Respect my authoritah on "integrative medicine"!

David Katz doesn't much like skeptics, particularly those of us who question the value of "integrative medicine." In fairness, I can't say that I much blame him. We have been very critical of his writings and talks over the years to my criticism of his statement advocating a "more fluid concept of evidence" more than once, to my pointing out that his arguments frequently boil down to a false dichotomy of either abandoning science or abandoning patients.

Last week, my friend Jann Bellamy discussed an unfortunate special supplement of the American Journal of Preventative Medicine (AJPM) entitled Integrative Medicine in Preventive Medicine Education. This supplement included articles summarizing the results of project called IMPriME (Integrative Medicine in Preventive Medicine Education), funded by the Health Resources and Services Administration (HRSA), to advance the inclusion of "integrative medicine" in Preventive Medicine residency programs. Not surprisingly, this project was led by Dr. Katz. Jann used this special issue as a jumping off point to show, quite correctly, how, when it comes to so-called "integrative medicine," it is always about the "potential," which has always been elusive and has never been realized. Unfortunately, the elusiveness of the amazing potential attributed to "integrative medicine" (formerly referred to as "complementary and alternative medicine" or "CAM") has done almost nothing to dampen the ardor of its cheerleaders for "integrating" as much woo as they can into medicine, which is why a major journal would allow someone like David Katz to edit a special issue dedicated to articles discussing IMPriME's findings.

It appears that Dr. Katz is most displeased with Jann, to the point that he felt the need to lash out at her and all skeptics who question his greatness. To express his displeasure, he has rattled off a little rant over at his usual non-academic hangout and quack-friendly Internet outlet, The Huffington Post. There, he castigates us with a post entitled Science and Medicine, Fools and Fanatics: The 'Fluidity' of Woo. Yes, right off the bat, it's the same old strategy, to paint advocates of "integrative medicine" as the "reasonable" ones while those of us who object to integrating prescientific quackery into medicine are clearly the "fanatics" (or, if you prefer, the fools). In it, as usual, Dr. Katz lays down some real howlers in defense of his integration of woo with medicine.

David Katz’s bragging reminds me of the threat display of Chlamydosaurus king, or the frilled-neck lizard, except that his neck frill consists of pages of his CV. David Katz’s bragging reminds me of the threat display of Chlamydosaurus king, or the frilled-neck lizard, except that his neck frill consists of pages of his CV.

 

Respect my authoritah! I'm a real scientist, dammit!

Many species of animals (humans included) engage in various agonistic behaviors. One form of such behavior is known as threat display and consists of the animal doing something to show its strength or make it look larger and more dangerous in order to intimidate potential opponents and thereby win without having to fight. For example, when threatened the frilled-neck lizard engages in an impressive display in which it raises its body, gapes its mouth to expose a bright-colored yellow lining, and spreads out its frill showing bright orange and red scales. It's a reaction used to assert territory, intimidate predators, and impress females. Male gorillas howl and beat their chests to accomplish the same goals. The way Dr. Katz starts his article reminds me very much of an academic equivalent to the display of the frilled-neck lizard in the way he puffs himself up and tries to assert his academic dominance over us by showing us his science bona fides. Substitute the pages of one's CV for the impressiveness of the neck frills, and you get the idea.

Boasting how he was a "logical choice" to lead IMPriME and clutching his pearls mightily at the very thought that mere peons like us would have the temerity to criticize such an initiative led by such a bold visionary as himself, much less l'il ol' us, Dr. Katz sarcastically noted, "Predictably, no sooner had the electrons announcing this settled into the Medline index, than the clique calling itself 'Science-based Medicine' weighed in, with customary disparagements," before puffing up the frill on his neck thusly:

That this suggestion [of a more "fluid concept of evidence"] was parlayed into allegations of quackery, or flirtations with it, has always amused me when it hasn't annoyed me, and struck me as absurd in every way. For one thing, I make for quite a bad quack. I have run a federally-funded clinical research lab for nearly two decades. My colleagues and I have contributed nearly 200 peer-reviewed papers to the literature, some few of which demonstrate the utility of certain "alternative" medicine modalities, some few of which suggest the futility of others. Along the way, our efforts spawned a novel technique, called evidence mapping, later adopted by the World Health Organization for other applications, which showed the variability of evidence underlying the domain of so-called "complementary and alternative" medicine.

My passion for science is rather an open book, as are my musings on what "holistic" medicine is, and should be. Speaking of books, I have authored one textbook exclusively about evidence-based medicine and its relationships with both research methods, and clinical decisions; and multiple editions, in the company of colleagues, of an epidemiology text much devoted to that same domain. I will protest no further in that regard.

Lately, Dr. Katz seems to begin his rebuttals to any criticism of his advocacy for integrating quackery with medicine this way, with an appeal to authority—his authority. Yes, Dr. Katz. We get it. You're freakin' awesome! You're so much more a real scientist than any of us because of your couple hundred publications, your federal grants, and your "passion" for science. (Or so you say.) In contrast, what have I to offer, a mere peon with only one federal grant at present for a preliminary study and a fraction of the number of publications? Heck, I'm not even a full professor yet (although, barring any unforeseen glitches in the process, that situation should be rectified by spring). All I can offer are science, critical thinking, and snark, in that order. Fortunately, for arguments as bad as David Katz's, they are more than enough. After all, it is the quality of evidence, science, and argument that matters. That’s why I rarely dwell long (if I mention them much at all) on my own qualifications, even when I’m writing about topics that fall under the purview of my specialty that I might reasonable be considered to be an expert in, such as screening mammography. As I've said before, doing so is just…unseemly to me. In my experience, it's almost always an indication that the arguments to come will be weak. Even if the experience that leads me to that rule of thumb is mostly confirmation bias, Dr. Katz's article does nothing to counter that experience.

Besides, given the rise of quackademic medicine, defined as the infiltration of quackery into academic medical research and practice, coupled with the existence of the National Center for Complementary and Integrative Health (NCCIH), formerly known as the National Center for Complementary and Alternative Medicine (NCCAM, a much nicer abbreviation), having federal grants and publishing a couple of hundred papers are no guarantee of being quackery-free.

Basically, here Dr. Katz is telling us, like Cartman on South Park, to respect his authoritah. Don't get me wrong. I do respect academic authority. I'm just not overawed by it. I also don't think it's wrong to appeal to the authority of someone like Paul Offit on vaccines as a shorthand for having to go through all the evidence. What I respect far more than authority, however, are science, critical thinking, and compelling arguments. It bothers me little or not at all that I'm frequently attacked for not having being a "real" expert in scientific disciplines I discuss, and it's usually not even other physicians doing it but lay people with no training in those disciplines themselves. In other words, David Katz needs to spend more time burnishing his arguments and less whining about upstarts who dare criticize his genius.

Starting with a reasonable premise and then using it to justify pseudoscience

To be fair, Dr. Katz does make a couple of reasonable points. The problem is that, as he has done so often in the past, he takes those points and drives right off the cliff of woo with them. For instance, Katz's infamous 2008 quote about resorting to a "more fluid concept of evidence" would have sounded a whole lot less quacky if he hadn't yoked it to a patient anecdote in which he took the advice of naturopaths and referred the patient to them, where he was treated with homeopathy, The One Quackery To Rule Them All, using the anecdote to illustrate why he thinks physicians must be willing to use that more "fluid concept." It would also be less objectionable if he didn't also construct a false dichotomy wherein if a physician is not willing to consider pseudoscience like homeopathy when he reaches the end of what science-based medicine can do for a patient, then he is "abandoning" the patient.

Referencing one of the articles he wrote for the AJPM supplement he edited, Dr. Katz argues:

Moving on to the "fluidity" that has proven such a diverting target for the slings and arrows of my science-based colleagues, what did I mean? Well, that, too, is a matter of the published record -- previously, and again in the new compilation in AJPM. Colleagues and I proposed, based on years of wrestling with complex patients, many of whom, urgent medical needs still insufficiently addressed, had tried and exhausted all of the well-supported, conventional treatments, that evidence traversed 5 key considerations. Those include: what is known about a treatment's safety; what is known about a treatment's efficacy; how well those first two are known (i.e., the clarity of evidence); the patient's preferences; and, importantly, the availability of other, untried treatments for the condition in question.

It's hard to argue with too much of this; that is, up to a point. This is the sort of thing that science-based medicine does all the time, particularly with rare conditions for which gathering "gold standard" randomized clinical trial evidence for treatments is difficult or even nearly impossible. It's also the sort of thing science-based medicine does all the time with pretty much every patient for which science-based treatments might be lacking or far less than ideal. It is not Katz's contention here about the "fluidity" of science that is the problem. Clinicians who wrestle with complex patients on a daily basis are more than familiar with such questions, to the point that Katz's argument above is basically trivial. Besides, it's not the point above that we object to; it's how it's used to justify "integrating" quackery like homeopathy into science-based medicine.

For instance, Katz then writes:

One need not be a clinician, wrestling with especially challenging patients or otherwise, to see the relevant spectrum of decisions. Whenever a treatment option is unsafe, ineffective, unclearly supported by evidence, unpreferred by the patient, and/or surrounded by other, ostensibly better treatments for the same condition -- it is time to move on, be that treatment a product of tree leaf, or test tube.

Who could disagree with this? Certainly not me. Well, not quite. Here's one problem. Katz clearly doesn't move on when a treatment is clearly unsupported by the evidence; e.g., homeopathy. Here is a physician who, as I keep harping on, used the "fluidity of evidence" as the justification for sending a patient to naturopathic quacks and letting them treat him with The One Quackery To Rule Them All. Here is a man who is quite comfortable working with naturopaths, whose specialty is a cornucopia of mutually contradicting pseudosciences and quackery.

Also, notice the last two conditions, if the treatment is "unpreferred by the patient, and/or surrounded by other, ostensibly better treatments for the same condition," then it's time to move on. As I've said time and time again, a competent adult can choose or refuse any treatment he or she wants, but if a patient refuses a validated science-based treatment modality it is not a valid justification for a physician to use quackery. Similarly, the lack of "ostensibly better treatments" for a condition is also not an excuse to invoke quackery. Yet that is exactly what Katz does, although he denies it to high heaven. For instance, look at this table from the article he references (click to embiggen):

Katz Table

Again, this sounds superficially reasonable. The problem comes in how CAM/integrative medicine enthusiasts define the word "possible" under the Efficacy column and the word "unclear" under the Science column. Once again, the science for homeopathy is not "unclear," nor is its efficacy "possible." For instance, later in the paper, Katz argues:

Recent outcomes research on models (or “whole systems”) of integrative care32, 33, 34, 35, 116, 117, 118 demonstrate promise and innovation, as well as potential cost savings,8, 119 despite a lack of large-scale funding160, 161 and methodologic challenges.162, 163, 164

I note that most of the "whole systems" references cited by Katz refer to naturopathy and traditional Chinese medicine. As before, I point out that naturopathy is not only a cornucopia of quackery but that homeopathy is part of naturopathic training to the point of being included on the naturopathy licensing examination (NPLEX), and that what we now refer to as "traditional Chinese medicine" is the result of a rather cynical retconning of Chinese folk medicine by Chairman Mao Zedong in the 1950s. Indeed, 150 years ago, acupuncture was indistinguishable from bloodletting.

In which Dr. Katz lights a straw man about medical plausibility on fire

As you can see above, if your criteria for determining whether the science is "unclear" or the efficacy of a treatment is "uncertain" are lax enough, you can use Dr. Katz's criteria to justify trying almost anything on a patient. Faith healing, anyone? Reiki? Well, it turns out that Dr. Katz does not accept that energy healing modalities are incredibly implausible. In what has to be the most embarrassing passage in the entire article (at least I'd be embarrassed if I had written it), Katz declares:

What is most fascinating and relevant about [E.O.] Wilson's account is not the technology that is now revealing to us realities to which we were insensate before: colors we could not see; sounds we could not hear; energy fields we could not feel. What is most compelling is that all of these ARE perceivable to biology, just not OUR biology. There are animals that see colors we can't; animals that hear sounds we can't; and animals that feel one another's electromagnetic fields. This, of course, is not woo; it is established biological fact.

The sounds, the colors, and the fields exist; and biologies other than our own can access them. Given, then, the range of human aptitude -- from Helen Keller to the Rain Man; Michelangelo to Mozart; Edison to Einstein -- are we truly prepared to say that no human being could possibly perceive the energy field produced by our bodies? Are we prepared to know in the absence of evidence that no such person endowed with a heightened sensitivity blunted in the rest of us, could interact with the energy field produced by a body in close proximity?

My radical version of alleged woo is captured in my answer to these questions: no. I simply don't know what we don't know. No one else does, either. No one else, that is, save fools and fanatics.

This is a straw man so massive that the heat derived from burning it could be used to generate electricity for the world for decades, much like Katz's hot air boasting about his credentials. No one says that it's impossible that a human being might be able to perceive energy fields. We say that it is incredibly improbable based on what we know about the basic sciences of biology, physics, and chemistry. It's the same reason that I never quite say that it's absolutely impossible that, for example, radio waves from cell phones might influence the development of cancer. I just know, based on cancer biology, chemistry, and physics, that it is so incredibly implausible that radio waves cause cancer, of the brain or breast or other organ, that it is reasonable, barring new evidence, to provisionally treat it as impossible. It is then up to believers like Katz—and, make no mistake, he is a believer in CAM, his protestations of being all about the science notwithstanding—to provide the evidence that a phenomenon like humans who can detect and manipulate other humans energy fields actually exists. It would also help if they could actually demonstrate that a human energy field, of the sort claimed to be manipulated by energy healers and TCM practitioners, actually exists, which they can't. Given that, for example, for homeopathy to be true huge swaths of conventionally understood physics and chemistry would have to be radically rewritten, there would be many Nobel Prizes involved in such a discovery. The same is true of energy healing. Why hasn't the evidence been found? Could it be because this phenomenon doesn't occur?

At this point, it is obligatory, and rightfully so, to show that the hypothesis that a human being can detect another human's "energy field" is rather trivial to falsify, so trivial that even a 12-year-old girl can do it.

Science doesn't know everything, and skeptics criticizing woo are akin to the Spanish Inquisition

Circling back to Jann's article that so riled Dr. Katz up in the first place, I note that her central idea was that, because so much of CAM and "integrative medicine" is based on pseudoscience and quackery, there is little or no evidence of its efficacy for the indications claimed, which leaves its apologists nothing but pointing to the "potential" of CAM. Flowing naturally from that central idea is the observation that that "potential" has never been realized—and almost certainly will never be realized—because there's no "there" there. CAM is all either pseudoscience or the co-opting and rebranding of perfectly science-based disciplines like pharmacognosy or "nutrition" as being somehow "alternative," so whatever "potential" CAM might have would come from such rebranded treatments as being CAM rather than medicine. Even then, the results have been disappointing, claims that the recent Nobel Prize in Medicine somehow "validates" traditional Chinese medicine notwithstanding.

So what someone who declares himself "passionate about science" to do when science doesn't support his view on medicine? Easy! Pull the "science doesn't know everything" gambit (a.k.a. an appeal to future knowledge or an appeal to future vindication) by comparing yourself to great scientists of the past whose discoveries overthrew old scientific paradigms:

That the proposition -- the fluid nature of evidence, and more importantly science, should be respected -- is contentious in the first place is, frankly, bizarre. I trust I am reliably conjoined to my science-based confrères (they are, in fact, male predominated so far as I know, and whatever that implies) in noting that the greatest of scientific minds -- Einstein and Hawking and Newton; Darwin and Dawkins; Copernicus and Galileo and Herschel -- were exceptionally devoted to the fluidity of science. They have, and in some cases still do, challenge the conventional understanding. They respect what we know, and how we know it, but humbly concede the potential for it to change as new evidence accrues.

This is, of course, another massive straw man. Perhaps Dr. Katz could point me to a passage—any passage!—in the entire nearly eight year history of this blog that could be construed as saying that science isn't fluid or that there are findings in science that are absolute and not subject to change. I can't find it. However, there are some parts of science that are—shall we say?—more fluid than others. Out near the "cutting edge" of science, findings and understandings are very fluid; back towards the core, less so. In other words, it's a lot less likely that central laws, such as the three laws of thermodynamics, will be overthrown than it is that more recent and tenuous findings will be. Science is not a monolith. Besides, major paradigm shifts build on the old; they seldom completely replace it. My favorite example of this is how the theory of relativity supplanted Newton's laws. Of course, it didn't really supplant Newton's laws, but rather improved on them. Newton's laws are, in fact, still used for most calculations of motion used in aeronautical engineering because relativistic corrections are not necessary until velocities reach a fraction of the speed of light sufficiently large to exceed the precision required for a task. Basically, at most speeds that humans can observe and use, the theory of relativity reduces to Newton's laws. That's how science works.

Unfortunately, for something like energy healing or homeopathy, both of which Katz has advocated, new science much more revolutionary than the theory of relativity replacing Newton's laws would be required to make them plausible. Barring that, Katz's likening CAM investigators to Einstein, Hawking, Copernicus, et al is risible at best. Apparently, Katz views himself and his fellow integrative medicine enthusiasts as scientific groundbreakers who are unappreciated. I'm reminded of what Carl Sagan once said: "The fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright brothers. But they also laughed at Bozo the Clown." I'm surprised at this point that Dr. Katz was able to restrain himself from using Arthur Schopenhauer's dubious quote about how "all truth passes through three stages."

Of course, it's not enough to appeal to "science doesn't know everything" and imply that someday Katz and his fellow CAM enthusiasts will be viewed as scientific pioneers (a.k.a. the fallacy of future vindication). They must also paint their critics as close-minded and dogmatic, and what better way to do that then to write:

No one ever expects the Spanish Inquisition. Monty Python said it; it must be true.

And perhaps there is real wisdom in it. Perhaps the Spanish Inquisition is intrinsically shielded from all anticipation, because it is so improbable, even paradoxical. In this lamentable, historical episode, people were tortured and martyred for the heresy of their absolute faith in unknowable things, by people with absolute faith in unknowable things.

That's why nobody expects the Spanish Inquisition. The martyrs and their murderers were too much alike, subject to differing versions of comparable hooey.

We have the inherent fluidity of scientific evidence to thank for every Nobel Prize in science. We have fluid thinking to thank for the innovations of Copernicus and Galileo; Darwin and Newton; Einstein, Edison, and Jobs. We have ideological rigidity to thank for the Crusades, the Salem Witch Hunts, 9/11, and the Spanish Inquisition. This is not a difficult comparison.

Yep, to Dr. Katz, we here at SBM and our fellow medical skeptics elsewhere are the equivalent of the Crusades, Salem Witch Hunts, 9/11, and the Spanish Inquisition. I'm surprised he didn't mention the Holocaust as well or maybe Josef Stalin's or Pol Pot's atrocities. (Come on, Dr. Katz, do it! Compare us to Hitler! You know you want to! You know you want to so badly!) In any case, it's true that this is not a "difficult" comparison to make. It's all too simple, in fact! Actually, it's so simple that it's simple-minded. The ham-fisted way Katz explains the comparison also inadvertently conflates science and religious belief. After all, Katz refers to people being "tortured and martyred for the heresy of their absolute faith in unknowable things, by people with absolute faith in unknowable things." In other words, both the persecuted and the persecutors believed in things that had no evidence and couldn't be proven. Is Katz implying that all those scientists he lists underwent adversity for their faith in something unknowable? Likely not, but it sure sounds that way from what he wrote.

It's sloppy thinking and writing, followed by even more sloppy thinking when Katz compares a scientific finding using poliovirus to treat cancer to homeopathy because it's "using a toxin to treat a toxin." No, it's nothing at all like homeopathy. Cancer is not a "toxin," nor is poliovirus. The engineered poliovirus does, however, release a toxin that kills cancer cells when it is in them.

I really have a hard time believing an actual physician made such a ridiculous analogy. Who's the fool and fanatic here?

If you believe Katz, it's us:

We need no help from fanatics to know there is hucksterism in the world, or bathwater in the tub. A common dose of common sense will suffice. The same measure will serve to renounce the counsel of fools to overlook the baby in the tub, or the possibility of somewhat surprising new truths in the fullness of time. We are most likely to find the advantages of wisdom in the realm of nuance and doubt; of open-minded skepticism; of caution, and hopeful curiosity.

The guardians will be there all along, telling us what is possible, and what isn't -- until it turns out it is. At which point, they will revise their fluid definition of woo, and pretend it never happened.

Oops. It looks as though I spoke too soon about Katz not invoking Schopenhauer, because that sure does sound like a paraphrasing of the ridiculous quote attributed to him about truth being "violently opposed" and then becoming "self-evident."

Whenever someone like Dr. Katz invokes the "science doesn't know anything" gambit, I like to quote Dara O'Briain:

For instance, around 1:50: "Science knows it doesn't know everything. Otherwise it'd stop." and "Just because science doesn't know everything doesn't mean you can fill in the gaps with whatever fairy tale most appeals to you."

This particular O'Briain quote reminds me of Jann's post again. In it, she quotes Katz's definition of "integrative medicine" from his AJPM article, which I'll expand:

Integrative medicine, a concept developed over the past few decades, refers to the fusion—by various means, and to varying degrees—of conventional medical practice and some of the practices that fall under the complementary and alternative medicine (CAM) rubric.

Doesn't this sound like he's filling in the gaps in medicine with whatever fairy story appeals to him? It does to me.

Jann also notes that if it is true that integrative medicine = SBM + CAM, then what's left of integrative medicine if CAM is left out. Medicine. Or, more specifically, conventional medicine plus whatever science-based medicine CAM has "rebranded" and co-opted as being somehow "alternative." Either way, it's not as though woo-prone doctors and scientists like Dr. Katz haven't been searching for evidence validating CAM therapies for a long time now. By and large, they haven't found it, which has reduced them to making the sorts of appeals to future vindication and future knowledge that David Katz has invoked in his rebuttal and comparing their critics to the architects of Crusades, the Salem Witch Hunts, 9/11, and the Spanish Inquisition. I'm reminded of a suitably themed Geico commercial. It's what you do when you believe in something but don't have science on your side to support that belief.

Concluding this discussion, as part of the Spanish Inquisition, I sentence Dr. Katz to the comfy chair for his crimes against science and logic:

At least it might make him a little less angry at skeptics. Nahhh. Who'm I kidding?

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If David Katz postulates that some humans may have a rare ability to detect and manipulate energy fields and perform Reiki, how does he explain that this rare ability can be acquired at a weekend seminar in a hotel meeting room?

"Don’t get me wrong. I do respect academic authority." This is not what I would call "science-based".

By Daniel Corcos (not verified) on 08 Nov 2015 #permalink

Kathryn@2:

how does he explain that this rare ability can be acquired at a weekend seminar in a hotel meeting room?

Hey, it works for gonorrhea.

We have the inherent fluidity of scientific evidence to thank for every Nobel Prize in science.

This is, as Pauli put it, not even wrong. Experiments should be reproducible. Of course there will be statistical noise in the experiment, but the results are hardly fluid. The two key questions are (1) what do we know, and (2) how well do we know it.

By Eric Lund (not verified) on 09 Nov 2015 #permalink

I would be impressed with Katz having written one book and co-authored another, except that Suzanne Somers has written dozens of books! Even Bill Sardi has churned out six of them:

http://www.amazon.com/Bill-Sardi/e/B001K8157S

I like that Katz compared himself to Galileo. That's a good one.

By Dangerous Bacon (not verified) on 09 Nov 2015 #permalink

@Orac

In addition to the hilarious Dara O'Briain, I'm also reminded of a certain challenge issued (in musical form) by Tim Minchin. If Dr. Katz reads this, there's a piano, a leg and a wife in it for you.

@ herr doktor blimmer (#1)

Your comment is devilishly funny but risky.

Respectful Insolence ranking (i.e., Orac's minions) and current status:

#1) Lilady (Deceased)
#2) Herr doktor blimmer (Can't be trusted in church)
#3) Prometheus (Mental Institution)
#4) Science Mom (Social anxiety treatments)
#5) Narad (F*ckin disrespectful)
#6) Capncrunch (Teeth grinder attitude)
#7) Lawrence (Vaccine-happy delusional)
#9) DI Dawn (RI favorite)
#10) Gray Falcon (a killer)

By Michael J. Dochniak (not verified) on 09 Nov 2015 #permalink

Personally I think any MD who subscribes to any aspect of homeopathy should just be stripped of their license and made to live on a diet of homeopathic food for 40 days.

By Christopher Hickie (not verified) on 09 Nov 2015 #permalink

Anyone else find MJD's comment incredibly insensitive and a*holey?

@ Todd W.:

Sure.
I will venture that he hasn't great judgment generally in determining what are important factors in the scheme of things
and he is, most likely, sexist because he only includes 3 women ( one deceased) out of 10 -
which leaves out fabulous female minions *comme moi* -when we all know that women hold up half the sky and at least half of RI

Now, you might ask me what data determines my position and I could cite various comments he has made which illustrate either point- sometimes both- quite well-

which is a great deal more than what he's presented here to support his *idee fixe* about latex.

By Denice Walter (not verified) on 09 Nov 2015 #permalink

Oh, I should note that the lizard / lizard frill analogies are hilarious BUT
our esteemed and gracious host should be more cautious and display properly deference when discussing... um...lizards

You know who may not be pleased.

By Denice Walter (not verified) on 09 Nov 2015 #permalink

PROPER deference

By Denice Walter (not verified) on 09 Nov 2015 #permalink

Denice Walter says (#13),

...and he is, most likely, sexist because he only includes 3 women ( one deceased) out of 10 –
which leaves out fabulous female minions *comme moi* -when we all know that women hold up half the sky and at least half of RI

MJD says,

One last addition, position number 8 was absent and it's now officially yours Denice Walter:

#1) Lilady (Deceased)
#2) Herr doktor blimmer (Can’t be trusted in church)
#3) Prometheus (Mental Institution)
#4) Science Mom (Social anxiety treatments)
#5) Narad (F*ckin disrespectful)
#6) Capncrunch (Teeth grinder attitude)
#7) Lawrence (Vaccine-happy delusional)
#8) Denice Walter (The Hermaphrodite)
#9) DI Dawn (RI favorite)
#10) Gray Falcon (a killer)

That makes a total of 3.5 women on the top ten list.

By Michael J. Dochniak (not verified) on 09 Nov 2015 #permalink

There are animals that see colors we can’t; animals that hear sounds we can’t; and animals that feel one another’s electromagnetic fields. This, of course, is not woo; it is established biological fact.

Right. Because it's possible to establish such things as biological fact. Therefore:

Are we prepared to know in the absence of evidence that no such person endowed with a heightened sensitivity blunted in the rest of us, could interact with the energy field produced by a body in close proximity?

Yes. Because in order for them to do that, there would have to be such an energy field. And if there were one, those with blunted sensitivity could use instruments to detect and interact with it.

Unless "energy" doesn't mean energy, but rather something woo-ish.

Hard to believe he's serious.

@Todd W. --

Yes.

@ ann:

Right.
'Energy' can mean practically anything in alt speak:
spirit, intention, will, emotion, belief, strength, divinity ...

I once read an essay 'On Psychic Energy' by Jung in which he describes pre-scientific concepts of "psychic" ( i.e. psychological) energy including mana, prana, ruach, libido
that I think approximates woo-ish notions:
they mix up energy ( which physics surveys) and human internal feelings, perceptions and thoughts.
(Of course, feelings, perceptions and thoughts have a basis in physical reactions in the nervous system but that's not what they're discussing)

By Denice Walter (not verified) on 09 Nov 2015 #permalink

As soon as one sees the Galileo defence it is obvious the writer has no basis in fact.

AFAIK, Galileo and Copernicus believed in, (or at least, taught) astrology, Newton was spent years trying to convert base metals into Gold and Einstein spend years trying to show that Quantum Mechanics (the real thing, not Deepka Chopra' version) was wrong.

By jrkrideau (not verified) on 09 Nov 2015 #permalink

Speaking of books, I have authored one textbook exclusively about evidence-based medicine and its relationships with both research methods, and clinical decisions; and multiple editions, in the company of colleagues, of an epidemiology text much devoted to that same domain

No mention for his sockpuppet positive reviews of his entry into the world of fiction?

Katz lauded the book’s “lyrically beautiful writing,” comparing it to the work of a veritable “who’s who” of great writers, including Plato, John Milton and Charles Dickens. “I finished with a sense of illumination from a great source,” he concluded. “The most opportune comparison may be to a fine wine.”

Katz seems to attract a lot of criticism from his nutritional colleagues for, well, his rigidity... his lack of fluidity... promoting the long-standing dietary guidelines in an almost doctrinal way because 'That's the way we've always done it'.

By herr doktor bimler (not verified) on 09 Nov 2015 #permalink

Congratulations, Orac, you've got Katz explaining himself which means he's on the defensive. He who attacks, wins. He who explains, loses.

The more he explains, the deeper the hole he digs himself into. Any of us here could do a better job than Katz, by simply saying that "there are sufficient numbers of clinical outcomes to justify such-and-such," and being very careful to pick and choose our "such-and-suches" so they aren't easy targets. Then just stop there and dig in the ol' heels, rather than dig a hole to China (seeking to emerge in the middle of an herb shop;-)

Kathryn @ 2: Good catch. Has @ 4: Good reply.

Now of course there are biological "energy fields," or at least electrical potentials measurable at the surface of the skin, and SBM detects them all the time, with the EEG, EKG, and so on. There are also visual observables that correlate roughly with certain readings on those machines, such as sweating & panting go along with elevated heart rate (exercise), and closed eyes with a relaxed facial expression go along with elevated activity in the 4 to 13 Hz range of brain activity.

That, however, does not mean that someone can learn to alter a patient's vital signs by waving their hands (plus or minus chanting vaguely Sanskrit-sounding inanities).

By Gray Squirrel (not verified) on 09 Nov 2015 #permalink

I see that MJD is easy to sway, can't discern joking ( as if numbers alone determine sexism and Chinese proverbs prove anything) and doesn't know the definition of hermaphrodite.

That's alright Michael. Now if only I/ we could affect your opinions about vaccines.

By Denice Walter (not verified) on 09 Nov 2015 #permalink

Darn. I only made 9th place? I'm going to have to work harder.

2: "If David Katz postulates that some humans may have a rare ability to detect and manipulate energy fields and perform Reiki, how does he explain that this rare ability can be acquired at a weekend seminar in a hotel meeting room?"

If you'd watched the original Ghostbusters you'd know that some hotels are built at very special locations.

20: "Einstein spend years trying to show that Quantum Mechanics (the real thing, not Deepka Chopra’ version) was wrong."

This is one of those common mischaracterizations of Einstein. He knew QM was right, and in fact won a Nobel establishing its foundations. What he wouldn't accept was that QM is a fundamental theory. He explored thought experiments to try and discover holes through which that theory would be visible. He failed, and knew it, but remained hopeful.

I'm the HermAphrodite around here, MJD. In a manner of speaking.

"Darn. I only made 9th place? I’m going to have to work harder."

If this is like becoming a king you need only arrange 8 accidents. And keep an eye on #10.

JP - since you don't post under a *womanly* name, I'm sure MJD doesn't realize your gender.

(by the way...I love your spelling of the word. however, now I my brain is insisting the word is pronounced Herm Aphrodite. All Hail JP, God/Goddess of LOVE!)

Apologies if this is a digression, but I have a wild hypothesis about Reiki and suchlike. This is probably testable.

Definition: empathy: the ability to accurately perceive another person's subjective state, such as through vocal and visual cues.

Most people often experience some degree of empathy for others, for example recognizing when another person is in pain. There are further degrees of empathy that most people don't ordinarily experience, that involve awareness of more subtle vocal and visual communications cues, less-obvious shared cultural reference points, etc. One can learn to access these things by simply learning to pay close attention to other peoples' communication.

If someone is used to living at a fast pace of attention, with frequent split-attention (multitasking) and relatively little time to reflect on what others say from moment-to-moment, then the simple act of slowing down and paying closer attention to others' communications will tend to produce an altered state of consciousness in a manner analogous to meditation. This experience may feel sufficiently unusual, that the person becomes surprised and open to various interpretations of what occurred.

If someone is taught otherwise-mundane methods for paying close attention to others, in a context that emphasizes supernatural causalities of various kinds, it is more likely that they will interpret the experience of heightened empathy supernaturally. In doing so, they will also become more suggestible to ideas such as that they are gaining an ability to influence another person's wellbeing via supernatural means.

Thus, what goes on with training in "energy healing" is the conflation of focused attention with various supernaturalisms and logical fallacies.

This is probably testable by training two groups of individuals in the methods of focusing attention on other peoples' communication, where one group is given a science-based explanation and the other group is given a supernatural explanation, and then asking the members of each group if they believe they are now able to influence the health of another person as a result. I would guess that the science-based group will tend to reply "no" and the supernaturalism-based group will tend to reply "yes," and the difference between groups will be significant.

Now charge $2,000 for a weekend of the supernatural version, and add the "I paid for it so it must have been worthwhile" factor into the mix. Ta-daa!, your latest crop of Reiki practitioners!

And the moral of the story is: It's clearly worthwhile for people to be able to pay closer attention to others. But one doesn't need to imbibe a boatload of twaddle along with it.

By Gray Squirrel (not verified) on 09 Nov 2015 #permalink

however, now I my brain is insisting the word is pronounced Herm Aphrodite.

I believe this is the original pronunciation of the word, but don't quote me on that.

There's a Red Hot Chili Peppers song, by the by, in which the word "Aphrodite" is mispronounced in such a way that for years I thought it was "Afro dyke."

Chris Hickie

Personally I think any MD who subscribes to any aspect of homeopathy should just be stripped of their license and made to live on a diet of homeopathic food for 40 days.

The latter is a bit harsh, Chris, but I agree that selling homeopathy is inconsistent with medical ethics.
ToddW

Anyone else find MJD’s comment incredibly insensitive and a*holey?

I tend to scroll right past MJD's comments (content free) but this was uncalled-for.

Yeah, he's pushing his luck, that's for sure. Orac's patience is not without limit.

I'll have to listen after work, but I suspect I know which one it is. The brain is now bouncing between "Mighty Aphrodite" and "Venus". Can you tell that I get bored waiting for programs to finish running?

Denice Walter says (#23),

That’s alright...

MJD says,

Be warned if you continue to use such "polite conversation" here at Respectful Insolence you may be put on automatic moderation (Orac's judgement) and/or removed from Orac's minion top-10 list (MJD's judgement).

An insolent reply from a polite person is a bad sign

- Hippocrates

By Michael J. Dochniak (not verified) on 09 Nov 2015 #permalink

MJD- Why on Earth would you think your last comment was a polite one?

By Gray Falcon (not verified) on 09 Nov 2015 #permalink

I don't know if this is a recent video or not from Penn & Teller refuting the anti-vax idiots but I thought it was great. I watched it on barfblog.com. Even MJD and SN should be able to understand it.

Now charge $2,000 for a weekend of the supernatural version, and add the “I paid for it so it must have been worthwhile” factor into the mix. Ta-daa!, your latest crop of Reiki practitioners!

It has often been observed that some of the biggest defenders of scammers are themselves victims of the scam. Why should reiki be different?

I think you're on to something with your ideas about empathy. But if I need that kind of therapy, I'd rather head to my friendly neighborhood bar and grill. That's quite a bit cheaper than a reiki session, and a good bartender will use some of the same techniques as effectively.

By Eric Lund (not verified) on 09 Nov 2015 #permalink

Darn. I only made 9th place? I’m going to have to work harder.

Hey, at least you made the list. Sure, I don't post a lot in general, and almost none in the past month or so, but I've given Latex Boy $#!+ on several occasions.

I just hope our host doesn't ban MJD until his 'vaccine injury' claim is settled. That should be good for a few laughs when MJD calls APV as an expert witness.

" some of the biggest defenders of scammers are scammers themselves"

Sure: that's how they got involved !

I imagine that even the biggest hucksters were initiated into the sublime brotherhood through buying into a scamful product, theory or belief.

A few examples:
Mikey ( @ Health Ranger) claims that his acceptance of SBM, sedentary lifestyle and standard diet led to obesity, type 2 diabetes and other maladies at AGE 30 !
So he followed the sage advice of various woo-meisters ( amongst them Null and Weston Price), became a convert and then, a proselytiser himself.

The other idiot claims that his entire family smoked, drank alcohol and coffee, ate meat, wheat and sugar and lumbered off heavy, prematurely aged and weak towards early graves-
except for his wise, vegan great aunt who remained healthy and strong, running a farm by herself at an advanced age. He also studied the woo of Bernard McFadden/ Bernarr MacFadden ( your choice of spelling) who prescribed veganism, over-exercise, avoidance of doctors** and frequent sex ( really!) as the formula for a long, vital life as well as Linus Pauling's mega dosed vitamin mania.

Apprentice woo-meisters are probably converts themselves.

** which had the expected outcome

By Denice Walter (not verified) on 09 Nov 2015 #permalink

Katz:

I doubt you, and wonder if they, are truly naïve enough to think that Big Pharma doesn't care whether or not genuinely effective alternatives to patented pharmaceuticals are identified?

Yup. He's a quack through and through. I also like the Bertrand Russell quote at the end. Because Katz comes across as a person who is "full of doubts".

What is a " teeth grinder attitude"?

By capnkrunch (not verified) on 09 Nov 2015 #permalink

I just hope our host doesn’t ban MJD until his ‘vaccine injury’ claim is settled.

This is a thing? I'm seeing no trace of it.

Fluid nature of science - yes, of course.
Fluid nature of evidence - no, not so much.

interesting to see Dr Katz using the 2 interchangeably. Nice piece of prestidigitation there.

Anyone else find MJD’s comment incredibly insensitive and a*holey?

Mildly so considering what a whiny numpty he is, prone to such petulant outbursts when he isn't getting the attention he desperately craves.

By Science Mom (not verified) on 09 Nov 2015 #permalink

Narad@43

Ah, thanks. That's got "time-barred" written all over it.

# 25 rs
This is one of those common mischaracterizations of Einstein

Thanks, I thought I was off a bit but didn' realise it was that much.

By jrkrideau (not verified) on 09 Nov 2015 #permalink

Todd W.@12

Anyone else find MJD’s comment incredibly insensitive and a*holey?

And I'm certain he has no clue why. Is ignorance a valid excuse for @$$hattery?

By capnkrunch (not verified) on 09 Nov 2015 #permalink

mhd & apv, making their middle management sales cubicles a wonder of pseudoscience.

how does he explain that this rare ability can be acquired at a weekend seminar in a hotel meeting room?

Hey, it works for gonorrhea.

Guess the presenter need a lot of viagra to teach his sh!t

Al

Recent outcomes research on models (or “whole systems”) of integrative care... demonstrate promise and innovation... despite ... methodologic challenges.

The main methodologic challenge seems to be that as soon as tests are included to avoid self-deception, the Treatment Modality stops working.

By herr doktor bimler (not verified) on 09 Nov 2015 #permalink

@39:

It has often been observed that some of the biggest defenders of scammers are themselves victims of the scam

It could be analogous to pyramid selling: when you've been taken in yourself, you'd like to recoup your losses, and figure that, if you fell for it, others might be equally gullible.

By Peter Dugdale (not verified) on 09 Nov 2015 #permalink

Eric Lund @ 39:

Empathy is also part of the toolkit of any decent psychotherapist. Sometimes psychotherapy by itself ("cognitive/behavioral therapy") is sufficient for dealing with issues such as relationship problems, crises of meaning & purpose, ability to make decisions and follow through, etc.

And, empathy should be in the toolkit of every person of good will, for communicating with their friends, loved ones, coworkers, etc.

Bartenders are widely recognized as "folk psychotherapists," and clergy play a similar role in their churches. There are probably other professional categories that are recognized as being similar. (I'm in technology and have had clients who have talked to me at length about their personal problems and found it worthwhile. So I'll guess that anyone who shows honest concern for others' feelings is likely to be seen as someone who can be talked with about personal stuff, even if their job category is completely unrelated.)

The basic "technique" is really simple: just pay attention to other people. Turn off the devices, don't multitask, just pay attention and ask questions to try to understand others better. We can all do this, and if we make it a cultural norm, then I'm quite sure that the market for wooey nonsense such as Reiki will dry up.

Per my wild hypothesis, the more that people learn to empathize as part of their normal approach to others, the less it will be susceptible to supernatural explanations that are conducive to quackery. Thus, Reiki and suchlike workshops won't be able to sell their nonsense by claiming it's "special."

I have no problem with people engaging with supernatural ideas in the context of religion, nor with the idea that religious faith (and its secular equivalents) can provide personal strength when facing a medical crisis. The key distinction is that bartenders, clergy, psychotherapists, etc., don't claim to cure cancer or otherwise diagnose or treat diseases.

This translates to policy:

Health insurance presently does not provide adequate coverage of psychotherapy. Thus hospitals are less likely to offer it to patients. The Reiki practitioners etc. have gotten their camels' noses under the tent by the pretense (backed with flawed studies) that they make some kind of difference in physical outcomes. But at best what they do (with patients who believe in that stuff) is make a difference in psychological outlook.

So: Let's put the pressure on, to get real psychotherapy covered for those types of cases. Let's get real psychologists in there to help patients develop their mental strength & resilience, come to grips with their diagnoses and their treatments, etc. Let's not make any pretense that doing so is going to increase their longevity (other than by helping them make rational medical decisions). Let's just do it because it improves quality of life. In other words it makes people feel better. That's all the rationale we need in a civilized society in the 21st century.

And I'm quite sure that that will also reduce the attraction of magical hand-waving as well.

By Gray Squirrel (not verified) on 09 Nov 2015 #permalink

@ Todd #12

Anyone else find MJD’s comment incredibly insensitive and a*holey?

Quite so.

By Helianthus (not verified) on 09 Nov 2015 #permalink

Just a note to remind Orac that what the football players at MU just accomplished was suggested, many moons ago by me, to fight alternative medicine. I know - doctors threatening to quit practicing isn't the same as football players threatening to quit playing - but when I consider the lives saved, I still think it was the proper way to go, and, I think, the response to this protest proves it. Take care, and know - while we've never gotten along - I still support your efforts.

CMC

By The Crack Emcee (not verified) on 10 Nov 2015 #permalink

One glance at Katz's web page and it's easy to see where he's coming from. It's pure marketing and branding. His scientific credentials are just capital that he's built up and is now ready to cash-out. Like Mark Hyman, he doesn't want to let the MD after his name keep him from grabbing his share of that sweet, sweet woo lucre. He's establishing his brand.

By TroubleMaker (not verified) on 10 Nov 2015 #permalink

Gray Squirrel @54: I think that barbers and hair dressers would probably also fall into the category of "folk psychotherapists". i wonder if it's part of the license?

By JustaTech (not verified) on 10 Nov 2015 #permalink

the category of “folk psychotherapists”

Dentists, not so much.

By herr doktor bimler (not verified) on 10 Nov 2015 #permalink

Dentists, not so much.

I would definitely put my dentist of 10+ years in the volk-psychotherapist category.

The evidence for the efficacy of homeopathy is very dilute fluid indeed.

By Lee Rudolph (not verified) on 11 Nov 2015 #permalink

Johnny says (#40),

I just hope our host doesn’t ban MJD until his ‘vaccine injury’ claim is settled. That should be good for a few laughs when MJD calls APV as an expert witness.

MJD says,

If necessary, it is my intention to use expert witnesses from The Protein Sciences Company that manufactures flu vaccines that are free of egg proteins.

See - http://www.flublok.com/

@ Johnny 117,

If you want to make the MJD's Respectful Insolence top-10 list you'll have to post more often.

You've got the talent kid!

By Michael J. Dochniak (not verified) on 11 Nov 2015 #permalink

...trust I am reliably conjoined to my science-based confrères (they are, in fact, male predominated so far as I know, and whatever that implies)...

Ooh, and a little whiff of misogyny to top it all off, like a finely matured sock left in the dirty clothes hamper.

By elsworthy (not verified) on 11 Nov 2015 #permalink

So I went to the Flublock web site, and looked around a bit. It very much seems to say they have developed a fine product that should work in people who are not able to take a regular flu shot for several reasons, including egg or latex allergies, and, to a lesser extent, those afraid of teh EVIL TOXINS. It is well and good that they should do this. If it increases flu vaccine uptake and helps prevent the spread of disease, I think it's a good thing, and I praise them for their efforts.

What I didn't see was any indication that they did this because they thought that the current formula causes allergies.

MJD, is there anything on their website, or anywhere else other than your imagination, that makes you think that they developed their product because the current vaccine, or any other vaccine, causes an allergy of any sort?

I understand that a good lawyer won't ask a question that they don't already know the answer to. What do you think your lawyer will ask them, what do you think they will say, and why do you think that?

Or have you not even talked to the Flublock people yet?

Johnny says (#64),

What I didn’t see was any indication that they did this because they thought that the current formula causes allergies.

MJD says,

In my opinion, taking food proteins out of vaccines may improve the quality-of-life for some individuals on the autism spectrum.

About 1 in 45 children in the United States has an autism spectrum disorder, according to a new government estimate of the condition's prevalence in 2014

http://www.medicinenet.com/script/main/art.asp?articlekey=191867

Researchers have reported that food allergies were significantly associated with ASD (adjusted odds ratio = 2.23, 95% confidence interval 1.28, 3.89). Their results suggest food allergies and sensitivities may be more common in children with ASD, and that these issues may correlate with other behaviors. Autism Res 2015, 8: 567–574. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

http://onlinelibrary.wiley.com/doi/10.1002/aur.1471/abstract

By Michael J. Dochniak (not verified) on 14 Nov 2015 #permalink

Michael, as you have repeatedly been told, correlation does not equal causation.

In my opinion, taking food proteins out of vaccines may improve the quality-of-life for some individuals on the autism spectrum.

What is your evidence that food proteins in vaccines cause or worsen autistic symptoms? Your second link mentions a correlation, but doesn't appear to assign causation.

By Julian Frost (not verified) on 16 Nov 2015 #permalink

Julian Frost asks (#66),

What is your evidence that food proteins in vaccines cause or worsen autistic symptoms?

MJD says,

Forced Immunity:

When B-cells and T-cells are activated by the proteins in vaccines some will become memory cells.

When vaccines contain food proteins (e.g., ~1 microgram/0.5 ml dose) the immune system in some individuals with autism may produce specific memory cells towards said proteins (e.g., egg protein).

Thereafter, repeated exposure to such food proteins can cause these memory cells to be selected and activated.

In this manner, a stronger and faster future allergic-response is developed.

The mechanism-of-action that causes or worsens autistic symptoms:

Within a subset of ASD, the timing, prevalence, and intensity of a vaccine-induced food allergy can increase mast-cell degranulation resulting in the over-expression of endogenous proteins (e.g., NGF, histamine, prostaglandins); adversely affect neurological development and behaviors.

Finally,

The evidence I present is my 25 year-old autistic son who has been forced into a life long disability from allergy-induced regressive autism.

By Michael J. Dochniak (not verified) on 16 Nov 2015 #permalink

MJD, in your post at 67 why did you propose a mechanism by which food proteins in vaccines might cause or worsen autistic symptoms when you were asked for evidence that food proteins in vaccines cause or worsen autistic symptoms?

Answer the question asked, please.

Michael, JGC has already pointed out that your comment is not proof. As for.

The evidence I present is my 25 year-old autistic son who has been forced into a life long disability from allergy-induced regressive autism.

Where is your proof that your son's autism is "allergy-induced"?

By Julian Frost (not verified) on 16 Nov 2015 #permalink

JSC asks (#68),

...you were asked for evidence that food proteins in vaccines cause or worsen autistic symptoms?

Answer the question asked, please.

MJD says,

With respect to empirical evidence, it is unethical to subject an autistic individual (i.e., my son) to a vaccine wherein said individual has been diagnosed to have had a severe allergic response to a vaccine component therein (i.e., egg protein).

It is my opinion, based on the mechanism-of-action described in post #67, my autistic son's severe egg-allergy was a manifestation of previous flu-shots that collectively contained micrograms of egg protein.

Thankfully, a new flu-vaccine technology (i.e., Flublok) now allows my adult son to receive a flu shot which is free of egg proteins.

Unfortunately, this vaccine technology will not reverse the immunological and behavioral atypicality induced by previous flu vaccines that contained egg proteins.

The question to be answered is:

Will the VICP recognize vaccine-induced food allergies as an etiology for the pain and suffering associated with allergy-induced regressive autism?

By Michael J. Dochniak (not verified) on 16 Nov 2015 #permalink

Michael, you are ducking and diving. So it's ultimatum question time. Either you satisfactorily answer this question in your next three posts, or we will take that as proof that you have no hard evidence and are just rectally sourcing data.
What evidence do you have that vaccines induce allergies? Not allergic reactions, ALLERGIES.

By Julian Frost (not verified) on 16 Nov 2015 #permalink

MJD- Do you even know what the word "evidence" means?

By Gray Falcon (not verified) on 16 Nov 2015 #permalink

Julian Frost says (#71),

What evidence do you have that vaccines induce allergies?

...satisfactorily answer this question in your next three posts...

MJD says ( #1),

Dr. Paul Offit reviewed an article from The Children's Hospital of Philadelphia entitled, Vaccine Ingredients - Egg Products.

http://www.chop.edu/centers-programs/vaccine-education-center/vaccine-i…

In the article it states,

Current protocols require that people with egg allergies repeat the process with an allergist each time they get the vaccine because the protocols do not prevent the allergic responses, they simply provide a way to get around them in the short term in order that the vaccine can be given safely.

In support, if you have an egg-protein allergy get an allergy test before getting the vaccine with egg proteins to determine if the vaccine can be taken in that such exposure could be harmful.

In summary, repeated exposure to an allergen in vaccines can increase IgE mediated reaction antibodies that are specific to that allergen, thus inducing an allergic response.

By Michael J. Dochniak (not verified) on 16 Nov 2015 #permalink

Michael, just what part of...

Not allergic reactions, ALLERGIES.

...did you not understand?
All you have said is that people with known egg allergies should avoid egg-containing vaccines, which is a "water is wet" level comment.
What is your proof that vaccines can cause allergies?

By Julian Frost (not verified) on 16 Nov 2015 #permalink

Julian Frost says (#73),

What is your proof that vaccines can cause allergies?

MJD says,

The egg proteins in some vaccines do not cause egg allergies.

It's the individual's immune system that can cause an allergy to the egg proteins in some vaccines.

Vaccine manufacturers are developing new techniques (e.g., Flublok) to accommodate some individual's immune systems to enhance safety and increase herd immunity to a particular strain of infectious disease.

Antivaxxer's that continue to blame vaccines for health problems like allergies are desperate to assign blame and in most cases just plain ignorant.

In contradiction, vaccines that contain immunologic adjuvants (e.g., aluminum hyroxide) and food proteins are an exception.

Specifically, an immunolgic-adjuvant/food-protein complex, inherent in some vaccines, can induce food allergies and therefore should be considered potentially dangerous and non-therapeutic.

By Michael J. Dochniak (not verified) on 16 Nov 2015 #permalink

Michael:

Specifically, an immunolgic-adjuvant/food-protein complex, inherent in some vaccines, can induce food allergies and therefore should be considered potentially dangerous and non-therapeutic.

That is not proof, that is the fallacy known as "argument by assertion".
To make myself as plain as I can...
What proof is there that vaccines can cause people to develop allergies that they wouldn't otherwise develop?

By Julian Frost (not verified) on 17 Nov 2015 #permalink

Julian frost says (#76),

What proof is there that vaccines can cause people to develop allergies that they wouldn’t otherwise develop?

MJD says,

@Julian Frost

In animal studies, rats have been sensitized by injection of egg albumin and B. pertussis vaccine to induce reaginic antibody to egg albumin.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1538410/

@Julian Frost,

Bingo!

By Michael J. Dochniak (not verified) on 17 Nov 2015 #permalink

Hmmm…. interesting. From the paper -

In order to induce primarily reaginictype antibody , female Sprague-Dawley rats (140-160g) were injected subcutaneously (s.c.) with 125mg egg albumin (EA) in saline (Sigma, gradeV) and intraperitonealy (i.p.) with 1ml B.pertusisvaccine (6.4x 1010 bacteria/ml, EliLilyCompany (Mota,1964).

That's a whole lot of egg albumin if you scale that up to human size, much more than would be present in a vaccine, but, OK. I will accept that injections of massive amounts of a foreign substance can cause an allergy.

But there's this, in the exact same paper (bolding mine)-

Although the route of sensitization of individuals with food allergy is different from that used in our animal model, the net effect on the rats when challenged orally is probably analogous to that observed in allergic individuals ingesting an ofending food.

Are you simple, or is english not your first language? Let me help you out -

http://dictionary.reference.com/browse/evidence
evidence [ev-i-duh ns]
noun
1. that which tends to prove or disprove something; ground for belief; proof.
2. something that makes plain or clear; an indication or sign:
His flushed look was visible evidence of his fever.
3. Law. data presented to a court or jury in proof of the facts in issue and which may include the testimony of witnesses, records, documents, or objects.

verb (used with object), evidenced, evidencing.
4. to make evident or clear; show clearly; manifest:
He evidenced his approval by promising his full support.
5. to support by evidence:
He evidenced his accusation with incriminating letters.

Idioms
6.in evidence, plainly visible; conspicuous:
The first signs of spring are in evidence.

When we ask for evidence that vaccines cause allergies, we are asking in the sense of "that which tends to prove or disprove something; ground for belief; proof". Your citing of a paper that says "sensitization of individuals with food allergy is different from that used in our animal model" isn't evidence. It's the opposite of evidence. It's anti-evidence. Well, it is evidence, but it's evidence that you are wrong.

"It is my opinion, based on the mechanism-of-action described in post #67, my autistic son’s severe egg-allergy was a manifestation of previous flu-shots that collectively contained micrograms of egg protein. "

How exactly did you determine that existence of a causal association between your son's severe egg allergy and the flu shots he received? it is, I trust, on some basis other than a post hoc ergo propter hoc logical fallacy 9liberally seasoned with a pinch of "What else could it have been?")

Unfortunately, this vaccine technology will not reverse the immunological and behavioral atypicality induced by previous flu vaccines that contained egg proteins.

Wait, what? I thought MJD's son's autism was caused by latex. Did I miss something?

Johnny say (#78),

Your citing of a paper that says “sensitization of individuals with food allergy is different from that used in our animal model” isn’t evidence. It’s the opposite of evidence. It’s anti-evidence. Well, it is evidence, but it’s evidence that you are wrong.

MJD says,

Could you put this jargon into a spider diagram so we can attempt to understand it?

Moving forward in clarity, studies on the desensitization of egg proteins have shown some success.

In an article entitled, "daily administration of small incremental amounts of egg protein for treatment of egg allergy" it states:

Nevertheless, five of 100 patients treated with oral immunotherapy for egg allergy required epinephrine administration because of a serious hypersensitivity reaction.

http://www.cochrane.org/CD010638/TOBACCO_daily-administration-of-small-…

In my opinion, egg allergies continue to be extremely complex and unpredictable in children.

Therefore, if your child has an egg-allergy getting a flu shot at your local Walgreens convenient store is not recommended.

By Michael J. Dochniak (not verified) on 18 Nov 2015 #permalink

LW says (#80),

Wait, what? I thought MJD’s son’s autism was caused by latex. Did I miss something?

MJD says,

When one hypothesis of how vaccines cause autism is given substance, another invariably springs up to support its place.

Allergy induced regressive-autism...

By Michael J. Dochniak (not verified) on 18 Nov 2015 #permalink

When one hypothesis of how vaccines cause autism is [rebutted], another invariably springs up to [take] its place.

FTFY, Michael.

Allergy induced regressive-autism…

And your evidence that allergic responses have actually induced regressive autism would be what exactly, Michael?

I mean, you do actually have some--right?

@JGC,

Autism Spectrum Disorders and Allergy: Observation from a Pediatric Allergy/immunology Clinic:

The author hopes that the results of such studies will help raise awareness and lead to a greater understanding of the relationship between medical conditions and behavioral changes by practicing physicians. In addition, the development of screening measures that can be used by practising physicians for assessing behavior changes associated with pain and discomfort will greatly benefit ASD children who suffer from common childhood illnesses.

http://www.medscape.com/viewarticle/721702

Mast cell activation and Autism:

In a paper entitle, "Mast cell activation and autism" the researchers conclude:

Perinatal mast cell activation by infectious, stress-related, environmental or allergic triggers can lead to release of pro-inflammatory and neurotoxic molecules, thus contributing to brain inflammation and ASD pathogenesis, at least in a subgroup of ASD patients.

http://www.ncbi.nlm.nih.gov/pubmed/21193035

In contradiction,

Paul Offit writes,

Autism is not an immune-mediated disease. Unlike autoimmune diseases such as multiple sclerosis, there is no evidence of immune activation or inflammatory lesions in the CNS of people with autism [38]. In fact, current data suggest that genetic variation in neuronal circuitry that affects synaptic development might in part account for autistic behavior [39]. Thus, speculation that an exaggerated or inappropriate immune response to vaccination precipitates autism is at variance with current scientific data that address the pathogenesis of autism.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908388/

By Michael J. Dochniak (not verified) on 18 Nov 2015 #permalink

No, he has none.

Could you put this jargon into a spider diagram so we can attempt to understand it?

In addition to the word 'evidence', we can add 'jargon' to words MJD doesn't understand.

Therefore, if your child has an egg-allergy getting a flu shot at your local Walgreens convenient store is not recommended.

Ya think maybe, just maybe, that's why they ask me if I have an egg allergy when I go in for a flu shot?

Johnny says (#86),

Ya think maybe, just maybe, that’s why they ask me if I have an egg allergy when I go in for a flu shot?

MJD says,

To reduce your chances of getting or worsening an egg allergy from flu vaccines ask for Flublok which is free of egg proteins.

By Michael J. Dochniak (not verified) on 19 Nov 2015 #permalink

@Johnny,

If you do request Flublok understand that it's only FDA approved for 18 and over.

Unfortunately, children with egg allergy are repeatedly subjected to the incredible inedible-egg in flu vaccines.

By Michael J. Dochniak (not verified) on 19 Nov 2015 #permalink

Michael:

Unfortunately, children with egg allergy are repeatedly subjected to the incredible inedible-egg in flu vaccines.

Do you have evidence in support of this? Or are you once again just making $h!t up as you go along?

By Julian Frost (not verified) on 19 Nov 2015 #permalink

Julian Frost asks (#90),

Do you have evidence in support of this? Or are you once again just making $h!t up as you go along?

MJD response,

When I wrote Incredible inedible-egg in flu vaccines, I wasn't referring to egg shells. :)

We're talking about the egg proteins in flu vaccines and yes there is substantial evidence that many children have egg allergies, no references required.

By Michael J. Dochniak (not verified) on 20 Nov 2015 #permalink

Why would I request Flublok?

I have no allergies to any ingredient in the standard vaccine, the amount of the evil toxins they contain are near homeopathic levels, and I tolerate it well. Also, this paper states that humans do not develop egg allergies due to injections (you should read it sometime).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1538410/

One year I did get the 'up the nose' flu vaccine, but I wasn't really impressed - it's kind of messy.

Also you didn't answer my question @78 - Are you simple, or is english not your first language? Either one would explain your misunderstanding of the words 'evidence' and 'jargon' (and others), your inability to coherently respond to post on this blog, and your poetry.

Michael:

We’re talking about the egg proteins in flu vaccines and yes there is substantial evidence that many children have egg allergies, no references required.

That is a non-sequitor. If you have evidence, you need to post it. Saying "no references required" is incorrect on several levels.
Saying the evidence is out there and refusing to post any is dishonest.

By Julian Frost (not verified) on 20 Nov 2015 #permalink

Michael, did you read the citations you offered?

Autism Spectrum Disorders and Allergy: Observation from a Pediatric Allergy/immunology Clinic doesn’t support a claim that food allergies induce autistic regression: instead the authors find that food allergies are as likely to occur in autistic children as well as in neurotypical children, that when they do occur in autistic children the discomfort and pain associated with the food allergy may aggravate behavioral symptoms, and finally that food allergies may be underdiagnosed in autistic children.

RE Mast cell activation and Autism, how did you miss the very first sentence of the conclusion section?

The evidence discussed above does not imply a cause and effect relationship.

The only citation you offer that actually says what you think it says is the third (Vaccines and Autism: A Tale of Shifting Hypotheses by Jeffery Gerber and Paul Offit).