplements have a role.

And SBM completely rejects vitamins and minerals in the management of disease. Riiiight.....

By Christine (the… (not verified) on 18 Nov 2012 #permalink

Christine (tpsC),

You wrote: “And SBM completely rejects vitamins and minerals in the management of disease. Riiiight…..”

Vitamins, etc., are used in treatment of disease - objections are usually to claims of benefits for those that do not have deficiencies or to anecdotal claims as ‘evidence’ in support of dubious remedies.

The example where Orac mentions vitamins in his article was referring to the latter point, which is different to what you're pointing at. In his example, his point was not if they are used or not, but that anecdotes about ‘treatments’ using whatever (count vitamins, minerals in) don't cut the mustard as evidence.

Is it just me, or does anyone else hear the band Boston when they read the title of this post?

By Mephistopheles… (not verified) on 18 Nov 2012 #permalink


Christine is being facetious. :)

By Composer99 (not verified) on 18 Nov 2012 #permalink

Grant - agree with you completely. I didn't express myself very clearly. When people start touting megadoses of vitamins as the Great Cure-all, I run away very quickly.

By Christine (the… (not verified) on 18 Nov 2012 #permalink

Grant, I think Christine's point was that claims of SBM completely rejecting vitamins and minerals in the management of disease are shown to be false by the project she references, which is SBM investigating the hypothesis that certain vitamins and minerals can indeed materially affect the course of a disease - not just investigating the hypothesis but accepting it to be true when rigorously collected data supports it.

I could be wrong; I had to puzzle over it a while trying to figure out if Christine's summation was sarcastic or sincerely meant.

By Antaeus Feldspar (not verified) on 18 Nov 2012 #permalink

I think the problem is, SBM is very clear that vitamins and minerals have an important role to play in health management. But it's not the be-all and end-all that alt-medders claim. And because of this, alt-medders will insist SBM rejects the use of vitamins and minerals completely.

By Christine (the… (not verified) on 18 Nov 2012 #permalink

Antaeus - I was not being sarcastic - I am still very proud of my limited involvement in that project, because I was able to give the nurses running the data they needed to prove their hypothesis (about the managed use of calcium, magnesium and vitamin D suppliements, along with other treatments, in preventing re-fractures). Their clinic model is now being rolled out to other hospitals because it's been shown to be so effective.

By Christine (the… (not verified) on 18 Nov 2012 #permalink

Erp, sorry.

I find most of us aren't too good at conveying tone in short-form writing, like blog comments. (Me, neither.) I'm also lousy at reading it, I guess.

By contrast, I guess, there are some who are so naturally gifted with it, and prolific with it, that it's hard to know when they are being sincere! :-)

Christine - good to hear your work is being put to effect. I suspect it's a pet frustration of many researchers that their output is limited to academic impact.

@Grant: no probs. I re-read what I wrote and realised I hadn't expressed myself clearly. There's another point I should make: the nurses knew they weren't making any ground-breaking discoveries by saying calcium would prevent re-fractures. What they wanted to do, was put in place a program to target people at risk of re-fractures (such as menopausal women) and encourage them to follow strategies that would prevent them from having re-fractures, but they needed to convince the hospital administration of the need for such a program. And my little bit of work gave them the data they needed to make their three-month trial clinic a permanent clinic which then got rolled out to other hospitals in our area, and is now being used as a model for similar programs across the state.

To go back to my general point: an alt-medder would look at the finding that taking calcium, magnesium and vitamin D reduces the risk of re-fractures in some patients and say "I've got the cure for osteoporosis! YAY!!!!!" And then, when the recommended dose doesn't work for everyone say "all you have to do is increase the dose and you'll still cure osteoporosis!! YAY!!!!!!!!!!!!" Whereas SBM recognises that calcium, magnesium and vitamin D REDUCES the risk not eliminates the risk, and for some patients other strategies will need to be employed to effectively prevent re-fractures and manage osteoporosis.

By Christine (the… (not verified) on 18 Nov 2012 #permalink


“an alt-medder”

Surely an alt-meddler ? :-)


To go back to my general point: an alt-medder would look at the finding that taking calcium, magnesium and vitamin D reduces the risk of re-fractures in some patients and say “I’ve got the cure for osteoporosis! YAY!!!!!”

They also ignore the evidence that calcium supplements are associated with a far higher risk of cardiovascular events (PMID: 22626900) than Vioxx for example(PMID:15809459). On Planet CAM supplements are never associated with adverse events and evil pharmaceuticals always are.

By Krebiozen (not verified) on 19 Nov 2012 #permalink

My point is that SBM recognizes the need to balance benefits against risks where CAM either denies there are any risks (supplements) or that there are any benefits (drugs).

By Krebiozen (not verified) on 19 Nov 2012 #permalink

There's an interesting article on weighing the risks and benefits of calcium supplementation @ WebMD ( Denise Mann; April 2011): you need to look at whether you have CV risks ALREADY vs having more risk of breaking bones. Also, starting high dose calcium abruptly might also be associated with CV events.
-btw- one of my myriad cousins is precisely in this boat: mild osteo and moderate risk due to heart valve issues ( guess what that came from) .

By Denice Walter (not verified) on 19 Nov 2012 #permalink

Topics such as this underscore, I think, a big contrast between the science-based & sCAM approaches to medicine (insofar as sCAM can be called medicine, which really it can't).

- understands nuance
- understands complexity & complication
- undertstands comparative cost/benefit analysis

- alternates between over-simplified, dichotomous reasoning (Vioxx BAD!! megadose supplements GOOD!!) on the one hand and overly relativistic reasoning on the other (science is 'just another way of knowing')
- ignores cost-benefit accounting by counting only costs in some cases (Death By MEDICINE!!!) and benefits in others (Power of PLACEBO!!)

By Composer99 (not verified) on 19 Nov 2012 #permalink

@ Composer99:

Woo, by cutting out information that doesn't make its case, confines adherents' thinking to simplified black-and-white choices: I think that this derives from alt med's origins in advertisement. In the end, your choice is ultimately a dichotomy: do I follow this advice or not?; woo circumvents the arduous process of weighing information and making choices based on many factors by eliminating essential information used in decision-making.

I haven't yet run across woo-ful explanations of the calcium data- they're probably just say pharma fixed the data so they could sell more pills.

By Denice Walter (not verified) on 19 Nov 2012 #permalink

I'm not surprised overdoses of calcium (hypercalcemia) could cause cardiovascular issues, since I remember that case of chelation causing death by heart attack due to hypocalcemia. If a sudden shortage can cause problems, it's not a stretch to imagine an overdose causing related problems.

Ended up looking at Wikipedia's entry on calcium, since I got curious about calcium's role in heart function. Also read one interesting bit:

Several sources suggest a correlation between high calcium intake (2000 mg per day, or twice the U.S. recommended daily allowance, equivalent to six or more glasses of milk per day) and prostate cancer.[26]

Yeah. Imagine the supplement manufacturers would avoid mentioning that sort of thing if they're allowed to get away with it. Nutrition woos would be in outright denial, since the altie black-and-white thinking doesn't acknowledge that there can be too much of a good thing.

By Bronze Dog (not verified) on 19 Nov 2012 #permalink

A great reference for vitamins, minerals and dietary supplements is the NIH Office of Dietary Supplements Health Professional Fact Sheets:


I experienced "tingling" while donating platelets during platelet apheresis procedures...quickly remedied by the blood donation center's staff, feeding me chewable calcium tablets:


"When I donate platelets, I sometimes feel a little tingling sensation. Why?

The anticoagulant used in the apheresis donation process will temporarily bind with the calcium in your blood. As your body adjusts to this temporary binding, you may feel some tingling. Donors are highly encouraged to inform a staff person if this sensation occurs. Staff may adjust the equipment, and/or supply a calcium supplement to help ease the tingling. Additionally, increasing your calcium intake a day or two prior to donation may help you feel more comfortable."

Bronze Dog -- as a person with GERD, that scares me a bit. I don't have to worry about my prostate, as being female I don't have one, but I have definitely had days where I took over 2000 mg of calcium in the form of Tums. That's basically two of the ultra-strength tablets, and I've had days where I needed a bunch of them. Especially when I was pregnant. (Lord. I was sleeping upright and basically eating Tums like candy.) And drank milk, and had cheese..... I'm on Prilosec, which has definitely changed my life. I love that stuff. Still occasionally need Tums, though. Especially if I get a GI infection. Diarrhea definitely reduces the effectiveness of that stuff, as it gallops through the system.

I did read about how, before the invention of the H2 inhibitors and then the proton-pump inhibitors, there was experimentation with treating erosive esophagitis (a major complication of GERD, the only present treatment for which is to control the reflux long enough to let the esophagus heal) with massive doses of calcium carbonate for I think a couple of weeks. It worked, but they did have some nasty side effects, and I think there was even a death or two. I believe this was way, way more than 2000 mg, though.

By Calli Arcale (not verified) on 19 Nov 2012 #permalink

OT Doctor Who reference:

lilady, I couldn't help, when reading your post, thinking of the antibodies on the Tesselecta in "Let's Kill Hitler":

"Please remain calm as your life is extracted. You will feel a tingling sensation and then death."

By Calli Arcale (not verified) on 19 Nov 2012 #permalink


"alt-meddler" - love it! If I had a dollar for every alt-meddler who's tried to push me onto the latest superfood/weird bacterium pill/whacko diet with the promise it would cure my Crohn's Disease, I'd be supping fresh-ground, fresh brewed Turkish coffee at a resort somewhere rather than instant coffee out of a jar.

By Christine (the… (not verified) on 19 Nov 2012 #permalink

@Christine (the public servant Christine)

I’d be supping fresh-ground, fresh brewed Turkish coffee at a resort somewhere rather than instant coffee out of a jar.

Either that or putting fresh-ground, fresh brewed Turkish coffee up your butt at a clinic in Mexico :)

By Militant Agnostic (not verified) on 19 Nov 2012 #permalink

@Militant Agnostic:
If an alt-meddler suggested I do *that* with really good Turkish coffee, I would be serving a prison sentence for assault. Ye gods, I have enough problems with people telling me colonic irrigation would cure me! How sticking a pipe up my butt and pumping water up there is supposed to help heal an inflamed illeum is a question I've never had answered.

By Christine (the… (not verified) on 19 Nov 2012 #permalink


The anticoagulant used in the apheresis donation process will temporarily bind with the calcium in your blood.

That would be citrate; binding calcium is how it actually works as an anticoagulant.

That reminds me of the early days of liver transplantation when we would do blood tests during surgery. Because the patients bled so much, having liver failure and essentially no clotting factors, they were massively transfused during surgery. The blood bank guy would get very grumpy when the word went out that a liver transplant was imminent, knowing his stocks were about to take a big hit. I have never seen so much blood as during the one liver transplant I witnessed back then, and since I have worked with blood all my life that's saying something.

Because only patients at death's door with liver failure were considered suitable for liver transplant back then they weren't terribly successful, whereas they are done much earlier these days with much better outcomes.

Anyway, since the transfused blood was anticoagulated with citrate, our normal calcium analyzer which measured total calcium was useless - there's little use monitoring chelated calcium that is not bioavailable so we had to get in a nifty ionized calcium analyzer to measure the unchelated ionized bioavailable fraction.

By Krebiozen (not verified) on 19 Nov 2012 #permalink