Mark Hyman

Homeopathy

Naturopathy

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Quackery

Robert F. Kennedy Jr.

Toby Cosgrove

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After all is said and done, I still don't really know just what functional medicine is despite having read today's article (and even attending a lecture about it presented by a "doctor" of chiropractic). I'd very much appreciate it if someone can come up with a concise and informative definition that even a layman can understand.

Great article… Operation Backbone has been a disruptive mechanism in active duty,military and VA in a positive way…. The issue is not so much the disruptive nature in a positive way… It's the leadership at the CEO and CFO level, that doesn't understand what a mechanism can do in a positive way if it seems At First to go against the grain… It's the leadership that becomes Buried in paperwork bureaucracy… Not even so much the bottom line… But stepping outside the office and seeing the actual flow… That's what vision does - not the status quo. No excuses… There are tremendous success out there however red tape is not an alternative to constantly challenging the status quo, or the flow and nature of a disruptive new mechanism that can alter the path for so many people now and in the future

Ah, the old Galileo Gambit: People who disagree with us really are just trying to protect the status quo for some nefarious reason.

Functional medicine = Functional entertainment

I so thoroughly detest the abuse of those words "disrupt" and "innovation." They do not mean what their chirpy promoters think they mean.

"Oh boy!, let's go _break something!_" "And let's _make new_ regardless of whether new is better or worse, or even if 'new' is old, _and_ worse, as in homeopathy." The first sounds like Steve Bannon ideology, and the second sounds like planned obsolescence, and now it also sounds like quack-o-rama. Bleh.

What I'd really like to see some day: a line of peaceful protesters making their way through the Board meeting of one of these institutions that touts "disruption" and "innovation," chanting "Dis-RUPT! Dis-RUPT!" loudly enough to do just that for, oh, five or ten minutes, and then they all leave, having made the point.

Speaking of disruptive innovations in quackery, here's a prediction: e-Iridology. The computer takes a photo of your iris and spits out a diagnosis. There will also be an app that enables using your i-Thing to do it as a form of "selfie," and send in the photo for a "diagnosis" any time you like (only $49.99, act now!).

It will seem "sciency" because it comes with an app and a robot, and as we all know, anything with an app and a robot is super-duper cool. Someone will make a lot of money on this and patients will die from false negatives for dangerous diseases. FDA might shut it down in 2022 or so, depending on election outcomes in 2020. Hurry! hurry! hurry!

You want to know the crazy thing, Mr./Ms. Squirrel? If I marketed a b.s. auto-diagnostic I could make a fortune - my financial troubles would be over forever. Or be a professional science denier. Or a professional RW troll.

So many times have I refused to participate in lucrative swindles, and my reward is poverty. At least the old lady next door whose walkway I shovel for free thinks I will be rewarded by Jesus. Sometimes I wish I could make myself believe this. But good deeds aren't if you do it in anticipation of reward.

Those that readily accuse RI commenters of being 'shills' are not simply wrong - they have things exactly backwards. Very, very bad taste. It is principled advocates of reason who willingly accept financial loss to defend what is right.

Walk in peace, scientific skeptics, and always remember that the principle of charity can go too far. You are morally superior to Kennedy, Gordon, Wakefield, and that entire cast of venal clowns. You don't have to be self-righteous or a 'dick' to have pride in yourself.

"After all is said and done, I still don’t really know just what functional medicine is despite having read today’s article (and even attending a lecture about it presented by a “doctor” of chiropractic). I’d very much appreciate it if someone can come up with a concise and informative definition that even a layman can understand."

Functional medicine: a system which functions to provide a beneficial outcome for farsighted practitioners.

I so thoroughly detest the abuse of those words “disrupt” and “innovation.” They do not mean what their chirpy promoters think they mean.

The game here, as when these words are similarly abused in technophilic and Silicon Valley contexts, is buzzword bingo. Certain people have gotten used to allegedly novel schemes being marketed in just this way. Why should medicine be different? "Disruption" is made to sound exciting. Never mind that it tends to be "interesting" in the Chinese curse sense of the word.

And as in Silicon Valley, a handful of people who have the luck to be in the right place at the right time make out like bandits.

The main difference between disruption in medicine and disruption in the tech business is that occasionally the latter ends up helping the consumer directly. Several iDevices have served as examples over the years. When this kind of disruption helps a patient, it is invariably a combination of luck and the placebo effect.

“Oh boy!, let’s go _break something!_”

"Let's go get sushi and not pay."

What I’d really like to see some day: a line of peaceful protesters making their way through the Board meeting of one of these institutions that touts “disruption” and “innovation,” chanting “Dis-RUPT! Dis-RUPT!” loudly enough to do just that for, oh, five or ten minutes, and then they all leave, having made the point.

There's a Been Down So Long reference to be had here, too, but the word on the street is that there's a bunch of mass storage to be had in the campus library's electronic recycling, which has been vitally important to me lately.

No need to worry about the chemical medicine paradigm. It will continue to thrive and be hailed by unquestioning believers, even as our population steadily becomes even more unhealthy than it is already, while spending more than ever.

Trauma care is great in the US, but there's a relatively small market for it. The real money is in the creation and perpetuation of chronic disease, because there's a constant supply of symptoms to mask and tests to perform.

Even when it's performing at its optimum, the modern medical system is the third leading cause of death in the US--as researchers from Johns Hopkins pointed out in studies from 2000 and 2016. See http://www.drug-education.info/documents/iatrogenic.pdf; and Makary Martin A, Daniel Michael. Medical error—the third leading cause of death in the US BMJ 2016; 353 :i2139.

So-called "integrative medicine" is just responding to a demand that was inevitable. Sure, there have always been opportunistic "quacks," but they'll never rise to the level of the official quacks running a system that kills, conservatively, over 250,000 people every year.

Lol. If only the problem were isolated to a single source, it could be pretty easily resolved. :D

But 'disruptive' sounds so, so... rebellious and paradigm shifting!

Let's f@ck up the establishment and usher in a new era ...
or something.

NWO; yes medical error does either directly or indirectly cause the deaths of a number of people per year (I believe the 250,000 number is has been strongly reputed). However, how many people every year die from using FM, ND, HM, wheatgrass, etc, etc. Ask the young model how well having a chiro twist you neck works: oh sorry you can't she's dead.

Real modern medicine works and I am proof. In the last 3 years my prostate cancer is cured or in total remission and I survived a heart attack in which I had less than a 7% survival chance. I've had even better news on the heart attack: my ejection rate during the attack was below 35% and as of December my ejection rate in now over 60% (55% being average) which suggests little to no heart muscle damage.

NWO...wow.

First off the number if deaths CAUSED by medicine is a flat out lie. Someone who is diagnosed as terminal is not killed by science. Second, live expectancy is longer now than pre science based medicine, suggesting that we are healthier. Death is pretty unhealthy. Third, new diseases and disorders are found as we discover them, primarily because we now know what we are looking for in research. It is foolish to talk as if society was better off in the 1890s.

Well, Dr. Starfield's study identified 106,000 deaths per year caused by properly prescribed and administered, FDA approved drugs. So that would be the most direct "cause" by medicine--along with 12,000 deaths per year from unnecessary surgery.

In other paradigm-shifting news...

It seems that woo-meister extraordinaire, Gary Null, may be soon dismissed by his long time land-based (free) airtime provider, WBAI. He lost one day a week months ago and ranted that he may lose even more. They allowed him time to run a promo for his 'health retreats' that will benefit the station as well as himself. Long story about retreats available upon request.

Although he maintains that he has other outlets broadcasting his dreck, ( unnamed ), an internet locus and woo by phone, I believe that he gets the most money via the radio station because of his longtime association with it and the fact that it reaches NYC money. Who else can afford powdered, dried vegetables at high prices?

NWO Reporter:

Trauma care is "great", because it is based on the results of scientific research. Chronic care is terrible because it's based on the results of scientific research.

How does that work?

Denice @ 17:

You have made my day.

@ TBruce:

I always wonder how they manage to separate the two types of care.
Aren't education, research and training in medicine beyond such artificial and unrealistic distinctions?

It's hilarious to hear them harp upon this tune.

"No need to worry about the chemical medicine paradigm." Oh good. That means the chemical constituents of plants will continue to show activities, long after extracts of the plants themselves fail to live up to their purported use in folk-medicine, or the hyperbolics of marketers.

Chemgeek you ass-ume so much.

Most prostate cancer is genetic, dairy products have nothing to do with it. Let me think; the last time I had a glass of milk is around ten years ago. I did more than a google u research on the subject.

The reason I am in the 7% has to do with where I work (medical facility) and the care I received from here to the treatment hospital. I also lucked out I had the best cardiologist in the area treat me.

@ TBruce:

I know that he has been dismissed and recalled previously BUT we can hope. If he only gets one day a week, it might really eat into his profit margin.

Oh, and we have to stop meeting like this, Bruce.

There are hormones in Dairy products and the Chinese have very low rates.

Did you have any specific career paths in mind for your new job search, Fucklesworth?

From American Cancer Society:

Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables. Doctors aren’t sure which of these factors is responsible for raising the risk.

Some studies have suggested that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing prostate cancer. Dairy foods (which are often high in calcium) might also increase risk. But most studies have not found such a link with the levels of calcium found in the average diet, and it’s important to note that calcium is known to have other important health benefits.

Research shows that there may a slight increase in prostate cancer risks from dairy and red meats but whether it is a causation or a correlation is unclear.

NWO Reporter

Well, Dr. Starfield’s study identified 106,000 deaths per year caused by properly prescribed and administered, FDA approved drugs.

The real follow up question would be, how many are saved each year with the same drugs. Anticoagulants are one of the more dangerous prescription drugs by number of side effects and are often used as examples when talking about drug-related deaths. Except demonstrably they keep high risk patients alive longer than comparable patients without the drug. Chemotherapy also has nasty side effects, and sadly, many cancer patients undergoing chemo die. Now is this due to the drug, or the cancer? (you can argue for or against on individual cases, but again, statistically, patients on chemo survive much longer than comparable patients without).

There's also this:
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6137a6.htm

Two main points to take away from this link is a) the average age of those patients dying from medical complications. And b) the overall decline in the rate - obviously the evil nefarious international disease-mongering conspirators are constantly getting better at keeping people alive. How utterly wicked of them.

Regarding Dr Starfield's article (JAMA 2000 v284(4):483): Among the caveats noted by her in the article, the first is "most of the data are derived from studies in hospitalized patients" - remember that these patients were hospitalized for a reason. These are not deaths occurring in otherwise healthy patients looking for some dietary counseling during their annual well-care checkup. It is not possible to assess how many of these patients would have died regardless of treatment chosen.

A "caveat"? Seems more like a limitation. Most patients who die from unnecessary surgery, medication errors and other errors in hospitals, and hospital-acquired infections, would likely die in a hospital, but by no means all. And considering that many people outside of hospitals are also imbibing properly prescribed and administered, FDA approved drugs, the total deaths from them each year are likely much higher than the 106,000 that occur just in hospitals.

My limited experience with things like biopsy confirmed metastatic cancer is that conventional medicine flies blind with too few markers and panels to see the bullet coming, and fails frequently for this reason.

And then mainstream medicine fails to treat specifically enough with targeted, targetable mild materials (meds) for this reason , too. What I've seen with other patients' regular bloodwork makes me shudder. No wonder at all why so many crash and burn.

My limited experience with CAM/integrative medicine/FM is that morbid inflammatory processes can be attacked sooner, more thoroughly, more successfully, with less risky ammo than in regular clinical medicine.

That headline "Disruptive Functional Medicine Innovation Drives Value-based Future at Cleveland Clinic" really makes me think of the Weird Al song "Mission Statement", which is to say it's filled with meaningless buzzwords.

prn @28: If conventional medicine doesn't have enough markers and panels how would you suggest that we go about creating more? And what do you want the markers to be used for? Prognosis estimation, treatment planning, something else?
(I'm assuming that you're talking about biomarkers, please correct me if you mean something else.)

Some studies have suggested that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing prostate cancer.

OMG. I wouldn't think that the ACS would set-up a strawman.

Low.

Huggins first demonstrated the androgenic dependence of prostate cancer as a potential cause, as well as a point of intervention and therapy, ultimately leading to a Nobel prize in 1966 [1,2].

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134227/

It's hormones stupid.

Mr. Jost has not commented here since 2012. Travis Schwochert from Endeavor, Wisconsin, how is that job hunt going? Sorry, you can't blame us for your bad behavior. You should have thought about that before posting so much vile on the Internet.

A medium that never forgets.

Good bye, Travis Schwochert from Endeavor, Wisconsin.

I learned early on that the Internet does not forget, therefore I have always been careful about my behavior. Which was helped by having a very very common name. Still, I knew better than to post obscene photos, obscenities and meltdowns online.

Perhaps you should apply for Supplemental Security Income (aka disability payments) because your troll history is interfering with your job search.

Here is a quote from the cop when he was arresting some goons across the street for stealing barbecue supplies from a neighbor when they cried "But there are kids in the house!" (who they were ignoring)....

"You should have thought about that before you decided to steal."

Those goons provided a great deal of entertainment in our neighborhood. Instead of taping a piece of cloth over the window to block the street light, the idiot would go out and throw rocks at it to knock it out (stopped when we stood at the top of our steps to watch him). Then they had loud parties, but would not answer the door when when hubby pounded on their door with a rubber mallet. And it was fun standing next to my garage staring at this old guy as he honked his car horn that he summoned a female resident... he kept waving me away while I was standing on my own property! Cop cars made it a habit to park on our street during their breaks to watch that place.

It was so lovely when the guy who owned the rental next door begged their landlord to sell it to him. The landlord did... and before they moved out the idiots literally trashed the place. The building was expensively rebuilt, and nice folks moved in. Then the neighborhood became lovely and quiet.

Travis, we are waiting for you to shut up and leave. You are a stench on society. Don't expect us to help you find a job, you need to own up to your idiocy.

One big idiocy is that pharmaceutical companies get big bucks from preventing diseases... when in reality they make more by treating them:
a href="http://pediatrics.aappublications.org/content/early/2014/02/25/peds.201…">Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009

Also, for the record: I am a former aerospace engineer who just happens to be the mother of a young man with autism who has had a trip by ambulance because of a "grand mal" seizure from a now vaccine preventable disease.

I am not worthless because I fight for my kid. My kid is not worthless because he has potential. Mr. Schwochert, you need to reassess your priorities as you search for a job. Learn how to live with others who are different.

What "now vaccine preventable disease" are you alleging caused your child to have a seizure? I was browsing through the causes of non-epileptic seizures...I didn't see any "vaccine preventable" diseases on there--and that's in the Merck manual, where I assume they'd be anxious to mention such a cause. Just curious.

Disruption is so yesteryear. All the cool kids are pivoting.

Speaking of pivoting, Travis J. Schwochert, aka Fendlesworth, aka Fucklesworth, spin on this

And speaking of cool, man, that guy's got it made! If you do a Google search and misspell his name, Google suggests the correct spelling. How many of us can claim that kind of fame?!.

Heheh. Well, as you can see, the latest Fendlesock is gone. Sorry. I was up late multiple nights this week and fell asleep in front of the TV. So he had a few hours to play without my intervention. Such is life...

NWO @34: Are you familiar with the concept of a febrile seizure, the kind caused by high fevers, most often seen in children? Those can be caused by any number of pathogens that induce a high fever, some of which are vaccine-preventable and some are not.

HiB meningitis can also cause seizures, and thanks to the HiB vaccine, is now very rare.

JustaTech@30:
If conventional medicine doesn’t have enough markers and panels how would you suggest that we go about creating more? And what do you want the markers to be used for? Prognosis estimation, treatment planning, something else?

JT, conventional medicine simply doesn't use enough of what panels and markers that it's already got. There are several problems. Clinical medicine is so used to shortcuts and assumptions for the broad field, that doctors seem unfamiliar with a lot of useful literature and extended analyses in detail in any specific area. With the extra lab data, a lot of minor problems that can unravel you are easier to spot, delineate and/or adjust.

The extra markers improve monitoring and detection. problem detail, prognosis estimation and alteration, treatment planning and targeting - as much of the whole enchilada as one can research.

Of course I'll hear "cost", "overdiagnosis", "polypharmacy", "futility", "iatrogenic risks", (assuumed) "net benefit" (of assumed tretments) etc. These objections more reflect the problems of the current conventional medical models than (alternate medical) reality to me.

Also I'm finding that some panels are already run. Even if I didn't initially ask for them, some are recoverable after the initial results are in, or that they were running them anyway.

if ONLY the problem was limited to the Cleveland Clinic.

If only...https://www.statnews.com/2017/03/07/alternative-medicine-hospitals-prom…

Deep Throat advice is more relevant than ever; "Follow the money!"

SMH!

There are pros and cons of every issue, and there are always are some that twist things around as a money making scheme. As an RN working with the geriatric population, I wish we could all come together and find a happy medium. My patients are prescribed beneficial medicine, but are receiving little to no education on their nutrition and exercises plans. I feel like a better plan for all of us would be to go back to the basics of nutrition, exercise, sleep, stress relief, and hydration. And then on top of that, we could educate the children and families of these patients to help further the prevention of diseases. I believe functional medicine's core is getting back to these basic underlying issues, and although it might not be as scientific or glamorous, I feel that these are the basic components that the general population need help with to increase their quality of life.

What "functional medicine" really is

oracknows — Mon, 05 Dec 2016 02:16:06 +0000

What "functional medicine" really is

I’ve frequently written about a form of medicine often practiced by those who bill themselves as practicing “complementary and alternative medicine” (CAM) or “integrative medicine” (or, as I like to refer to it, “integrating” quackery with medicine). I’m referring to something called “functional medicine” or, sometimes, “functional wellness.” Over the years, I’ve tried to explain why the term “functional medicine” (FM) is really a misnomer, how in reality it is a form of “personalized medicine” gone haywire, or, as I like to refer to it, as “making it up as you go along.” Unfortunately, thanks largely to its greatest popularizer, Dr. Mark Hyman, FM is popular, so much so that Bill and Hillary Clinton count Hyman as one of their medical advisors and the Cleveland Clinic, not satisfied with embracing prescientific traditional Chinese medicine, has gone “all in” for FM by hiring Dr. Hyman two years ago to set up a functional medicine clinic. Unfortunately, it’s been “wildly successful” there.

Unfortunately its success is not deserved, at least from a scientific standpoint.

Functional medicine: A little bit right, a whole lot of wrong

FM, like so much of integrative medicine, sounds good in principle. Look at its seven principles and, knowing nothing more than what these principles are, you’ll find it hard to disagree:

Acknowledging the biochemical individuality of each human being, based on concepts of genetic and environmental uniqueness
Incorporating a patient-centered rather than a disease-centered approach to treatment
Seeking a dynamic balance among the internal and external factors in a patient’s body, mind, and spirit
Addressing the web-like interconnections of internal physiological factors
Identifying health as a positive vitality—not merely the absence of disease—and emphasizing those factors that encourage a vigorous physiology
Promoting organ reserve as a means of enhancing the health span, not just the life span, of each patient
Functional Medicine is a science-using profession

In any post about FM, I feel compelled to remind our readers that the very first principle is, in essence, FM’s “get out of jail free” card for basically anything its practitioners want to do. They can always find ways to justify any form of treatment, be it science-based or quackery, simply by invoking the “biochemical individuality” of the human being whom they are treating. I also like to remind my readers of my retort to this: Yes, human beings are individuals, and each human being is unique. However, we’re not so unique that our bodies don’t all work pretty much the same way. In other words, in terms of biology, physiology, and yes, systems biology, human beings are far more alike than they are different. If that weren’t the case, modern medicine, developed before we had the tools to probe our genetic individuality, wouldn’t work as well as it does. FM fetishizes “biochemical individuality,” not so much because humans are so incredibly different that each one absolutely has to have a markedly different treatment. We’re not. FM fetishizes “individuality” because it distinguishes FM as a brand from science-based medicine and, I suspect, because it makes FM practitioners feel good, like “total” doctors never at a loss for an explanation for a patient’s symptoms or clinical condition, and makes patients feel like special snowflakes whose every bit of “individuality” is being catered to. As for the last bit about FM being a “science-using” profession, FM “uses” science more as a means of justifying whatever its practitioners do rather than guiding them to scientifically-proven treatments.

Here, it must be stated that are some things that FM gets right, although these things tend to be no different than the sorts of things every primary care doctor should be getting right anyway, such as emphasizing healthy lifestyles, good nutrition, enough exercise, adequate sleep, cessation of habits known to be deleterious to health (e.g., smoking). One advantage FM doctors have over primary care doctors practicing science-based medicine (SBM) is that, because insurance often won’t cover much of what they offer, FM doctors tend to spend more time with patients, which is something that primary care doctors have a harder time doing these days. They emphasize prevention, which is a good thing but again something that good primary care doctors do anyway. Unfortunately, the FM version of “prevention” isn’t always in line with the SBM version of prevention. Where FM doctors go so very wrong is in what Grant Ritchey described as a major unstated premise. That premise is that FM really does address the root causes of disease better than conventional medicine. FM also encompasses a lot of quackery, such as acupuncture, chiropractic adjustments, and especially “detoxification” programs. It’s little wonder that many naturopaths are very enthusiastic about FM.

Although I’ve discussed FM before and even shown how its use to treat a cancer patient led to enormous amounts of unnecessary treatments, what I haven’t really done is to show what typical FM clinics offer. Given that it’s only been a week since those of us in the US finished enjoying (I hope) the Thanksgiving weekend and FM is, in part, all about the diet, I thought it might be interesting to survey a couple FM clinics.

Lauren Grace

Although not a physician, Lauren Grace is a self-proclaimed functional medicine practitioner. She is a licensed acupuncturist and doctor of oriental medicine who did “additional study” in naturopathy, whatever that means. (Apparently it means that she uses mesotherapy, homeopathy, and something called the Maxim Life Health System, which purports to “take patients through a series of detoxes to eliminate any disease or disorder” and claims a 95% success rate.) I don’t remember where I first encountered Lauren Grace. I think it was on Twitter, but memory is foggy. I do remember, however, that she was laying down some really dubious medical advice and statements. Unfortunately, I can’t find them now. Fortunately, I don’t need to because there are plenty of other examples right on her very own website and YouTube channel.

For example:

As is frequently the case with such practitioners, Grace starts out with reasonable advice about diet and not stopping exercising. However, by the time you get to the 4:30 mark, she’s suggesting “mini-cleanses” and selling her two week digestive cleanse, which, according to her, pretty much all of her patients do every three months anyway. For the holidays, she suggests three-day “cleanses” to get rid of “all those toxins.” What does this cleanse involve?

This:

There’s some serious woo here. For instance, Grace claims that, because there is a component of the immune system in the gut, cleansing the gut to make it “healthy” will boost your immune system. She even invokes the untrue claim about there being pounds of “rotting food” in your colon. Basically, to Grace, cleansing can fix all sorts of medical conditions, such as eczema, autoimmune diseases, digestive ills of all sorts. Amusingly, her cleanse seems to consist only of special magic smoothies, plus some supplements, a recipe guide, and a two week meal plan. The cost? $175. Oh, and the site has a quack Miranda warning right here.

I ran down the services offered by Ms. Grace and her physician collaborator Dr. Carter (who, for some reason, is listed only as “Dr. Carter,” no first name). Maybe this is why:

Dr. Carter is a Board certified physician who has been in practice for 22 years and over the last several years has focused on providing excellent care in the preventive medicine and minimally invasive cosmetic world. He was the previous owner, Cosmetic Surgeon and Functional Medical Physician at Atlanta Liposuction. His focus has always been on treating the patient as a whole, not only from an outward cosmetic improvement but from a naturopathic, holistic view which paves the way for overall health of the patient. Addressing the hormonal, adrenal, immune, GI and endocrine systems are all critical to balance for a truly successful and optimal outcome.

As the Medical Director here at Sarasota Integrative Health, Dr. Carter consults with Dr. Lauren Grace regarding client cases. He assists with diagnosis and treatment plans and contributes to the latest research studies in the field of functional medicine.

In case you’re wondering how Lauren Grace can provide medical services even though she doesn’t have a degree in medicine or even naturopathy, Dr. Carter is how. Amusingly (to me, anyway), Google reveals his name to be Dr. Michael Carter, and it didn’t even take Google Image Search!

Be that as it may, the services offered by Ms. Grace are fairly typical for an “integrative medicine” clinic, including quackery such as acupuncture, thermography (which is not a screening modality for breast cancer more effective than mammography), life coaching, and the like. However, for purposes of functional medicine, the money is in the description of integrative medicine and the “advanced lab testing” on Grace’s website. As with many other services, Grace offers this helpful video:

Grace starts out by saying that these are “not typical lab tests,” like the CBC (complete blood count). No kidding! Of course, she also claims that her tests are “much more preventative” and “much more advanced.” Personally, the FM definition of “preventative” tends to mean preventing disease by diagnosing lab abnormalities that have little or no effect on health or disease and then “treating” them aggressively with vitamins and supplements. As for “much more advanced,” that’s a ludicrous claim. These lab tests don’t test anything that conventional lab tests can’t test. It’s just that FM doctors use them indiscriminately to test pretty much anyone with any symptom whatsoever, no matter how vague.

Let’s take a look at the sorts of tests offered:

Genova or Spectracell Single Panel: $175
Diagnostechs Female Hormone Panel: $150
Diagnostechs Male Hormone Panel: $150
Doctors Data Heavy Metal Test: $100
Germany Stool Panel DNA: $175
Diagnostechs ASI Panel: $150
Genova Rhythm Plus: $175
Genova Thyroid Panel: $150

There are even combo deals:

Any 2 test reads: $250
Any 3 test reads: $300
Any 4 test reads: $350

You know right away that you’re dealing with highly dubious tests by one name that stands out: Doctors Data Heavy Metal Test. Doctors Data, as you might recall, specializes in dubious hair tests and “provoked heavy metal tests.” Basically, these are tests in which patients are given a chelating agent and then their urine is collected and various heavy metals, such as mercury, are measured in it. The results are then compared to “standard” levels in patients who have not received a chelating agent, an inherently deceptive way of measuring metal levels. Let’s just say that Doctors Data is well known among those of us who try to refute antivaccine and autism quackery, as it’s the go-to lab quacks use to justify chelation therapy. Quackwatch has documented this extensively, and as a result Doctors Data has sued Steve Barrett.

But what about the other lab tests?

Check out Spectracell Micronutrient Testing:

Are you taking too many supplements? Not enough? Nutritional status is a vital foundation of health and performance. SpectraCell’s micronutrient testing is an innovative assessment of nutritional status. Unlike traditional serum, hair and urine tests, SpectraCell’s tests evaluate how an individual’s white blood cells respond to varied environments of over 32 vitamins, minerals, amino acids and antioxidants. As a result, individual differences in metabolism, age, genetics, health, prescription drug usage, absorption rate or other factors are taken into consideration. Nutrient Functions & Deficiency Symptoms.

Ah, yes. Another test to pander to the patient’s need to feel special and unique. Not only is there no convincing evidence that this method of “micronutrient testing” provides actionable information more useful than other tests or that its use results in better outcomes, but it’s not cheap. It does, however, produce pretty reports:

Sure it's a pretty graphic, but does it actually mean anything?

Then there’s the Genova GI Comprehensive Stool Panel:

By evaluating targeted biomarkers, the GI Comprehensive Stool Profile can reveal hidden conditions that other stool tests may overlook. Balancing gut microbiota is key for improving core gastrointestinal functions, such as digestion and absorption of nutrients, as well as metabolic functions.

I looked at a sample report. It’s a mix of standard tests and tests that are basically meaningless. For instance, there is a test for ova and parasites, which is a standard stool test with specific indications. Ditto tests for fecal blood, C. difficile, Campylobacter, H. pylori, and certain strains of E. coli. Then there’s a nonstandard test of sensitivity of various fungi in the stool to various antifungals, both natural and pharmaceutical. This is a test that is rarely indicated, but quacks love it for diagnosing the catch-all made up disease of “systemic candidiasis.” Yes, I know that systemic candida infections exist, but generally if candida has infected the whole body the patient is usually immunosuppressed and becomes sick as snot (a real medical term) as a result. Naturopaths, however, like to blame “chronic candidiasis” or other yeast infections for all manners of vague complaints. Basically, it’s another version of chronic Lyme disease. In addition, by testing basically everybody who wants to be tested for all the conditions Grace tests for, the false positive diagnosis rate will be astronomical.

Then, of course, there is the Genova Full Spectrum Allergy Panel:

Testing aids the clinician in the specific dietary change that is needed, helping to achieve positive outcomes sooner, even when combined with elimination or provocation testing.

Because FM loves to blame all manner of symptoms on various “allergies,” whether the patient has such an allergy by standard criteria or not. Consistent with FM, Grace offers all sorts of tests for female and male hormone levels, thyroid function, and, of course MTHFR mutations, one of latest dubious lab tests beloved of FM practitioners and naturopath quacks (but I repeat myself) everywhere.

Basically, FM takes one of the worst aspects of conventional medicine (the “shotgun” lab tests) with speculation based on science not yet validated in humans, and uses it to order batteries of lab tests on patients, which, because of the sheer number of lab tests, will virtually always discover “abnormalities.” Then, FM doctors will state that these “abnormalities” demand treatment. Never mind that in the vast majority of cases it’s unknown or unclear whether these abnormalities have any health significance.

The Grand Poobah himself

You might be thinking that I picked too easy a target when I decided to “feature” someone like Lauren Grace as my first example, but she’s really not doing anything different than the Grand Poobah of Functional Medicine himself, Mark Hyman, who runs the Center for Functional Medicine at the Cleveland Clinic. Hyman is without a doubt the most famous and influential advocate for FM. Get a load of what is said about FM on the CCF website itself:

Cleveland Clinic Center for Functional Medicine physicians spend time with their patients, listening to their histories, mapping their personal timeline, and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex chronic disease.

Perhaps you have experienced being examined by your doctor, having blood tests done, x-rays or other diagnostic tests taken, only for your doctor to report back that “all your tests are normal." Yet, both you and your doctor know that you are unwell.

Unfortunately, this experience is all too common. Our physicians at the Center for Functional Medicine aim to reduce this problem by applying a new model that focuses on treating your body as a whole system, that treats the causes not only the symptoms, that sees the body as a whole organism, rather than simply a collection of organs. This emerging model of diagnosis and treatment – called Functional Medicine better matches the need to improve the management and prevention of chronic diseases.

By changing the disease-centered focus of medical practice to this patient-centered approach, our physicians are able to support the healing process by viewing health and illness as part of a cycle in which all components of the human biological system interact dynamically with the environment. This process helps to seek and identify genetic, lifestyle, and environmental factors that may shift a person’s health from illness to well being.

Damn those regular doctors practicing SBM! They run the standard lab tests and don’t find anything. Don’t worry, though. FM has way, way more lab tests to run. Dr. Hyman and his acolytes will definitely find “abnormalities” to “treat,” no matter how hard they have to look or how many hundreds of individual nutrients, minerals, hormones, and chemicals they have to measure!

Now, again, I have to concede that not all of FM is bad. For instance:

A new patient consult will last approximately four hours, that consists of a medical consult with the physician, nutrition counseling, education on laboratory testing and health coaching. We are committed to addressing all of your concerns and will provide recommendations as well as construct a personal health plan.

If you are traveling from out of town, please arrange overnight accommodations and be sure to fast prior to your appointment for same-day laboratory testing. You need to bring insurance cards, current medications and vitamins. It’s very important to also bring your medical records if they were not already sent.

A four hour visit with a physician, dietician, and a “health coach” could well be beneficial for many people. However, the price of that the potentially good parts of that visit is the massive overtesting that FM mandates, which is, of course, baked into the visit. As is frequently the case with clinics like this, particularly ones affiliated with academic medical centers, the Cleveland Clinic is fairly vague about what actually happens at its Center for Functional Medicine. After all, I suspect that even the Cleveland Clinic at some level knows it’s peddling quackery and doesn’t want to advertise that too obviously. If you wander over to Dr. Hyman’s website, however, you’ll find “detox” (of course), “ultrametabolism,” and this gem about autism:

TODAY MOST PEOPLE BELIEVE that Autism is a genetic brain disorder. I’m here to tell you that this isn’t true. The real reason we are seeing increasing rates of autism is simply this: Autism is a systemic body disorder that affects the brain. A toxic environment triggers certain genes in people susceptible to this condition. And research supports this position.

Think about it. Rates of autism have skyrocketed over the years, from an estimated 1 child in 3,000 to just 1 in 150 kids today. Sure, wider criteria for diagnosis and better detection might explain some of it but not an increase of this magnitude.

He dances around the issue of whether he thinks vaccines cause autism by noting that he treated a 2 year old boy named Sam who “was born healthy but diagnosed with autism after his vaccination for measles, mumps and rubella at 22 months,” noting:

Every child with autism has unique genetics, causes or triggers. And it is not usually one thing but a collection of insults, toxins and deficiencies piled on susceptible genetics that leads to biochemical train wrecks we see in these children.

In other words, “I’m not sayin’ it was the vaccines, you know, but it was the vaccines plus other nasty stuff, you know, ‘toxins.’” No wonder Hyman was willing to be co-author of an antivaccine book by Robert F. Kennedy, Jr! In any case, Hyman subjected Sam to a huge battery of tests typical of the “autism biomed” movement and, as is usually the case, found all sorts of “abnormalities” in detoxification pathways (a favorite of autism biomed quacks), methylation (another favorite of autism biomed quacks), and oxidative stress (still another favorite). Of course, Dr. Hyman found elevated levels of aluminum and lead in Sam’s blood and antimony and arsenic in his hair. (Yikes! I thought Hyman, at least, would know not to use hair tests for metals. It sounds as though he probably used the typical quack tests for heavy metal “toxicity.”) Oh, and Sam was found to have multiple allergies and a “gluten sensitivity” as well, because, of course he did.

In any case, you can guess the rest. Sam improved, which is not unexpected, given that autism is a condition of developmental delay, not stasis. Sam “lost his autism diagnosis,” which, contrary to popular belief, happens in a significant proportion of children with an autism spectrum diagnosis. Most likely, Hyman’s nostrums had nothing to do with Sam’s loss of his autism diagnosis, but there’s no way of ever knowing for sure one way or another because there are no good clinical trials to tell us whether his nostrums do anything for the symptoms of autism or to affect the course of the developmental delay associated with autism.

Yes, this is the doctor in charge of a major clinic at a major academic medical center. Quackademic medicine rules in the form of functional medicine.

Functional medicine: Fake “individualization”

It’s been noted before many times how how CAM and “integrative medicine” fetishize “individualization” of treatment über alles and how, unfortunately, that individualization is more akin to making it up as you go along than it is to any sort of science-based individualization. This is an aspect of all of CAM, and it strikes me, more than anything else, as a means of catering to the normal human desire to feel special. It also caters to the physician’s desire to feel like a “real” and “complete” doctor who can take care of the “whole patient” and handle basically anything. None of this is to say that it’s not important to individualize treatments, but such tailoring of treatment to patient must be based on evidence and science, coupled with what the patient values. It must be shown to produce superior outcomes. Functional medicine has failed that test.

Basically, FM borrows from the worst tendencies of conventional medicine through its indiscriminate use of dubious lab tests, all in the name of “individualization.” Unfortunately, FM is “individualization” run amok based on more on a desire to individualize for the sake of individualization more than anything else.

oracknows Sun, 12/04/2016 - 21:16

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http://store.drhyman.com/supplements-1/10-day-detox-combo-pack-wellness…

Functional medicine seeks to improve the quality of life for people

Isn't this that "regular" medicine is supposedly seeking, too?
(also shamans, spiritual advisors, marriage counselors, betazoid counselors...)

It's so broad as to be meaningless.

Also, seeing the pastoral-and-seaside picture of FM, I cannot help but think of today's strip of Schlock Mercenary.
Hint: the character's conclusion is correct.

The results are then compared to “standard” levels in patients who have not received a chelating agent, an inherently deceptive way of measuring metal levels.

If you want an analogy, picture your favorite drill sergeant making an inspection of your room with a white glove, and then for comparison opening the next room's door, looking quickly for any pile of dirt, and then closing the door.

When patients are at their sickest, functional medicine doctors are at their scarcest. If functional medicine was as powerful as people claim, ICUs and ERs should be crawling with doctors who practice the principles of functional medicine. Yet, instead, they are where patients are at their most lucrative.

Yet, instead, they are where patients are at their most lucrative.

Exactly. As Deep Throat said, follow the money.

re RFK jr

I just had a sublime pleasure of seeing him interviewed on television n regards to environmental issues surrounding the
Dakota pipeline.

At least he didn't bring up vaccines.

I find it very interesting that Cleveland Clinic has Functional Based Medicine and Integrative Medicine departments, when their physical therapy department will no longer use modalities such as ultrasound and e-stim because they are not evidenced-based therapy practices...does that make sense to anyone??

. . . Don’t worry, though. FM has way, way more lab tests to run. Dr. Hyman and his acolytes will definitely find “abnormalities” to “treat,” no matter how hard they have to look or how many hundreds of individual nutrients, minerals, hormones, and chemicals they have to measure!

Or how many hundreds of your dollars they have to spend to find something.

What a lovely picture of Lake Erie at the top of the OP!

Cleveland, city of light, City of magic
Cleveland, city of light, you're callin' me

If advice on diet and nutrition are things FM gets right, hings that FM gets right, "no different than every primary care doctor should be getting right", does that mean I should run down to the South City Salvation Army and grab copies of Mark Hyman's books? They always have some, and they charge $3 for hardcover $1 for paper, and have BOGO sales on a regular basis. I could bring home The Immune Syste Recovery Plan, The UltraMind Solution: The Simple Way to Defeat Depression, Overcome Anxiety, and Sharpen Your Mind, Eat Fat, Get Thin and one more for ,ess than a half-sawbuck. That's a lot cheaper for some sensible diet advice than forking over $175 to Lauren Grace – plus I wouldn't have to travel to Florida.*

But, drat, maybe I do need to consult some FM expert. How else can I know whether The UltraSimple Diet: Kick-Start Your Metabolism and Safely Lose Up to 10 Pounds in 7 Days, the 10-Day Detox Diet: Activate Your Body's Natural Ability to Burn Fat and Lose Weight Fast, or The 21-Day Plan to Detox, Fight Inflammation, and Reset Your Body is the right one for me? Since Dr. Hyman is all about individualized approaches, I'm sure Genova has a stool test that can tell me whether I'm better suited for 7 day, 10 day, or 21 day paths to ideal health.

_________
* Florida. Of course. It's always Florida.

#7 @sadmar

Of course, the people I deal are always insisting on their own special uniqueness that requires special individualized treatment as demonstrated by their special individualized reactions to EVERYTHING!

When I go to the trouble as asking "why, exactly, do you think you are different from everyone else" I tend to get less "well, I have this gut biome workup and a total gene scan correlating with blah blah blah" than "you smug scientists think you are SOOOOO special."

Which I find a bit ironical.

This is quite possibly the most ridiculous thing I've ever read. In a country where everything we eat is killing us, and doctors are controlled by insurance and only allowed to run certain tests, even the good GP's aren't getting it right. Most diseases are not a lack of a drug. I'm certain there are times that they are needed but not passed out like candy because that's all the insurance company will allow. FM's don't take insurance because tests that actually tell you things other than a CBC many times will not be covered by insurance though they are necessary. I've not been to one traditional GP that addressed diet. This is what functional medicine stresses, that diseases are a buildup of toxins in the body and to fix them at the root you have change your lifestyle. Traditional medicine just gives drugs. And big companies get rich off of them. And every functional medicine practitioner that I've been to use practices that have been in existence for thousands of years and have a long track record of success. Accupuncture and chiropractic were once thought to be quack medicine as well and now are offered in most every clinic or docs office available. Not to mention that thousands of studies prove their effectiveness. Take the controversial adrenal fatigue for instance. Do you really think that in disease we just wake up one morning with Cushing's or Addison's? No. That damage takes years to happen but can be addressed when it is still in the adrenal fatigue phase before it turns into all out disease (for people who acquire it, not when it is congenital). Or diabetes, pre-diabetes was once believed to be a ridiculous term and now every doctor I know uses the term. Unless you were born with diabetes, you don't just wake up with one day without surgery to cause it or something of that nature. Functional Medicine and viewing the body as a whole is why places like Mayo Rochester and Clevelend Clinic have been so successful, because they actually follow those principles. Functional medicine is taking over because it is sensible. Viewing the body in compartments is ridiculous. Everything works together.

and medicine is individual which is why traditional medicine gets it so wrong. Human bodies do not all operate the same. There is no one size fits all.

Medscape enables functional medicine quackery

oracknows — Fri, 14 Oct 2016 04:00:50 +0000

Medscape enables functional medicine quackery

It’s no secret that I’m not exactly a fan of Dr. Mark Hyman he of the “Ultrawellness” medical empire and arguably the foremost promoter of the “subspecialty” (if you will) of “integrative medicine” known as functional medicine. Integrative medicine, as I’ve told you time and time again, is a specialty dedicated to “integrating” alternative medicine into conventional science-based medicine; i.e., integrating quackery into medicine. One very prominent, very common strain of integrative medicine is known as functional medicine, and Mark Hyman is, although not its originator, its current main guru. I first encountered him back when he was known primarily for his UltraWellness Center, which he still runs. Given his background, I was disappointed to see Medscape doing a three part interview with Dr. Hyman, “The New, Old World of Functional Medicine” (Part 1, Part 2, and Part 3). Reading Hyman’s blather, as you might imagine, can’t help but attract the attention of this blinky box of lights.

When I first encountered Hyman, lo those several years ago, it was because he had drawn my attention by busily mangling autism science, cancer biology, and systems biology in the service of woo and arguing that we should turn back the clock and rely on anecdote-based medicine instead of evidence-based medicine. These days, he’s head honcho at a new functional medicine clinic at the Cleveland Clinic, which, unfortunately, appears to be a wildly successful. He’s even been counseling Bill and Hillary Clinton about their health and, should Clinton be elected, be an influential advisor on health issues. Unfortunately, the alternative, Donald Trump, is far worse, given his hard core antivaccine beliefs and all his other baggage and vile behavior. Unfortunately, Hyman also shares some of those antivaccine views, having co-authored an antivaccine book with Robert F. Kennedy, Jr. and appeared on The Dr. Oz Show to help him promote it.

Functional medicine, of course, is quackery. It’s actually one of the harder forms of quackery to explain, for the simple reason that functional medicine practitioners sure sound science-y. They do lots of lab tests—lots of lab tests!—and act on them all, replenishing nutrients, trace elements, and vitamins whether it’s necessary or not and “personalizing” treatments based on the “biochemical individuality” of each individual. Of course, as I like to say, this appeal to “biochemical individuality” is functional medicine’s “get out of jail free” card for basically anything its practitioners want to do. They can always find ways to justify any form of treatment, be it science-based or quackery, simply by invoking the “biochemical individuality” of each human being. The problem is this. Human beings are individuals, and each human being is unique. There’s no denying that. However, we’re not so unique that our bodies don’t all work pretty much the same way. In other words, in terms of biology, physiology, and yes, systems biology, human beings are far more alike than they are different. If that weren’t the case, modern medicine, developed before we had the tools to probe our genetic individuality, wouldn’t work as well as it does. FM fetishizes “biochemical individuality,” not so much because humans are so incredibly different that each one absolutely has to have a markedly different treatment. We’re not. FM fetishizes “individuality” because it distinguishes FM as a brand from science-based medicine and, I suspect, because it makes FM practitioners feel good, like “total” doctors never at a loss for an explanation for a patient’s symptoms or clinical condition. As for the last bit about FM being a “science-using” profession, I like to say that FM “uses” science the same way that an illusionist or magician uses misdirection: So that the audience can’t see how he pulls off his trick. That’s the short version. The long version is that functional medicine is making it up as you go along.

In fact, one of the things about functional medicine that I never understood is why it's so popular with those drawn to "complementary and alternative medicine" (CAM) or, as it's now called "integrative medicine." People drawn to CAM tend to be interested in more "natural" medical treatments and suspicious of conventional medicine. Yet, from my perspective, functional medicine takes one of worst aspects of conventional medicine, namely its tendency towards overtesting, and puts it on steroids, leading to overtesting to the Nth degree. Just go back and reread my post about the functional medicine case report of a woman with breast cancer. The functional medicine doctors who treated that woman ordered a dizzying array of unnecessary and unhelpful laboratory tests and put her on a boatload of supplements, nearly all unnecessary. The only things the functional medicine doctors suggested that might have helped the patient were exercise, a personal care giver, counseling, and perhaps her sleep log to help her get enough sleep. So, basically functional medicine combines one of the worst aspects of conventional medicine (the tendency to test every lab value under the sun), cranks it to orders of magnitude worse, and then adds woo. Maybe it's the woo that attracts patients, with the lab testing that leads them to thinking that the functional medicine doctors know what they are talking about when they extrapolate from basic science to think that measuring these markers gives them any guidance whatsoever about how to manage their patients' problems, not realizing that they're basically doing the equivalent of reading the entrails of goats, given that there are no high quality data that clearly tell doctors what to do with many of the lab test values they order.

So why was Medscape interviewing Dr. Hyman? Who knows what got into Dr Hansa Bhargava, medical editor for Medscape and WebMD? Whatever it was, she for some reason thought that a fawning interview with one of the foremost practitioners of quackademic medicine was a good idea, thus lowering Medscape still farther in my estimation. One thing I found interesting that I didn’t know about Hyman before was the circumstance of his conversion to functional medicine, which he relates in Part 1 of the interview. Basically, he started out as a family doctor in a small town in Idaho, after which he worked as an ER doc in Massachusetts for a while. Then he became medical director at Canyon Ranch in Lennox, which explains a lot, because Canyon Ranch is a resort and spa catering to well-off executives with wellness programs (at only $5,575 for a four day stay or $4,355 for a two day stay) and weight loss programs. Hyman’s evolution into an “integrative medicine” practitioner and the foremost practitioner of “functional medicine” is making a lot more sense in light of this revelation (to me, at least). This story also tells me a lot:

Right after I started at Canyon Ranch, I became quite ill. I had chronic fatigue syndrome. My whole system broke down: My muscle enzymes were elevated with creatine phosphokinase levels over 600. I had a positive anti-nuclear antibody, a low white blood cell count, elevated liver function tests, and severe cognitive dysfunction. I had myalgia, weakness, rashes, sores on my tongue, and severe diarrhea for years. My whole system just collapsed. I went from physician to physician, to Harvard and Columbia, and more. But I got no answers other than to take antidepressants or sleeping pills.

I began to search for other ways to understand what was happening. I knew it wasn't in my head. I finally discovered that after living in China for a year I had gotten mercury poisoning.

I learned through this process that there was a whole new field of thinking that had a systems-biology view of medicine. It addressed the root causes of disease—not just symptoms but also etiology. It's medicine by cause, not just symptoms. It's medicine by understanding mechanisms, not just geography, or where the symptom or pathology exists. It was a whole new operating system for understanding how to diagnose and treat chronic disease.

So I started practicing functional medicine at Canyon Ranch and healing myself. I started seeing extraordinary results with patients and myself. I joined the faculty and eventually became the chairman of the board of the Institute for Functional Medicine, which trains physicians and other healthcare providers in functional medicine, a powerful systems-based model that takes our observations of the root causes of disease and our biological networks, and integrates them into a framework for clinical application.

Systems biology. You keep using that term. I do not think it means what you think it means. Hyman has already shown that his understanding of systems biology is what I would consider less than optimal. Particularly annoying is how Hyman seems to think that, before functional medicine, no one ever thought of cancer as a systemic disease or wondered about the microenvironment of the tissues in which cancers form and grow. He is also very sloppy about citing studies to support his point of view.

Be that as it may, Hyman had some sort of mysterious illness that may or may not have been fibromyalgia, and it changed him, activating a latent tendency towards embracing pseudomedicine. Obviously that tendency was already there, or he probably wouldn’t have taken the position of medical director of a spa for executives. Characteristic of functional medicine is a rather large dollop of arrogance, as though functional medicine were something amazingly new and different that we hidebound physicians could never have thought of and only enlightened innovators like Dr. Hyman can appreciate. It’s utter nonsense, of course, but get a load of Part 2 of the interview if you want to see more annoying stuff. Dr. Bhargava basically launches a really slow pitch softball question with a huge high arc right over the plate. Not surprisingly, Hyman easily hits it deep. What’s really irritating is how he does that. As usual, he denigrates conventional medicine as not looking at the whole picture and, in contrast, paints functional medicine as considering things that conventional medicine fail to consider. Of course, there’s a reason why evidence-based medicine doesn’t do what functional medicine does; it’s because it’s not evidence-based. None of this stops Hyman, of course:

But in conventional thinking, the end stop is the differential diagnosis, which we all learned in medical school. That's usually the end of our thinking. Once we've made the differential diagnosis and we have the diagnosis, we know what to do. We pick up the Washington Manual of Medical Therapeutics for residents. We have the standard of care. It's not that complicated. Once you make the diagnosis, you know what the treatment is, right?

In functional medicine, the diagnosis is the place where we start to think. It's not the end of our thinking. In traditional medicine, it's the naming and blaming game. We name the disease and blame the name for the problem, and then we tame it with a drug. Let's take depression, for example. Someone comes in, and they're hopeless and helpless. They're sad. They have no interest in life. They have no appetite. They're not sleeping. They have thoughts of suicide. You say, "I know what's wrong with you. You have depression." Depression isn't the cause of those symptoms. It's the name of those symptoms. Then, we ask, "What's the cause of those symptoms?"

Arrgh!

Hyman no more knows the cause of depression any better than his portrait of conventional medicine’s understanding. Don’t believe me? See what he says next:

Well, there may be dozens of causes of depression, right? It could be psychosocial trauma, early life experiences, or Hashimoto thyroiditis, an autoimmune disease that leads to low thyroid function and is caused by eating gluten, which creates an autoimmune thyroid disease. The depression could be because you have been taking a proton-pump inhibitor for 10 years and you have vitamin B12 deficiency, or because you live in the Northeast and you have vitamin D deficiency, or because you have taken antibiotics that altered your gut flora, or because you love sushi and you're eating sushi all the time and you have mercury poisoning, or maybe you hate fish and have omega-3 fatty acid deficiency, or maybe you're insulin resistant and love cinnamon buns and have prediabetes. All of those can cause depression. So it's a methodology for sorting through the root causes and the things that are driving it and then addressing those.

Wait, what? Hyman is basically saying that conventional doctors who treat depression, like primary care doctors and psychiatrists, don’t look at thyroid function and psychosocial trauma. (Hint: They do.) In fact, what Dr. Hyman is doing is touting how functional medicine does what medicine does. Basically, he’s constructing a differential diagnosis. Let’s say a patient comes into your office with symptoms of depression. You evaluate him, and he fits the DSM-V criteria for depression. Now what? You have to see if this patient has any known causes of depression, such as, yes, thyroid disease, psychosocial trauma, genetics, nutritional deficiencies, endocrine disorders, lupus, and several others. Unfortunately, Hyman doesn’t stop there. Functional medicine considers all the known science-based causes of depression and then adds pseudoscience, such as the “mercury poisoning” from sushi, plus the usual panoply of lab abnormalities from the extensive lab panels that functional medicine demands. The other problem is that, while a lot of conditions are associated with depression, the causative relationship is not always clear. For instance, diabetes and prediabetes are indeed associated with depression, with diabetics being at a higher risk of depression, but that doesn’t mean that diabetes necessarily causes depression. Basically, Hyman exhibits a whole lot of hubris by asserting that functional medicine does so much better than conventional medicine in examining the causes of depression.

It’s a hubris that extends into Part 3:

I studied Chinese in medical school and learned about Chinese traditional healing systems. I've had much acupuncture in my life. In fact, it cured me of chronic pain that I had from back surgery. I do use other alternative modalities all the time as an adjunct to support my health.

But, when you use other modalities, how do you use them? When do you use the modalities? What is the diagnostic map? If you have migraines and you go to a group of integrative medicine doctors, one might say that you have a dosha imbalance, that maybe your vata/pitta is out of balance. An acupuncturist might say that your kidney chi is not right. The psychologist is going to say that maybe you're stressed and you should get therapy. The biofeedback person will say you need biofeedback. The herbalist is going to tell you to take feverfew.

In functional medicine, we don't do that. We ask, "Why are you having a migraine? What's the cause of your migraine?" If the cause of your migraine is that you're eating gluten, all these modalities are not going to help. We have a simple rule: If you're standing on a tack, it takes a lot of aspirin to feel better. You need to take out the tack. If you're standing on two tacks, taking one out isn't going to make you 50% better. You need to get rid of all the causes.

Give me a friggin’ break. This is nothing but more hubris. Basically, what functional medicine really does is to run every lab test under the sun and try to correct abnormal values. This is what Hyman refers to elsewhere in his interview as “the original precision medicine,” an assertion that made me want to head to our liquor cabinet and open up a bottle of scotch. Fortunately, I resisted. It was, after all, a work night when I wrote this. Otherwise, I might have had a more violent reaction to this:

I think the concept of precision medicine is fantastic. It is in alignment with functional medicine. In fact, functional medicine is the first application of precision medicine.

I get concerned about this getting coopted by pharma as being about pharmacogenomics. Precision medicine is how we match the drugs to the person. We know that if you have a 2C19 polymorphism, then maybe you should be adjusting your warfarin differently. Fertility doctors will check methylated SNPs, MTHFR. If you have a methylated SNP, you might need methylated folate or a higher dose. These are more personalized drug therapies as opposed to a holistic systems approach.

I think we have to be careful with it. It's really looking at more of a Leroy Hood model in systems biology, what he calls P4 medicine: personalized, preventive, predictive, and participatory. That's essentially what we do in functional medicine.

I do so find a lot of amusement in how Hyman loves to invoke systems biology without having the slightest clue what systems biology actually is or entails. Oh, and I have observed Leroy Hood for many years. Mark Hyman is no Leroy Hood. he’s also rather obvious:

Dr Bhargava: Now I'm going to take the lens of the skeptics. You have probably seen their websites.

Dr Hyman: I've seen them all. Have you looked at their credentials? They're usually shills for pharma. I'm saying things that are not popular.

Ah, yes. The pharma shill gambit. If there’s one thing I know, it’s this. Whenever someone tries to dismiss his critics as “pharma shills,” I know that that person has nothing else. The same is true here. Notice how Hyman just dismisses his critics as “pharma shills.” There are no details. There’s no actual evidence presented that any of them are, in fact, in the pay of big pharma. He just seems to think that saying “pharma shill” is enough. To his incredible shame, Dr Bhargava lets Hyman’s use of the “pharma shill gambit” pass unchallenged. Pathetic. Even if Dr. Bhargava were sympathetic to the quackery that Hyman was laying down, it’s an utter, shameful failure in his role as medical editor for Medscape and WebMD to have allowed Hyman to make such statements completely unchallenged.

What this interview tells me, more than anything else, is that the medical editor of Medscape and WebMD is not only clueless about what “functional medicine” is but that he is more than willing to let someone like Dr. Hyman spout self-aggrandizing pseudoscientific bullshit unchallenged. That is the deficiency among those of us who are ostensibly defending evidence- and science-based medicine. We are not willing to call quackery when we see it. Quacks who can talk the talk and seem to be practicing evidence-based medicine are the beneficiaries of this reluctance.

oracknows Fri, 10/14/2016 - 00:00

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I finally discovered that after living in China for a year I had gotten mercury poisoning

Yes, Mark, but that's just the symptom. What was the real cause of getting mercury poisoning?

A billion people live in China without getting mercury poisoning. I cannot help wondering what is so special about this snowflake that made him so uniquely sensitive to the toxic environment.

FWIW, I have not been able to stand reading anything on Medscape for a few years now. The quality of articles there is brutally poor, and it all seems very agenda-driven. To what end, I'm not sure, but too often they start with a conclusion and fill in the rest of the story to match.

"Functional medicine seeks to improve the quality of life for people" Yes, the people who practice it.

Never under-estimate the power of click-bait articles to help raise advertising funds. Sucks that Medscape is following that trend, but it is happening on most sites.

I'm still waiting to see what Doc Hymen does that is so different from any real doctor. You see doctor with problem, doctor runs tests to figure out what the problem is, doctor prescribes fix for problem, you go home healthier if not happier. Doc Hymen just figures he has to pad his bill a lot with irrelevancies. My issue is with the too human frailties arising in doctor's that causes some to do a half-ass job of diagnosis, but that is irrelevant to this topic.

Oh, Medscape. I ended up putting them into my Spam folder, because most of their articles are just click-bait. Very rarely have I gotten anything of interest from them any more.

As for Dr Hyman: sorry, doc. When I'm depressed, I want a doctor who looks at the normal causes and treats me appropriately, not go running off looking for zebras in the underbrush and making me pay tons out of pocket.

you’re eating sushi all the time and you have mercury poisoning

Sounds reasonable to me (if you live in Grassy Narrows).

@ 1 herr doktor bimler

Clearly Japan has a more serious mercury poisoning problem than we realized.

I like preceding functional medicine with an article about overdiagnosis. Functional medicine is overdiagnosis raised to a power.

Yep. Now that you mention it, maybe I should have said that in my article. Maybe I will add it somewhere later... :-)

Pharma Shill? PHARMA SHILL??? Argh. Grifter Mark Hyman calling anyone a Pharma Shill is just rich. Nothing more than vile, disingenuous projection.

He's one of the biggest affiliate marketing scammers out there. He's involved in a large network of incestuous cross-promoting scammers that includes Ty Bollinger with his uberscam "The Truth About Cancer," Mercola, Mike Adams' Natural News, HealthTalksOnline health "summits," Sayer Ji's GreenmedInfo, Frank Lipman, Life Extension, Dr Axe, Dr Mark Sircus, David Avocado Wolfe, Hay House, etc.

These predators seem to have quite a lucrative scam going, promoting each other and paying/collecting commissions for doing so. For example, Ty Bollinger alone brags about having paid out over $8 MILLION in commissions for marketing his own brand of cancer quackery (and he's working on an antivax version now).

It's a dishonest and underhanded system that amplifies every kind of snake oil there is, and their pervasive advertising ensures that it reaches more and more consumers/victims.

It makes me sick to my stomach.

Hyman's involved with Ty Bollinger, Joe Mercola, and Mike Adams, etc.? Do tell...

Did he mention the chemtrails?

I don't think the lab tests are what draw patients to functional medicine. I think it is the idea of "biochemical individuality". I feel like a lot of people who are drawn to woo and all of its affiliates have what I think of as "Special Snowflake Syndrome" where they truly believe that they are somehow SO different from everybody else, and need the most special attention because they are the most special people. I'm sure they would not describe themselves this way, but that is my impression of people who get into this stuff. They are also the people who believe they are so smart and special that they know more than an MD and are oh-so-certain that their MD just doesn't understand how very, very special they are. Give me a freaking break.

@#1 herr doktor: I want to know how functional medicine cured his mercury poisoning. He makes a huge leap between the supposed cause of his symptoms and goes right into the functional medicine blather but he doesn't actually tell us how he got better . . . . or IF he got better.

I am also a bit annoyed with what he has to say about migraines. Sure SOME people have food triggers. But to know that you have to keep a migraine diary.

MY trigger is the weather. So what does he want me to do, move to the International Space Station? Even if NASA would allow it, that's a bit drastic. I'm still going to need Excedrin, and even then there are just some days (like the past three) where I just have to suffer.

@#5 MI Dawn: some articles are OK. Some are even peer reviewed articles they republish. But oh yeah, there is so much woo and the quacks come out of the closet every time a USPSTF recommendation or a vaccine article is published. I blush with shame at some of the things my fellow nurses will say (assuming they are actual nurses, but unfortunately I know far too many RNs who buy into the BS).

Ugh, I now have some residual guilt about my comment. I feel bad characterizing an. Entire group of people that way, as I'm sure many people are simply duped by the incredinly convincing and entirely subversive fake medical jargon spouted by woo-peddlers. Lots of people are being taken advantage of which is heartbreaking, but there is no shortage of willfully ignorant f***s loafing about among the people who are truly being taken advantage of.

They do lots of lab tests—lots of lab tests!—and act on them all

Sounds like cargo cult science to me. Richard Feynman had some choice words about it in his 1974 commencement address at Caltech. (The speech even includes some forms of quackery that RI readers will have heard of.) They are adopting the forms of science-based medicine, but it isn't making people well (beyond the placebo effect), any more than the simulated airfields of the post-WWII cargo cultists in the South Pacific attracted planes full of cargo.

@ Panacea

he doesn’t actually tell us how he got better

For some reason, I am now picturing Hyman claiming he was changed into a newt.

What caused his mercury poisoning? Almost certainly methylation of one or more of the genes for enzymes of the mitochondrial metal transporter (MMT) family. Obviously, this would cause accumulation of toxic metals in his mitochondria -- the powerhouses of the cell -- leading to his chronic fatigue syndrome.

One of many examples: http://naturalmedicinesummit.com/
This is just one of the many health "summits" and network affiliate gigs. Each of the "experts" joins the ring of cross promotion and promotes the hell out of it with their bogus blogs, tweets, FB posts, etc. IMO, it's why we're bombarded with stupid memes and scammy vapid nonsense in pretty pictures from eg. David Wolfe, Kristie Leong, Razi Berry, Naturopath News, etc. And advertising works.

HealthTalksOnline is just one of them, but it's a very typical MLM-esque example of the Circle of Woo affiliate programs they all have: "Affiliates receive a unique link to promote our events to their fans and followers. There is no cost to be an affiliate.
Promotion might include emails, blog posts, social media posts, radio shows, podcasts, news articles and more! When someone who clicked an affiliate’s link makes a purchase, we credit a commission to your affiliate account!"
"An effective way to generate commissions and reach more people, is to register other affiliates! When someone makes a purchase from an affiliate that you registered, you will receive a bonus 10% commission on that sale."

Could be mere coincidence, but see also Evolution of Medicine's (EOM) inner circle "Practice Accelerator" affiliate program, which happens to be celebrating a big launch this month, with promises to "pay affiliates a 33% commission on the Practice Accelerator Product, along with a 10% commission on any upsells during the launch."

"Hashimoto thyroiditis, an autoimmune disease that leads to low thyroid function and is caused by eating gluten"

Listen, I am not, and will never be a doctor, but I do have Hashimotos, and I have never, in my 3 years if life had it attributed to gluten. Is thus actually the case? Cause it sounds fake and woo-y.

I mean, yeah, his whole interview is just awful, completely awful, but this stuck out to me.

"FM fetishizes “individuality” because it distinguishes FM as a brand from science-based medicine and, I suspect, because it makes FM practitioners feel good, like “total” doctors never at a loss for an explanation for a patient’s symptoms or clinical condition."

Of course, mainstream clinics and practices also promote the idea that they alone see the patient as super-individual, a tactic used to bolster their income.

Our local academic medical centers trumpets in its ads "there is no routine cancer", as though everyone else just leafs through the Washington Manual and plugs everyone into a single standard course of therapy.

Hyman: "In traditional medicine, it’s the naming and blaming game. We name the disease and blame the name for the problem, and then we tame it with a drug."

I'd argue that commonly in functional medicine and other brands of woo, it's name the disease (often erroneously) and then blame the patient for the problem. You ate the wrong things, exposed yourself to toxins, weren't optimistic/spiritual enough, and let Conventional Medicine ruin your system, thus it's your fault for being sick.

It is odd to peruse Dr. Bhargava's LinkedIn. On the one hand, she wrote a nice article called "Why I Vaccinate My Children". But on the other hand, she's already listed this embarrassing interview with an anti-vaccine quack as an accomplishment:

In a more journalistic area, she has participated in a panel with and interviewed the First Lady, Michelle Obama as well as the current and past AAP Presidents, the CEO of UNICEF Caryl Stern and CDC director Dr Tom Frieden at CDC. Most recently she reviewed President Clinton's physician and Director of Functional Medicine for the Cleveland Clinic, Dr Mark Hyman.

If Dr. Hyman really believed in treating patients as individuals, I would think he would stop peddling expensive supplements to strangers over the internet. Instead, he is selling detox supplements for nearly $300 to people he has never examined. It's hard to be more unethical than that.

I also wonder why doctors like Hyman spend time touting their genius in videos on talks. When do you think the last time he was responsible for a hospitalized patient? Or saw a patient in the ER? Or worked late at night? Or on a weekend?

Real doctors test their medical skills daily with sick people. Quacks like Hyman make YouTube videos promoting their skills, but will *never* be in the hospital when people are really sick.

Yep, his supplements are affiliate network-marketed too, eg. PureFormulas (Metagenics, Thorne, etc)
Affiliate Program Details:
•Up to 8% Affiliate Payout (coupon based payout is 4%)
•$65 Average Order Size
•48% Conversion Rate
•NOW MOBILE ENABLED!

It's not about the patients or about health at all. It's ALL about the marketing potential.

@Panacea, I present for your examination, the case of two RN's, who attended all of the same classes at Widner University's school of nursing, graduating in the same class.
One is vehemently antivax, the other, our eldest daughter, evidence based and pro-vaccine.
Go figure.

As for the quack's cure from "mercury poisoning", somehow, I'm willing to bet his cure included removing gluten from his diet.
That's one of the biggest flags around, when random disease X suddenly gets linked by the quack to gluten.
As one who has friends who suffer from celiac disease, those kinds of claims make me grind my teeth.

Now, to poll the house to see if anyone else is interested in an eggplant lasagna. I substitute out the ricotta cheese with tofu and parmesan cheese mixture. It picks up my home made sauce flavor, while not being gritty, it's creamy instead.
Yeah, I'm also a reformed chef as well. :)

" I had... severe cognitive dysfunction" Dr MH

I just HAD to!

But more seriously, I can understand** why people who experience puzzling symptoms and don't get relief easily can fall into the woo- bucket.
Even ( I venture) smart people like Hyman.

Of course, why not take your situation and market the possibilities?

** as someone who is suffering from an injury that has limited some of my activities and re-appears sporadically out of nowhere
.
Fortunately, I found myself intriguing additional work.
I like to tell myself that perhaps the Universe was 'trying to tell me something' so that I would change or suchlike ( not that I really believe that).

Not that I would market anything.

" ...you're eating sushi all the time and you have mercury poisoning"

If so, you're eating in the WRONG places.

affiliate network-marketed

This is the polite term for organizations that resemble Ponzi schemes but manage to stay within the letter of the law because they deliver an actual product. Amway is the most (in)famous example, but we have seen other supplement marketing outfits with this kind of corporate organization.

OT but

it's late, there are already many comments, it's nearly the weekend,
the Universe worked against my noting it yesterday and
it's REALLY important that the minions know and celebrate-

In other news....

Bob Dylan ( aka Robert Allen Zimmerman, Shabtai Zisl ben Avraham, Lucky Wilbury etc)
received the Nobel Prize for Literature.

A billion people live in China without getting mercury poisoning.

But a gweilo like Hyman probably didn't have a diet typical of ordinary Chinese people. He probably ate a good deal more meat, like rich Chinese do, and depending on the source of that meat, it's possible that he got mercury poisoning from it. But that leads to Panacea's question:

I want to know how functional medicine cured his mercury poisoning.

There is an SBM treatment for mercury poisoning. It's called chelation, and removing heavy metals from the body is exactly what it is designed to do. Yes, this is the same chelation therapy that so many woo-pushers recommend for removing "toxins" that aren't heavy metals (and for which the treatment is therefore ineffective). Of course Hyman wants to skip this part of the story, because it doesn't involve functional medicine.

No, it's not a gluten-free diet which is used for mercury poisoning. It's chelation therapy. Ironically, his condition may have been caused by chelation therapy. If he was given chelation as preventative therapy against cardiovascular disease or other problems, he may have received too high a dose or for too long. Many chelation practitioners are far too aggressive -- they aren't satisfied until the provoked urine test shows levels at the extreme low end of the normal range. The standard chelator is EDTA, which is very non-specific against both toxic metals and essential micronutrients like vanadium and molybdenum. The body's response to a micronutrient deficiency is to down-regulate expression of the metal transporters, to conserve these essential micronutrients, by methylating the genes which code for the transporters, . The side-effect is accumulation of the toxic metals. So now, he's on the chelation treadmill -- he has to continue with chelation to bring down the toxic metals and take supplements of essential micronutrients to maintain their levels. It may take several years to taper off the chelation and slowly build back to a normal level of transporters. This is why chelation should be applied judiciously by a specialist who only does chelation, and never as a side-line to a chiropratic or naturopathic practice. It's the latter group who are giving chelation a bad name.

While I think there are popular bs diagnoses and overdiagnoses, there are also many complicated cases with multiple problems of missed diagnoses in classical medicine and nutrition that are difficult to unwind. Especially the further that you hit from a basic cause.

The chronically ill may have shockingly overt symptoms of gross malnutrition that quickly go away on correction or repletion but have multiple potholes in their situation. Patients also wrestle with iatrogenic causes and injuries in medicine too, often unacknowledged unless bad enough for lawsuits to rain down and succeed.

However inefficient naturopathy and FM may be, they can easily win if they make enough progress to relieve even some of the serious or chronic symptoms patients have that are unresolved. What I've seen
1. if they have serious GI deficits and problems, recognized and fixed?
2. if not, digestive aids and/or
3. supplements like for an uncorrected gastritis or sprue or even more ...

When even one bad symptom, or their worst symptoms, go away after some rough years, who are patients going to listen to after that?

Hyman's employer, Canyon Ranch, rang a bell for me. Sure enough, Hyman has been a previous recipient of Orac's Respectful Insolence. Not surprisingly for somebody who operates in the Berkshires (in Massachusetts close to the New York border), Hyman attracts a bunch of clients from the New York City area--Bill Clinton, in the specific case of the earlier post.

Only slightly OT:
In college I found a copy of the Canyon Ranch Cookbook. Beautiful, glossy, heavy, it must have cost $60, so I have no idea what it was doing in a dorm lounge.

I've never seen a cookbook with so many pictures and so little food. A smoothie might have a dozen ingredients, (most of which would clash on the palate) and then a note "to be consumed after morning yoga, and will suffice for the rest of the day", or some such nonsense.
After a while I was surprised that there wasn't a recipe for a single cabbage leaf, boiled.

So yeah, pretty short straight line from that kind of nonsense to total quackery.

Like Hyman, WebMD and Medscape started out well, but have since become so deteriorated by greed and ignorance that I warn against them.

Should Hilary Clinton become President, her treatment by the likes of Hyman would in my opinion constitute a threat to national security. Come to think about it, quackery in any form is already a threat to national security, but then so is stupidity.

@Denice Walter #29: The day that Bob Dylan receives the Nobel Prize for literature will be the day when Donald Trump runs for President. Seriously! Did someone put stupid in the drinking water? Google Bob Dylan, Plagiarism to see what I mean. If anyone else in the music world should have been chosen for the Prize, it would be Joni Mitchell, who years ago told me about Dylan's ripoffs. As you will see, Joni and other experts have long since gone public about that.

A smoothie might have a dozen ingredients, (most of which would clash on the palate) and then a note “to be consumed after morning yoga, and will suffice for the rest of the day”, or some such nonsense.

I went to college with a guy who was all into raw foods and "super foods" (hippie college) who once did part of one of his class projects on helping somebody quit smoking - by feeding her smoothies with tens of (expensive) ingredients. Ridiculous.

My mom does like smoothies; I'd rather go with cereal or eggs for breakfast, but she can drink them on the way to work.

And since we're talking about food, I'm currently caramelizing onions for a bleu cheese, pear and onion pizza. (Try it, you'll like it.) And have made a chocolate raspberry sheet cake.

Within the article and associated comments is more than enough evidence to justify outlawing advertising by physicians, pharmaceutical companies, and healthcare facilities alike. The untold millions of dollars spent by the healthcare industry on advertising every year would be better allocated to research and treatment. A patient who is sick will find his way to the hospitals. Hospitals shouldn't be hanging out their shingle and enriching marketing executives at the expense of patients.

Hyman has undoubtedly battened onto Bill Clinton, and may indeed be advising Sec. Clinton... but other than Hyman's own fulsome claims to a NYT life-style columnist, is there any evidence that she is *listening* to that advice, or even aware of it?
It is not as if Hyman is particularly reliable as a source about his own wonderfulness, and the NYT puff-piece was notably deficient in corroboration.

It's rather a moot point, once POTUS, medical treatment is performed by the DoD.

Wzrd, if Nancy Reagan can get astrologers in the White House, then quacks can treat the President.

@Panacea, I seriously doubt that the National Naval Medical Center in Bethesda will grant him admitting privileges or honor his prescriptions.
So, who is permitted access to the White House vs actually treating the POTUS tend to be a wee bit different things. For that matter, he likely couldn't acquire a Yankee White clearance to access the POTUS. That one's worse than acquiring a Q clearance.

"Mrs. Clinton's current medications include Armour Thyroid..."

Armour Thyroid is a brand name for natural desiccated thyroid (NDT) -- a prescription thyroid hormone replacement medication made from the dried thyroid gland of pigs.

https://www.verywell.com/hillary-clinton-thyroid-condition-3233019

So. Not exactly the 'standard of care', levothyroxine sodium.

Dochniak gotta latex
Cocos gotta x-ray
At least Gilly splits his time between getting high and Clinton's health. Two loons for the price of one.

Left a comment asking why Medscape did a puff-piece on a con artist. Currently it is in moderation though I have had a Medscape account for many years. Will probably close the account though considering how sloppy so many articles are, and no matter how bad there are always at least a few favorable comments on even the most egregious nonsense.

For that matter, he likely couldn’t acquire a Yankee White clearance to access the POTUS.

No. If POTUS says 'I want to see...', then they come in. Sure, they will have to walk thru the metal detectors, but that's about it.

Dear friends,
The purpose of this message is solely to inform you that all the scientific comments that I make in response to the criticism against my interpretation of the Overdiagnosis paper are removed by Orac, although they are on topic.
Then, you can judge whether you can have disinterested information in this blog.

It doesn't matter if your blather is "on topic." Our friend with the idea that latex in vaccines causes autism can argue that his nonsense is "on topic" whenever we discuss vaccines and autism, but it's still just as annoying and just as likely to hijack a thread way off the rails. You have proven every bit as persistent and annoying in your efforts to hijack every thread about mammography and overdiagnosis as he, and I'm, quite simply, tired of it. I will tolerate it no more.

Again, you were warned, and, as I predicted, you just couldn't help yourself. We've been down this road many times. You have this idée fixe that radiation from mammography causes so much breast cancer that it can completely account for the increased number of diagnoses of DCIS and early stage breast cancer observed with the onset of mammographic screening. It cannot, as the estimated increase is far too small.

So you will now remain in comment purgatory indefinitely, and I don't really care if you think it's unfair of me or not. I simply will not have you so persistently hijacking comment threads, and if you don't like that, you can always go elsewhere, write your own blog, or rant about how close minded, unfair, unscientific, and nasty you think I am wherever you like. In the meantime I will release our friend with the latex obsession from comment purgatory until such a time as he can't help himself (and I know that time will come, probably sooner rather than later) and starts commenting about latex and autism again. We should take bets on how long he can manage to stay on the straight and narrow.

I've always had a very light touch moderating comments, to the point where I've often allowed trolls to roam free far longer than I perhaps should have and longtime regular commenters, whom I value deeply, became fed up enough to complain. After nearly 12 years of having a very "hands off" moderation policy, I am currently rethinking my policy based on occurrences at my not-so-super-secret other blog and the relentless stream of Fendelsworth sock puppets both here and at the not-so-super-secret other blog. I've already become a lot more proactive about banning suspected sock puppets. Before, I would wait until I could absolutely prove it was a sock. I no longer wait that long. You can thank Fendelsworth for that.

Gluten is a constant danger! I highly recommend Clara Gluten-Free Water https://claraglutenfreewater.com/ which may not do your guts much good but will help cure swollen wallet syndrome.

Bob Dylan ( aka Robert Allen Zimmerman, Shabtai Zisl ben Avraham, Lucky Wilbury etc)
received the Nobel Prize for Literature.

That's not very good, is it? It should have been Leonard Cohen.

“Then Dylan says to me, ‘As far as I’m concerned, Leonard, you’re Number 1. I’m Number Zero.’ Meaning, as I understood it at the time—and I was not ready to dispute it—that his work was beyond measure and my work was pretty good.”...

Dylan defended Cohen against the familiar critical reproach that his is music to slit your wrists by. He compared him to the Russian Jewish immigrant who wrote “Easter Parade.” “I see no disenchantment in Leonard’s lyrics at all,” Dylan said.

http://www.newyorker.com/magazine/2016/10/17/leonard-cohen-makes-it-dar…

@jrkrideau (#49),

Clara's Gluten-free Water says, "Clara’s patented mixture of water and minerals is guaranteed gluten and additive-free while maintaining refreshing taste and comes in 100% recycled plastic bottles".

MJD says,

Patenting a mixture of water and minerals....no way.

I couldn't find such a patent in the USPTO website.

I am shocked - shocked! - that Gilbert is an anti-Semitic sh!tweasel.

# 51 Michael J. Dochniak

Well I don't believe them either but does the USPTO website cover patents worldwide?

Clara is not a US company. It claims to be headquartered in Toronto.

Oy, oy, oy, JP; I beg your pardon???

I'm an anti-Semetic sh!tweasel for quoting a reference to this guy?

Irving Berlin (born Israel Isidore Baline; May 11, 1888 – September 22, 1989) was an American composer and lyricist, widely considered one of the greatest songwriters in American history... Born in Imperial Russia, Berlin arrived in the United States at the age of five.

https://en.wikipedia.org/wiki/Irving_Berlin

I will confess that I rarely make it past the first sentence of Gilbert's comments.

I would give Gilbert a conditional pass on this one.

Preferring one Jewish poet songwriter to another is hardly anti Semitic.

I like Leonard Cohen also, but would give Bob Dylan the edge for overall influence, variety of material and long term productivity.

I would actually vote Leonard Cohen over Dylan, except for that horrible Phil Spector phase. Luckily he came back around with "Ten Songs" and later works.

I do realize that "I'm Your Man" is typically regarded as the comeback album, but I could never really dig it
I am a sucker for his "Zen" album "Dear Heather," though, which came out just before I started college.

Thanks for the tips , JP.

I also liked his voicing of Jungle Line by Joni Mitchell on Herbie Hancock album of her songs.

If I were to pick a Leonard Cohen song that best fits my mood at the moment, it'd be this one.

From my favorite album - Songs of Love and Hate.

Thanks, JP

I've had some down moments, but know you've been through far worse. I hope you get better.

Ah, I'll be fine, what withy therapist upping my appointments to twice a week and me really, really not wanting to end up in the hospital again.

If I were to pick a Leonard Cohen song

I alternate between 'Teachers' and 'Who by Fire'.

From Medscape and quackery to Dylan then to anti-Semitism, we were not far from Godwin's law. Fortunately, the moderator of this thread is here to avoid derailment ;-).

@HDB
My favorites are So long Marianne, Famous Blue Raincoat, Chelsea Hotel #2, and Hallelujah (in John Cale version)

I've listened to Lenny a lot more in my lifetime, but if a pop musician deserves a Nobel for the first time, it should be Dylan, or maybe Moe Tucker and John Cale (but they were influenced by Dylan, just like Lenny).

If we're in Lenny-worship mode, my favorite is 'Famous Blue Raincoat'. But I swear that song can't hold a candle to 'Hard Rain'.

@ Lighthorse:

Be that as it may, I don't care, I love him.

And YOU CAN'T ARGUE WITH LOVE, MAN.

My father was an early fan and turned me on to Bob very long ago. So he's been a part of my life forever.

'Famous Blue Raincoat' is one of my favorites too. My friend Olga and I couldn't believe that we didn't notice it was in amphibracs until grad school.

In any case, I'm sure Mr. Cohen is gracious enough that he would congratulate Dylan on the Nobel. I imagine Phillip Roth, on the other hand, is p!!!!!!!ssed.

@ Daniel Corcos;

" From Medscape to..... anti-Semitism"

We, as loyal Oracian minions, know how to derail threads in artful and informative ways.

You will note that my original OT was careful to state that it was INDEED OT and was meant to inform said minions of this very earth shattering fact LATE on a FRIDAY when there were already MANY comments in the bin
and AFTER ALL
quackery, Dylan and anti-Semitism are important in both universes- Orac's and the Big One.

Secondly, RI is a social place where minions come to share news, commiserate, interact hilariously and encourage each other in our daily lives.

Others ask "Why?" I ask " Why not?"

Hi JP:

I'm glad to read your words and learn that your therapist is increasing your sessions.

I'm sure that many- if not most- readers here would assure you that you contribute greatly because you are intelligent, artistic unique and sensitive to the oddness of reality in all of its shifting vicissitudes

I often quote you to one of my crea.. GENTLEMEN who thinks that you are quite the bomb ( in the 1990s, good sense of the idiom).

Remember that internal processes take a long time to work. You have to wait and then wait some more. I'm still recovering/ healing my injury and re-adjusting my activities accordingly.

Anyone who can come up with the phrase " Pumpkin spice Putin" is always high on my list of greatest hits.

@ herr doktor bimler (#39):

Right.
When she had pneumonia, her regular doc gave her high dose / powerful antibiotics for 10 days IIRC
and that would probably not be Hyman's choice ( unless supplemented with loads of prebiotics and probiotics and sauerkraut and/or miso).

Good save, Denice. ;-)

I imagine Phillip Roth, on the other hand, is p!!!!!!!ssed.

I'm none too pleased that he failed me the year I had him in the local deadpool, either, for that matter.

Gluten for Hashimotos? I am currently getting worked over because the doctor noticed my thyroid is big. Cancer has been ruled out, but thinking might be Hashimoto's because my great grandma and grandma had to have theirs removed. I don't really eat all that much bread (not a gluten free diet thing, just personal preference)

I’m glad to read your words and learn that your therapist is increasing your sessions.

What can I say, I make people nervous. Hell, I was meeting with my shrink once a week in Michigan for quite a while. He still calls and emails; I think he worries that I'm going to walk off and hang myself in the woods in short order or something. I try to reassure him. Good man; good doctor.

(My fingers are almost numb from a couple of hours sitting on the back deck in the cold, rainy, PNW weather, listening to Leonard Cohen and cuddling with the cat, who mostly lives outside by a certain person's dictate...)

@ JP:

You sometimes make ME nervous.
Which is quite a feat.
I do hope that you can get through this block of time when all seems bleak and disconnected perhaps.
Think of it this way:
there is a cat and Leonard Cohen.

Of course the Pollyanna-ish amongst us may say that this is a Time of Preparation for Better Days or suchlike or that you're like a Chrysalis/ Bud about to transform itself after a period of darkness into Something Wonderful.

I don't necessarily buy that because I know that sometimes life just goes on and on in a most wearing fashion and that not all buds blossom or plans come to fruition.

Sometimes we just sit and wait.

Sometimes we are not thrilled about anything at all.

Sometimes we observe and go through emotional turmoil and questioning that leads to nowhere
BUT at least we're still here.

Over the past several months I've changed my life . One of the worst things was having trouble driving with a clutch because it hurt my leg. I am frugal enough to not have gone out and bought another car- and I do love the car. NOW I am quite thrilled over the fact that I have conquered the clutch and can drive myself around to various appointments. I am doing additional Interesting and Important literary work for Somebody I Know ( Not Me).

Like sailors on the Main of Old we may get stranded in the Doldrums and there's not much that we can do about getting back into the drift and flow of obvious currents that lead to Places we want to be.

I try to find things that I like and indulge myself as much as I reasonably can. No asceticism here.

So good luck. I say that with great feeling for you.

Both due to massive distraction, which drew management and hence, HR attention and a massive error upon hiring, both on my part and corporate (corporate split delayed letting me know that I had converted from contract to hire and my own "cleverness" creating a problem that needs to be resolved soon), I've got HR hot on my heels.
Both due to my own wife's condition, which they learned of last week, a little of my own condition and the legal issues originating from delayed notification of hire (double paychecks that went unnoticed, as paper checks went uncollected and bank accounts went unchecked, I was busy and wife doesn't bother with online money).

Add in stressors of dad dying for five years that I gave up a very lucrative job to care for him, paying Wells Fargo for a number of years after, only to have them reject assumption of the mortgage, initiation of foreclosure on that family home, with a hell of a lot of our own property enclosed, a dispute with the township ("we do what we want to do" and closure of the home via condemnation signs), restriction of access to our former home of five years (what a wonderful way to welcome a decorated veteran home, may this nation burn in hell!), new job, three hours from home, eventual relocation, forbidden to access the home by movers, hyperthyroidism, aortic dilation to near aneurysm level, cauda equina syndrome, to levels threatening paralysis, cervical spinal stenosis where I was looking for what worked - the radiologist report proved my observation correct, everything is FUBAR.
Now, the newest movers claimed, quite literally, "Eeek, a dead mouse" and refused to honor the $10k relocation package, which was handed back to my employer.
I'll lose the lot of it on the 21st.
So, I'm goddamned sorry that I returned to this uncivilized land that I screwed up in defending for most of my life.
If I sound pissed off, you should hear me in person, put on hearing protection first.
I'm going to lose both my own baby pictures, films of me and my parents, family photographs, pictures of our own children growing up, furniture we purchased, computers, information on said computers, treasured mementos, pictures of my own parents, grandparents, family documents, historical documents and a lot more.

Well, the relocation service does have a contract, they've reneged upon it, variously (two movers) one condemned sign canceled the attempt, the other, "eek a mouse" and trash in a burglarized basement.

So, my stress level is... Immense.
To the point where, I mentally toy with the notion of a judicial duel, as PA has not statute or case law against such and to be honest, it'd be a bit of fun to at least tangle things up while things get sorted, foul the bank that double dealed up and additionally, make case law.
And yes, I'm immensely pissed off.
And slightly depressed, only slightly, I'm far too angry to remain much depressed.

Oh, for cream on the top of everything, my wife's gallbladder disease was dismissed by our former primary. It seems a habituation for him, as we've heard from multiple other women who also were ignored, to find new medical coverage - some specialists that assumed primary care of the patient.
Her gallbladder was so fouled as to induce bilary cirrhosis.

Now, can you imagine a man more angry than this husband of 35+ years?

Sorry to unload here, but I needed to do so somewhere.
Lest I actually harm someone that angered me.

Here's the laugh.
The difficulty in an inertial confinement system isn't the initial confinement, but in retention of confinement beyond disassembly at X shakes. This can be created by R, focused by Y, via Z. This can extend confinement far beyond 50 shakes, sufficient to both confine the fission to high efficiency *and* focus the energy to Q, via P, causing fusion, creating neutrons to be focused by AA, into RR.

And yes, I I do know the formulae. And the theory.
Oh wait, I'm not Snowden, seeking attention.
And no, nobody will *ever* get that information from the Madness Machine.
I still have nightmares from the still classified footage from both atomic bombings, I'd never wish that upon even my worst enemies.*

*Yeah, I'm serious on all points, especially viewing classified footage from Hiroshima and Nagasaki. Every moment of thinking of it makes me want to puke. Many, makes me actually cry.
Especially, a carbonized infant on her back, being removed. When removed, some flesh fell off, bloodlessly, she died when she saw her carbonized infant.
Feel nauseated? I always do, remembering *seeing* that film.

I've dealt with that and more.
Now, losing everything we inherited and owned, due to "eek a mouse!".

Now, do explain how you can find an emotional context with me?

Damn, Wzrd1.

It was evening when we came to the river
With a low moon over the desert
that we had lost in the mountains, forgotten,
what with the cold and the sweating
and the ranges barring the sky.
And when we found it again,
In the dry hills down by the river,
half withered, we had
the hot winds against us.

There were two palms by the landing;
The yuccas were flowering; there was
a light on the far shore, and tamarisks.
We waited a long time, in silence.
Then we heard the oars creaking
and afterwards, I remember,
the boatman called us.
We did not look back at the mountains.

In some sort of crude sense which no vulgarity, no humor, no overstatement can quite extinguish, the physicists have known sin; and this is a knowledge which they cannot lose. -- Robert Oppenheimer, physisist

Speaking of Leonard Cohen, It's closing time.

https://www.youtube.com/watch?v=7-0lV5qs1Qw

I try to find things that I like and indulge myself as much as I reasonably can. No asceticism here.

Yeah, I've been cooking a lot; it's something that I enjoy that actually makes me feel a little bit good about myself.

So good luck. I say that with great feeling for you.

Thanks, Denice.

Second 'graph was not supposed to be in italics...

@ JP:

Well, I DID mean things other than cooking but
whatever floats your boat.

I am relatively fine today except for my adventure... I mean business transaction with the Syrian plumber which was confusing but relatively inexpensive... so far.

Denise Walter says (#69),

RI is a social place where minions come to share news, commiserate, interact hilariously and encourage each other in our daily lives.

MJD says,

Additionally, the minions like JP are very interesting and entertaining. Thanks for making this blog both salty and sweet!.

Well, I DID mean things other than cooking but
whatever floats your boat.

I've become very interested in mycology and have been out in the woods regularly looking for edibles and pretty mushrooms. Does that count? ;-)

Some recent finds.

Nature's birdbaths.

I'm hoping that, even though it's gotten cooler, the recent rains will have pushed up some more boletes or something nice like that. Going out in a day or two once it's sunny and warm(ish).

P.S., Narad can speak to the therapeutic value of cooking for other people.

I can speak as well to the therapeutic effects of cooking for others.
When each parent died, I busied myself with cooking for guests who came by to offer their condolences.

I'll probably cook for my own funeral. If I have to lay there and listen to people lie about how great I was, I'd otherwise end up getting up and leaving. ;)

Additionally, the minions like JP are very interesting and entertaining. Thanks for making this blog both salty and sweet!.

Thanks, MJD. Perhaps it's something at least a few people can agree on. ;-)

What can I say, I make people nervous.

This assertion is doomed by plain counterexample.

And since we're off topic (sorry), Chris, what can you tell me about WA politics these days? I've been out of touch for about ten years.

@ JP:

Mushrooms most definitely count.
( Although I was thinking about something else.**)
Quite a few are visible in the 'park-like setting' that borders on my place.

In other news...
'fear and loathing in Las Vegas' ( stolen phrase) continues apace.

The Syrian plumber has finished... for now.

I have loads of work for my secondary avocation.

** I was thinking about creature comforts in general : I have an Armenian friend from Egypt who is very aware of the finer things in life and pursues them with great relish:
if there is a perfect cotton sheet or Martini to be had in the area, she'll find it- and usually at a discount. She is involved with a very well-to-do man who takes her on interesting jaunts around Europe and North America. (I have tried to emulate her because I believe I have somewhat more ascetic tendencies which often waste life) She just returned from a week in Sicily - she didn't cancel the trip despite having cut her foot ( 25 stitches !) because she didn't want to wreck her friend's plans. So she hobbled around Palermo sampling gelato and Espresso, I have recently only hobbled around Oakt... OAKLAND myself. But did have decent sushi later so it wasn't so bad,

I must aim higher.

I should correct myself:
JP doesn't make me "nervous" exactly BUT I do worry about her because I know that she's had setbacks and has been rather morose. Ultimately, I have hopes for her recovery although in a somewhat guarded way.

She is involved with a very well-to-do man who takes her on interesting jaunts around Europe and North America.

Gee, I need to find one of those. ;)

Ultimately, I have hopes for her recovery although in a somewhat guarded way.

Well, things don't stay together, some friends don't get better.

But we'll see.

JP:

I hope you find someone like that or alternately, create your own pathway to get whatever it is that you want.

Sometimes, in my own case, it's a little of both plus one.

I got the news tonight that Leonard Cohen has passed away.

http://www.msn.com/en-us/music/celebrity/leonard-cohen-dies-at-age-82/a…

Perhaps it truly is closing time.

If it be your will
That I speak no more
And my voice be still
As it was before
I will speak no more
I shall abide until
I am spoken for
If it be your will
If it be your will
That a voice be true
From this broken hill
I will sing to you
From this broken hill
All your praises they shall ring
If it be your will
To let me sing

From this broken hill
All your praises they shall ring
If it be your will
To let me sing

If it be your will
If there is a choice
Let the rivers fill
Let the hills rejoice
Let your mercy spill
On all these burning hearts in hell
If it be your will
To make us well

And draw us near
And bind us tight
All your children here
In their rags of light
In our rags of light
All dressed to kill
And end this night
If it be your will

https://www.youtube.com/watch?v=FkEYkUxdhcU

Making it up as you go along: So-called "functional medicine" is pure quackery

oracknows — Mon, 18 Apr 2016 01:00:36 +0000

Making it up as you go along: So-called "functional medicine" is pure quackery

I often describe "integrative medicine" as integrating quackery with medicine because that's what this inadvertently appropriately named branch of medicine in essence does. The reason, as I've described time and time again, is to put that quackery on equal footing (or at least apparently equal footing) with science- and evidence-based medicine, a goal that is close to being achieved. Originally known as quackery, the modalities now being "integrated" with medicine then became "complementary and alternative medicine" (CAM), a term that is still often used. But that wasn't enough. The word "complementary" implies a subordinate position, in which the CAM is not the "real" medicine, the necessary medicine, but is just there as "icing on the cake." The term "integrative medicine" eliminates that problem and facilitates a narrative in which integrative medicine is the "best of both worlds" (from the perspective of CAM practitioners and advocates). Integrative medicine has become a brand, a marketing term, disguised as a bogus specialty.

Of course, it's fairly easy to identify much of the quackery that CAM practitioners and woo-friendly physicians have "integrated" into integrative medicine. A lot of it is based on prescientific ideas of how the human body and disease work (e.g., traditional Chinese medicine, especially acupuncture, for instance, which is based on a belief system that very much resembles the four humors in ancient "Western" or European medicine); on nonexistent body structures or functions (e.g., chiropractic and subluxations, reflexology and a link between areas on the palms of the hands and soles of the feet that "map" to organs; craniosacral therapy and "craniosacral rhythms"); or vitalism (e.g., homeopathy, "energy medicine," such as reiki, therapeutic touch, and the like). Often there are completely pseudoscientific ideas whose quackiness is easy to explain to an educated layperson, like homeopathy.

Then there are modalities being "integrated" into medicine whose quackiness is not so easy to explain. Perhaps the most popular and famous of these is a specialty known as "functional medicine" (FM) whose foremost practitioner and advocate (in the US, at least) is Mark Hyman, MD, a man whose fame has led him to become a trusted medical advisor to Bill and Hillary Clinton. Perhaps Hyman's greatest coup came in 2014, when the Cleveland Clinic Foundation hired him to create an institute dedicated to FM, an effort that has apparently been wildly successful in terms of patient growth. Never mind that around the same time Dr. Hyman teamed up with rabid antivaccine activist Robert F. Kennedy, Jr. to write a book blaming mercury in the thimerosal preservative that used to be in vaccines for causing autism, an idea that was shown long ago to have no scientific merit. Unfortunately, elsewhere FM has been pretty successful as well, to the point where it has now even started to “integrate” itself with dentistry in the form of an emerging specialty of "functional dentistry."

The problem with "functional medicine" is that at its core it is close to being as nonsensical as the more "obvious" forms of quackery. It just hides it better, mostly behind a battery of fancy-sounding laboratory tests. It's also incredibly difficult to pin down just what the heck it even is, as I've discussed many times in the past. The late, great Wally Sampson's once wrote a post about FM entitled Functional Medicine: What Is It? It was a question he asked after referring to it as the "New Kid on the Block."

That's why I'm grateful to Jann Bellamy, who sent me a case study on the use of FM in oncology published in a journal that I had never heard of before, Integrative Medicine: A Clinician's Journal (IMCJ). Even better, the case is a woman treated for breast cancer, my area of expertise, which allows me to discuss the case presentation in even more depth. Before we do that, let's review a bit about FM as a prelude to diving into the specifics of this published case report. To be honest, I'm surprised that anyone would publish such tripe, as it's incredibly embarrassing. Or at least it would be to any competent oncologist. What really scares me is that FM is now specializing. What we are seeing here is the birth of "functional oncology," and it is terrifying to me.

Functional Medicine: What Is It?

I begin by asking the same question that Wally Sampson asked many years ago, just a bit more “insolently”: Just what the hell is functional medicine, anyway? It has been a long time since I’ve asked that question; so now is as good a time as any to ask it again. Indeed, I was curious to know just what has changed about functional medicine; so I even went back to the same source that Dr. Sampson used eight years ago, the Institute for Functional Medicine (IFM), an organization founded by the other big name in FM, Jeffrey Bland, PhD.

Like pretty much all of "integrative medicine" FM claims to look at the real cause of disease:

Functional Medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, Functional Medicine addresses the whole person, not just an isolated set of symptoms. Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, Functional Medicine supports the unique expression of health and vitality for each individual.

You could remove the word "functional," replace it with "integrative," and easily plop this paragraph down into just about any article written about integrative medicine by one of its advocates. It's the same weasel words of woo, different branch of woo. Or actually it's the same branch, just a different sub-branch. But what does this all mean? The IFM claims:

Functional Medicine offers a powerful new operating system and clinical model for assessment, treatment, and prevention of chronic disease to replace the outdated and ineffective acute-care models carried forward from the 20th century.

Functional Medicine incorporates the latest in genetic science, systems biology, and understanding of how environmental and lifestyle factors influence the emergence and progression of disease.

Functional Medicine enables physicians and other health professionals to practice proactive, predictive, personalized medicine and empowers patients to take an active role in their own health.

You know, I really hate it when woo-meisters liken things to "operating systems" while referring to "outmoded acute care models." One thing you can be sure of, though, is that whenever someone like Bland refers to using the "latest in genetic science, systems biology, and understanding of how environmental and lifestyle factors influence the emergence and progression of disease," you will be in for a heaping helping of abuse of those new sciences. We've seen it time and time again with, for example, epigenetics (which doesn't do or mean what quacks think it does), placebo effects, the power of diet (which is often grossly exaggerated), and, of course, systems biology, which FM guru Mark Hyman himself abuses shamelessly in the service of his made-up specialty. Indeed, Hyman is an excellent example, as he's mangled science in the service of FM in many areas, including cancer, autism (of course, given his latest foray into antivaccine propaganda), and, of course, Alzheimer's disease and other forms of dementia. That's just a sampling, of course. What's worse, is that FM seems to value anecdotes over actual clinical studies. Basically, its form of "personalized medicine" appears to be a "bait and switch" designed to lower the standard of evidence required to justify a treatment.

Don't believe me? Read it right from the horse's mouth, so to speak. First:

Functional Medicine is an approach to health care that conceptualizes health and illness as part of a continuum in which all components of the human biological system interact dynamically with the environment, producing patterns and effects that change over time. Functional Medicine helps clinicians identify and ameliorate dysfunctions in the physiology and biochemistry of the human body as a primary method of improving patient health. Functional Medicine is often described as the clinical application of systems biology. [Emphasis in original]

But more tellingly, see what Bland says about the evidence base for FM:

When people ask to see the evidence for Functional Medicine, they often mean, "Where are your research trials, comparing Functional Medicine to conventional medicine in a clinical setting?" Unfortunately, current research models do not have a way to test each individualized, patient-centered therapeutic plan that is tailored to a person with a unique combination of existing conditions, genetic influences, environmental exposures, and lifestyle choices. Clinical trials do play a significant role in evaluating and comparing the efficacy of new pharmaceutical treatments, especially when it is important to rule out placebo effects, but they have many inherent limitations which constrain their ability to inform clinical decision making.

So let's not even bother doing clinical trials, then, amirite, guys? Basically, this is a manifesto for doing whatever the heck a physician wants in the name of "personalizing" care. Whenever I see such piece of utter nonsense used as a justification, I can't help but point out that real doctors and scientists are trying very hard to figure out new clinical trial methodology in order to test precision medicine (which used to be called "personalized" medicine) in a scientifically rigorous manner. Yes, in the early "wild west" days (which we are only now coming out of), a lot of physicians made it up as they go along with respect to interpreting the results of whole genome sequencing to select cancer treatment, but that is increasingly frowned upon. If scientists can put together a trial as clever and complex as the SHIVA trial, I laugh at Jeff Bland telling me that FM can't be tested because it's two "personalized." It's a lame excuse—the very lamest—and exactly the same excuse that homeopaths, acupuncturists, and the like make for not doing clinical trials testing their quackery, though FM tries to "science it up" by rationalizing it with these seven principles:

Acknowledging the biochemical individuality of each human being, based on concepts of genetic and environmental uniqueness
Incorporating a patient-centered rather than a disease-centered approach to treatment
Seeking a dynamic balance among the internal and external factors in a patient's body, mind, and spirit
Addressing the web-like interconnections of internal physiological factors
Identifying health as a positive vitality—not merely the absence of disease—and emphasizing those factors that encourage a vigorous physiology
Promoting organ reserve as a means of enhancing the health span, not just the life span, of each patient
Functional Medicine is a science-using profession

That very first principle is FM's "get out of jail free" card for basically anything its practitioners want to do. They can always find ways to justify any form of treatment, be it science-based or quackery, simply by invoking the "biochemical individuality" of each human being. Here's the problem: Yes, human beings are individuals, and each human being is unique. However, we're not so unique that our bodies don't all work pretty much the same way. In other words, in terms of biology, physiology, and yes, systems biology, human beings are far more alike than they are different. If that weren't the case, modern medicine, developed before we had the tools to probe our genetic individuality, wouldn't work as well as it does. FM fetishizes "biochemical individuality," not so much because humans are so incredibly different that each one absolutely has to have a markedly different treatment. We're not. FM fetishizes "individuality" because it distinguishes FM as a brand from science-based medicine and, I suspect, because it makes FM practitioners feel good, like "total" doctors never at a loss for an explanation for a patient's symptoms or clinical condition. As for the last bit about FM being a "science-using" profession, I like to say that FM "uses" science the same way that an illusionist or magician uses misdirection: So that the audience can’t see how he pulls off his trick.

Overall, there are some things that FM gets right, although they are no different than the things every primary care doctor should be getting right, namely emphasizing healthy lifestyles, good nutrition, enough exercise, adequate sleep, cessation of habits known to be deleterious to health (e.g., smoking). They tend to spend more time with patients, which is something that primary care doctors have a harder time doing these days. They emphasize prevention, which is a good thing but again something that good primary care doctors do anyway; that is, except of course for the antivaccine FM practitioners (of which there are quite a few), who are the very antithesis of prevention.

Where they go wrong is in what Grant Ritchey described as a major unstated premise. That premise is that FM really does address the root causes of disease better than conventional medicine. FM also encompasses a lot of quackery, such as acupuncture, chiropractic adjustments, and especially "detoxification" programs. There also seems to be considerable overlap between FM and orthomolecular medicine, as FM practitioners seem quite enamored of high dose vitamin C infusions. Indeed, one of the quackiest of the quackademic medicine centers in this country, the University of Kansas, emphasizes FM and orthomolecular medicine and is run by a woman who is very much a proponent of high dose vitamin C infusions for cancer.

One of the most prominent identifying features of FM is its reliance on laboratory tests, lots and lots and lots of laboratory tests. They use these laboratory tests to seek out each patient's "biochemical" individuality and analyze his systems in these areas:

Assimilation: digestion, absorption, microbiota/GI, respiration
Defense and repair: immune, inflammation, infection/microbiota
Energy: energy regulation, mitochondrial function
Biotransformation and elimination: toxicity, detoxification
Transport: cardiovascular and lymphatic systems
Communication: endocrine, neurotransmitters, immune messengers
Structural integrity: subcellular membranes to musculoskeletal integrity

This search for "biochemical individuality" leads FM practitioners to order incredible numbers of labs, as you will see, many of which, as are bogus and of no use, and many of which are routine lab tests that regular doctors order but often end up massively misinterpreted and abused. In particular, FM practitioners appear to like to order lab tests related to endocrinology. Of course, "normal" lab values are usually defined to be a certain number of standard deviations from the population mean, which means that by random chance alone a small percentage of "normal" people will have an abnormal value of a given laboratory test. When a clinician orders a bunch of laboratory tests on a patient, the likelihood that one of those tests will be "abnormal" will approach 100% the more tests are ordered. No wonder FM practitioners can always find lab abnormalities to chase. Of course, to correct those lab abnormalities, there are always many, many supplements to be sold. Indeed, arguably the IFM was founded as a means of marketing the supplements Jeffrey Bland sold. Mark Hyman, through his "Ultrawellness" brand, also sells a lot of supplements.

Functional oncology in action

This brings us back to the case report, and boy is it a doozy. The authors include Elliot T. Taxman, BA; Erin D. Conlon, BS; Alex Speers, BA; Kristin L. Dismuke, BS; Tonya S. Heyman, MD, FACOG; Thomas L. Taxman, MD, FAAP. It turns out that Elliot Taxman, Erin Conlon, and Alex Speers are all students at the National College of Natural Medicine, while Tonya Heyman is a gynecologist specializing in "integrated personalized medicine" and Thomas Taxman is a pediatric gastroenterologist and functional medicine practitioner. The physicians are located at the Cleveland Health Institute in Lyndhurst, OH, which is a suburb of Cleveland. Given that the authors are all affiliated in some way with an "integrative medicine" clinic, I wasn't sure where the patient discussed was treated for real. (I mean real cancer treatment, as opposed to the quackery she was subjected to in addition to her cancer treatment in a "complementary" fashion.) Perhaps it was at the Seidman Cancer Center at the University Hospitals of Cleveland, given that Dr. Taxman is an assistant clinical professor at the Case Western Reserve University School of Medicine.

Be that as it may, here is the clinical presentation as described in the case report:

An 80-year-old Caucasian female patient presented to an integrative medicine clinic in December 2012 with a 1-month history of a tender right breast. Her history was significant for arthritis, obesity, hypothyroidism, chronic gastritis, and hypertension. Her current medications included hydrochlorothiazide and triamterene, quinapril hydrochloride, levothyroxine sodium, and esomeprazole. Her family history was positive for breast cancer (daughter at age 46 y and sister at age 70 y). Physical exam revealed an erythematous, warm mass with irregular borders and localized skin thickening palpated across both upper quadrants of the right breast. The mass measured approximately 15 × 10 × 5 cm. In addition, a prominent 1-cm right axillary lymph node was noted.

This presentation sounds like that of an uncommon and particularly nasty form of breast cancer known as inflammatory breast cancer (IBC). IBC is characterized clinically by more than half the breast being involved with an inflammation-like reaction and pathologically by tumor cells in the dermal lymphatics (the lymph vessels right under the skin). The standard treatment for this aggressive form of breast cancer is neoadjuvant chemotherapy (chemotherapy before surgery), a modified radical mastectomy (removal of the breast and the axillary lymph nodes), followed by post-mastectomy radiation therapy to the chest wall. By definition, IBC is at least stage IIIB. On the other hand, IBC is a clinical diagnosis. Absent a skin biopsy showing tumor cells in the dermal lymphatics, its diagnosis is purely clinical so this woman might not have had IBC. Still, from the description, it looks as though neoadjuvant chemotherapy was appropriate:

Mammography revealed increased irregular density in the central upper quadrants of the right breast. A subsequent ultrasound noted a mass in the right breast that was highly suggestive of malignancy and the accompanying guided biopsy concluded invasive ductal carcinoma, grade 3, with involvement of a right axillary lymph node. A magnetic resonance imaging (MRI) on January 7 confirmed the previous diagnosis and indicated that a small mass was found in the left upper outer quadrant of the left breast. A follow-up sonogram and mammogram of the left breast confirmed the MRI findings. She was given a Breast Imaging-Reporting and Data System (BI-RADS) score of 6 and her cancer was concluded to be ER/PR negative and HER2 positive.

A tumor that lacks estrogen receptor and progesterone receptor but does have amplified HER2 almost always gets neoadjuvant chemotherapy consisting of a regimen of cytotoxic chemotherapy combined with Herceptin, which targets HER2. The patient underwent a bone scan and PET-CT scan, the latter of which is bit of overkill, because PET-CT has never been shown to be superior to CT alone in the setting of breast cancer. Both were negative, which means that the patient was not stage IV and the title of the case report, "Chemotherapy and Functional Medicine in a Patient With Metastatic Breast Cancer: A Case Report," shows that the people writing and reviewing it were clueless about breast cancer. This woman did not have metastatic breast cancer, at least not the way a breast cancer surgeon and oncologist look at it. Lymph node metastases are generally considered regional disease; we usually don't refer to "metastatic" disease until there are metastases to distant organs (i.e., stage IV disease). Be that as it may, this woman was potentially curable and was clearly in pretty good shape for an 80 year old if they were willing to give her chemotherapy, even though she did have a fairly typical litany of diseases and conditions of the elderly (arthritis, obesity, hypothyroidism, chronic gastritis, and hypertension). On the other hand, it's not as though there was much choice, given that the cancer was ER/PR-negative and therefore estrogen blocking treatments were not an option.

In any case, what sounded like fairly standard chemotherapy was initiated, including docetaxel (Taxotere), carboplatin (Paraplatin), and trastuzumab (Herceptin), and the patient underwent a right modified radical mastectomy after six cycles, followed by radiation therapy. She also underwent a left simple mastectomy (no evaluation of lymph nodes) for reasons that were unclear to me. She apparently had had something spotted in the right breast on her preoperative MRI, but it was never biopsied, as far as I can tell, and therefore never proven to have been cancer. Given that there is no survival benefit in doing it in the absence of a deleterious cancer-causing mutation, it's hard enough to justify a prophylactic mastectomy on the other side in much younger woman, say 50 years old, but to do this operation on an 80 year old, whose life expectancy (and thus time remaining in her life to develop another life-threatening invasive cancer) is so much shorter, is questionable. Yes, they did find a small focus of ductal carcinoma in situ, but that would have been very unlikely to have progressed to endanger this patient's life in her remaining time. Of course, the choice of surgery was on the conventional breast surgeon, not the FM doctors, but I felt obligated to point this out, given that we're talking about my specialty here.

Now get a load of this chart, which shows what she got overall (click to embiggen):

She received 97 infusions of vitamin C. Yes, you read that right. In the eleven months or so that her complete science-based therapy of her breast cancer required, this woman was subjected to 97 unnecessary and potentially harmful infusions of ascorbate. Afterward, she received "sporadic" doses of vitamin C up through to August 5, 2014, which was one year after her mastectomy. Fortunately, she was tumor-free. As I've written before many times, there is no good evidence that high dose IV vitamin C has a clinically useful antitumor effect. No, Linus Pauling has not been vindicated, although FM practitioners, naturopaths, and other believers have been trying for decades.

But that's not all this poor patient received.

She was placed on a dairy-free, gluten-free, low glycemic index diet. Why? Who knows? There's no good evidence that such diets have an anticancer effect. Why make the woman eat a diet that makes it harder for her to keep her weight up during chemotherapy? Again, who knows? She was also placed on the following supplements:

Melatonin: 20 mg QHS
Digestive enzymes AC
Probiotics: 60 billion CFU BID
Lactobacillus acidophilus NCFM
Bifidobacterium animalis Bi-07
Medical food shake bid
Vitamin D3: 5000 IU QD
EPA:DHA: 6000 mg QD
Wheat germ extract: 5.5 g QD
Oral vitamin C: 18-24 g QD
Standardized herbal inflammation relief supplement

One wonders why she was taking 18-24 g (that's right, grams) of vitamin C per day in addition to the boatloads of vitamin C she was receiving intravenously three times a week. That’s enough to cause significant diarrhea. As for the rest, they probably don't hurt, but there's no reason to think they help, either. They add no detectable medical benefit, but they certainly do add cost. That's not even counting the labs ordered. Chemotherapy patients get a lot of labs done, but look at the additional unnecessary labs ordered on this patient. The results take up more than two pages of the case report, and include amino acid levels, "gut immunology" markers, secondary bile acids, parasite tests, pancreatic enzyme levels, heavy metal levels, and, of course, the most beloved lab tests of FM practitioners and autism quacks, oxidative stress markers like glutathione and coenzyme Q₁₀.

And I haven't even listed them all. None of these tests were necessary. Almost certainly, none of them added any value to the patient's care. Equally certainly, they added a great deal of cost to this patient's care. They are almost all pure quackery.

In fairness, what the FM practitioners added wasn't all bad. An exercise program was started consisting of 10 minutes of bicycling a day working towards 30 minutes, Qigong classes, a sleep log, individual counseling and group support, and a part-time caregiver. None of these things, however, is the least bit "integrative" and could easily have been done by any oncologist.

The end result: Nothing

So what was the result after all of this? The patient survived two years, but the odds of her surviving five years were probably around 70% anyway with conventional therapy and probably 85% of surviving two years, based on her clinical presentation and final pathology, worse if she actually did have IBC. Try as they might, even the FM docs who wrote up this case report couldn't make a case that what they did added anything to this patient's care, other than getting her off of her hypertension medications, which could easily have been result of weight loss and exercise, coupled with a hypersensitivity reaction she suffered when her cardiologist changed her medications. Indeed check out the final paragraph:

This case is unique because of the integrated approach guided in part by nutritional and digestive evaluation (NutrEval) from a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory testing company (Genova Diagnostics, Asheville, NC, USA) that was used in the management of this patient with advanced ductal breast carcinoma.⁵ Because this is a case report from the real world practice of medicine, it is not possible to determine the responsibility of the treatments in this patient's success in achieving remission. Nevertheless, the patient survived her cancer with minimal side effects during treatment and is now in her third year of remission. This case study highlights the potential benefits of integrative therapy in the comanagement of patients with invasive ductal carcinoma of the breast.

No, we can say with a very high degree of certainty that the only benefits this patient experienced came from exercise, a personal care giver, counseling, and perhaps her sleep log. The high dose vitamin C, the dozens of lab tests, and all the supplements did her no good but certainly cost a lot of money. I can't help but shake my head at this. In particular, I am amazed that the FM doctors presenting this case actually seem proud of what they did. They should be ashamed. Very ashamed.

I am, however, glad they wrote up this case report, as horrifying as it is. It shows what FM really is when in actual use. All those high-sounding ideals and principles, all the claims that FM treats the "underlying cause" of disease are revealed to be delusions when you just look at what FM doctors really do when treating cancer patients. Harriet Hall's aphorism about CAM in general fits perfectly: What's good about FM is not unique, and what's unique about it is not good. My conclusion about FM is, in addition to Harriet's, that it takes "making it up as you go along" to a whole new level, and that's not a good thing in medicine.

oracknows Sun, 04/17/2016 - 21:00

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Those quoted paragraphs were a prime example of saying nothing with lots of words.

I always have to laugh when sCAMsters claim that they treat the underlying cause of disease.

They do anything but that.

Oh, Genova. We have more trouble with doctors ordering their "personalized panels" which are much ado about nothing (as you've noted from their results. Then patients get very upset when their insurance won't pay for the tests. What amazes me is that this lady must have spent thousands of dollars with the supplements, IV vitamin C and special diet. Because I sure hope Medicare wasn't paying for that junk!

I am still wondering why they don't integrate the machine that goes ping in their treatment.

Dr. David Gorski is an established pro-vaccine internet troll with ties to the Barbara Anne Karmanos Cancer Institute, notorious for experimental cancer treatments and drugs that have been fast-tracked by the FDA.

Karmanos is also where cancer fraudster Dr. Farid Fata had his clinic. Fata used aggressive chemotherapy treatments on cancer-free individuals, over-administered chemotherapy on people with no chance of survival, undertreated cancer patients, overbilled insurance, and defrauded the government out of $17 million.

Gorski consistently trashes holistic medicine and vaccine skeptics under the pen name "Orac" on the website ScienceBlogs, heavily sponsored by the drug industry.

In an effort to discredit "anti-vaxxers," Gorski's followers promote the use of "emotional warfare" on "anti-vax blogs." That ScienceBlogs post instructs other trolls to embellish sad stories full of tears and "unbearable grief and terror" about friends and family members who died of terrible diseases in an effort to push harmful vaccines.

The "more gross the better," the post reads. Gorski's followers claim that this tactic will work like advertising and influence the minds and decisions of readers on the fence about vaccinating. Make sure to add a few grammatical errors to make it believable, it continues.

Gorski's commenters tell their fellow trolls to use an untraceable email address so their manipulations cannot be tracked. "The way to fight it [vaccine skepticism] is by sabotaging the anti-vaxers with crazy stuff that drives away undecideds," one post reads.

Gorski is a surgical oncologist at the Karmanos Cancer Institute and an associate professor of surgery and oncology at the Wayne State University School of Medicine, where he also conducts research for drug companies. This is where the problem lies.

Gorski has said himself that conflicts of interest (COIs) weaken scientific research, even when the science is sound.

"A general principle is that undisclosed potential conflicts of interest (COIs) are of far more concern and potentially far more damaging to the scientific process than disclosed COIs," he wrote in defense of vaccine propagandist Paul Offit, who's made millions off vaccines but routinely conceals that COI.

Gorski has also said that a true shill who conceals his ties to Big Pharma and pretends to be objective should be exposed.

But Gorski will not come clean about his own COIs, reports Jake Crosby, writing for Age of Autism. While Gorski is extremely outspoken about autism not being caused by vaccines, he mentions little about what he has to gain from this position.

Gorski poised to financially benefit from autism drug
It turns out, Gorski's employer, Wayne State University, has a lot to gain from an ALS drug called riluzole that could be used to treat autism, reveals Crosby, adding that Gorski is experimenting with that same drug to treat breast cancer.

The world's largest vaccine maker, Sanofi-Aventis, has a partnership worth up to $39 million with Wayne State. Sanofi-Aventis also happens to be the developer of riluzole, marketed as Rilutek.

"Therefore... Gorski has a reasonable expectation to receive money from a vaccine maker, even if it is through a third party," wrote Crosby.

In his Wayne State laboratory, Gorski focuses on the research and development of prescription drugs. However, he's working not to create new medications, but rather new uses for existing drugs, a process far more lucrative than creating new drugs from scratch.

"The potentially profitable drug Gorski is in the process of conducting a clinical trial for is the ALS drug Riluzole.... Amplifying the conflict further is that the same drug is also being studied for the treatment of autism."

At Autism One, a non-profit educational organization that focuses on autism, "the National Institute of Mental Health was handing out recruitment pamphlets for children ages 7-17 to take part as subjects in a clinical trial of Riluzole for its effectiveness in the treatment of autism spectrum disorders, and repetitive and stereotypical behaviors in particular."
In 2008, Sanofi-Aventis announced that it would be collaborating with Wayne State (as well as other partners) and could be making up to $39 million in payments over a five-year period to these partners. Gorski was chosen as the guy to conduct a series of clinical trials involving the company's drug, riluzole.

In short, Gorski and his team stand to earn millions from riluzole medication for autism, illustrating a great incentive to quiet vaccine skeptics about the link between immunizations and autism. If this isn't a blatant conflict of interest, than we don't know what is.

"Gorski's denial of being in the pocket of the drug industry stretches so far beyond what he is even regularly accused of," wrote Crosby, who confronted Gorski with this information:

Dr. Gorski,

This is Jake Crosby. I am doing a piece about your acknowledgment that disclosure of conflicts of interest is important, yet your lab at Wayne State University stands to benefit from Sanofi Aventis money for the breast cancer research you are conducting on a drug the company manufactures and markets, Riluzole, which is also being studied for the treatment of autism. Why isn't any of this disclosed on your blogs? I await your reply.

To read about Gorskis response: http://www.ageofautism.com/2010/06/david-gorskis-financial-pharma-ties-…

It would've been nice if the integrative functional care team had assigned this patient a Pill Administrator so she had help in managing her zillion drugs and supplements. Or maybe they gave her a giant-size compartmentalized Pill Wheel so she knew what and when to take every day.

I have a hard time believing all of the added "functional" sludge they gave her helped her gastritis issues or contributed in any way to quality of life, much less her remission from cancer. At least they didn't prescribe twice daily coffee enemas like those poor patients with pancreatic cancer treated by Nicholas Gonzalez.*

A Gonzalez website (updated in mid-March) still promotes his regimen for cancer patients, including coffee enemas and up to 175 supplement capsules a day, and the Gonzalez Foundation lives on (despite the doctor himself having been eliminated by the Pharma Lizard Alternative Doctor Murder Conspiracy:

According to Hyman's book, Ultra Prevention, patients suffer from one of five problems ( not "elements" mind you *a la* TCM) of which the two I recall are "sludge" and "rust". I wonder what IBC is.

-btw- the diet/ supplement/ IV vitamin C treatments sounds a great deal like what prn's guru and chief enabler RN utilise.

. . . Unfortunately, current research models do not have a way to test each individualized, patient-centered therapeutic plan that is tailored to a person with a unique combination of existing conditions, genetic influences, environmental exposures, and lifestyle choices. . . .

Translation: "Our methods and procedures are too sophisticated for plebeian sensibilities to understand. If you cannot see the obvious superiority of them, then you cannot appreciate the finery of the emperor's new outfits, either."

Functional Medicine offers a powerful new operating system

They say this as if it were a good thing. Those of us who are familiar with the Blue Screen of Death (Windows) and/or the Spinning Beach Ball of Death (Mac) might beg to differ--and that would be most of us. How do we know that the Functional Medicine OS doesn't have a BSOD equivalent? With nasty results for the patient if--or should I say when--the BSOD equivalent appears.

Daniel @3 -- I think that should be "the machine that goes ka-ching!

@ Eric Lund:

And what exactly would the FM OS's BSOD look like?

does it occur as the patient turns blue or spins or is it purely in the FM Dr's imagination? ( like the rest of FM)

The high dose vitamin C, the dozens of lab tests, and all the supplements did her no good but certainly cost a lot of money.
An idle assertion with apparently zero experience and capable work effort behind it. The experience of my cancer acquaintances is pretty much about vastly improved quality of life, otten within minutes or hours in terms of overwhelming pain, nausea and/or fatigue.
Also in a short term, stomatitis is reduced or disappears.

On an integrative tx basis, including IV vitamin C too, I've observed long term ESR drop by a factor of 3-4, like 40+ to <10. Various cancer markers improve to a favorable baseline or some optimum rather continue to deteriorate as conventionally expected. In favorable situations, the extra supplements with chemo are better cancer killers than SOC. I seen some good kill data the literature, I've invested in lab results I arranged for where the was new and surprisingly so to them, and in the subsequent blood data. In the literature, the comparable patients are ***all*** simply extinct several times over, after an unpleasant journey.

In the CRC world, you folks don't know [cough] squat about vitamin C even though it is just a multifactor tool rather than a silver bullet.

My comment on this article's "waste spending premises" is that the CDSA used to cost about $300-$400, not sure now since the Genova merger. Doing it 1-2 times would be pretty minor in the $50,000-60,000 per month standard of care I see others wasting away on with mCRC Std of Care.

Also in the US, blood test prices are fixed very high. In high volume international areas, $1-5 per panel is possible, sometimes offered retail. I've found more data, based on literature, very useful.

@prn: So why don't you have peer-reviewed publications about the magic of IV vit C? You keep posting how wonderful it is. So prove it. There's tons of money available from NCCAM (or whatever it is now) available for studies. Get some proof.

Standards of care are paid for by insurance because they are proven to work and are cost effective. If you could give insurance company proof that a less expensive treatment : 1. Is AS EFFECTIVE OR BETTER than the current treatment 2. Has the same or fewer side effects and 3. Is more cost effective they would be ALL over it, believe me.

But yammering from the peanut gallery and testimonials just don't cut it. Proof does.

Clean up needed on comment #4 from a troll copy/pasta from AOA. If they are going to post stuff, I wish they'd research the proof of it first... (for example, as far as I can find, Dr Farid Fata was never associated with WSU and the Karmanos Cancer Institute).

And quoting Jake Crosby's droppings is just proof that the troll is unable to do any independent thinking.

@Sulli - we are aware that Jake wrote an article attempting to prove someone has an unstated conflict of interest because of an 11 degrees of separation problem.

BTW - an internet troll is defined as someone who deliberately tries to "stir the pot" online by writing inflammatory or off-topic messages. Jake's use of the term does not appear accurate to me.

@ MI Dawn:

That quoted by # 4 is also at Natural News today as I noted on the BS 2 thread so even less thinking was involved by # 4

Is that all they have? Jake?

And the minions are mentioned a little in her NN article.

Orac's place is THE place to be!
Shills, minions, even Brian Deer stops by.
We the cat's pyjamas and the bees' knees.

I think Jake knows about the NN piece. I wonder what he thinks about AoA using his material?

Have they got any evidence that Orac want to do a clinical trial on autistics subjects? I mean, Orac is a surgical oncologist, not an academic shrink or neurologist ?!

Alain

"We treat/the underlying cause with personalized care."
-All sCAMsters ever

Then they proceed to "prescribe" many supplements, often similar for every patient. How is that different from a doctor prescribing medicine? Other than the evidence base of course.

If we ever need to illustrate what we mean by "word salad", the functional medicine site seems to be the place to go.

Didn't there used to be a competition for the most inane/contentless powerpoint slide? Functional medicine is going for it.

It is mildly hilarious that the same NN "staff writer" (Julie Wilson) who authored the article outing Orac et all as corporate shills, has another current article on NN proclaiming that "Women with larger behinds are healthier and more intelligent, study finds".

In the first article, we're told that any time Science upholds something that benefits big corporations, it's not to be trusted. Yet promoting fat a$$es (which obviously puts money in the pocket of Big Agriculture, Big Processed Food and Big Ice Cream) is unimpeachable science.

I suspect the reason for this dichotomy is a high incidence of massive rear ends among Mike Adams' followers, who like the idea that their lard-butts indicate higher intelligence and better health.

Mikey himself continues about our perspicacious host today in his post about Scientism ( sic) where the later enjoys rather illustrious company of Offit, Entine and Nye.

What up, anyway? Has Orac's visibility since the De Niro debacle increased his stature in woo-meisters' eyes?

Then they proceed to “prescribe” many supplements, often similar for every patient. How is that different from a doctor prescribing medicine?

Practicing doctors do not directly own pharmaceutical companies. Many of the alt-med doctors who "prescribe" these "supplements" actually do have controlling interest in the manufacturer of the prescribed supplements. This is a major reason why the "pharma shill" gambit is little more than projection on the part of the alt-med crowd.

Didn’t there used to be a competition for the most inane/contentless powerpoint slide?

That competition was long since won by the Gettysburg PowerPoint Presentation, a parody written when Bill Clinton was president (somebody discovered the hard way that <president@whitehouse.gov> was and is a real e-mail address), and still available at the original site if you Google "gettysburg powerpoint". In particular, slide #5, "Organizational Overview", turns, "Four score and seven years ago our forefathers brought forth on this continent a new nation," into a hilariously overdone Excel bar chart. Bonus points for using Lincoln's actual words, drained of their impact, in the parody. The author claims to have made only a few tweaks of PowerPoint's then default settings (via the too aptly named "AutoContent Wizard") to get this result.

Functional medicine doesn't have the luxury of starting with such great material, but they are certainly giving it a good try anyway. The slide displayed in the OP manages to say nothing and to do so at great length.

They should be ashamed. Very ashamed.

Ashamed all the way to the bank.

prn @11: What blood test are you getting for $1? Every time I run a CBC/diff it's $1.50 in reagents alone, not counting the instrument, the printer paper, the tube the blood is in, or any of the people involved.

@Justa #24 - Since you already know you're going to be selling a ton of crap to your patient, all you have to do to get a lab result is throw a dart.

Sulli @#4....ha
Ha ha

Ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha

What a load of

Justatech: Not to mention, prn seems to be doing blood tests very frequently. Maybe PRn meant a blood sticker- you know, whatever those things diabetics use to test their insulin are called. (And what level of insane do you have to be to want to do a full onblood test? I've hated every single one that I've had to do, mostly because I end up very shaky after.)

Homopathic classes are now taught at most major university's. I guess they believe it's science. If big pharma can't get people well, they will turn to something else that will, sorry Orac, your wrong about this one. Or should I call you by your first name, David Gormski?

X-Pac - could you please list of the universities that offer courses on homeopathy? Thanks in advance.

Many universities offer courses on English literature. Is that a science too?

could you please list of the universities that offer courses on homeopathy?

You're missing the nuance. "Xpac" wrote homopathic.

#4 Thanks- for the info

JT@24 everything in the US is high priced. Here's a 2012 "Chem-26" for $1.33/panel for profit walk-in retail (AFAIK) - look at the bottom for "Pacer-26"
http://www.aminspathlab.com/Pricelist_01Aug_2012.pdf
In another country, the international test makers were quoting to beat $1 in 2010 at the hotel expo down the street.

PGP@26: mCRC patients on chemo are usually blood tested every chemo cycle, every 2-3 weeks

You’re missing the nuance. “Xpac”
...thinks "David-Gormski" is a first name.

The bottom line for Big Pharma is profit but there is some hope for the development of antibioics.
http://www.wsj.com/articles/SB10001424052702303465004579322601579895822
"Even if antibiotics make it to market, oncology drugs are on average three times as profitable, and musculoskeletal drugs produce more than 10 times the returns, according to estimates from a 2009 London School of Economics report."

2 answers still in moderation at 1125 pm CST 4-18-16.

cont....."For example, ceftaroline fosamil, an antibiotic approved in the U.S. in 2010, costs around $600 for a seven-day course. Contrast that to yervoy, a new drug to treat melanoma, that costs $120,000 for a 12-week course."

How ironic- right under his nose- Farid Fata- https://www.justice.gov/usao-edmi/file/623461/download

This is what the patient reported about her treatment with CAM.
(Read the report) Patient Perspective
“I was worried about the side effects of chemotherapy but I
never had to have a blood transfusion, I only had diarrhea
once, and no nausea and vomiting. I had a little bit of fatigue
but stayed active and did not have to change my lifestyle
very much. I was able to be with my friends and family, and
to taste and eat food while I was being treated. I thought
that I looked better than the other chemotherapy patients I
saw when I went to get treatments. They all looked so sick
and so much older than me! The worst thing was losing
my hair! I knew that the medications had a long list of side
effects and at the beginning I did not understand that they
could be minimized, but they were! I had chemotherapy
and surgery but never had any radiation. Two years later, I
am still cancer free and feel great. I may be healthier now
than I was before my diagnosis and treatment.”

It's hard to carry a conversation here with the filter, 2 still waiting above here, and minus two last week.

Denice@6
...prn’s guru and chief enabler RN utilise.
I'm mystified. Who's RN ?

The question the people pushing this are evading is, if there's no way to test the regimens they're giving their patients, what are those regimens based on? What makes them think that (for example) all that vitamin C isn't worse than useless? Even the "in my experience" argument for using something without clinical trials falls down if the claim is that what works for me isn't going to work for you because we're all different.

How do they know they aren't just coming up with expensive, "personalized" ways to kill their patients quickly?

@ prn:

Hello, I hope you're well.

Not 'prn' meaning you but the radio station that transmits woo over the internet- its guru is Gary Null and the 'RN enabler' is an actual nurse who assists him by recruiting patients and setting up treatments through her business, Metropolitan Wellness ( see website). The two are partners in several ventures providing so-called health care in at least 3 US states, ultimately aimed at creating a health retreat resort ( The Texas Villa) that will work with seriously ill people which is now in its first stages of development in Mineola, Texas.

@ Vicki

How do they know they aren’t just coming up with expensive, “personalized” ways to kill their patients quickly?

One would also be arguing about the "personalized" part.
OK, so all these tests are run, and at the end it's surprisingly the same usual suspects - vitamin C injection and ingestion, gluten-free diet, colonics, juicing... The new post about the poor Australian lady with cancer shows this.

As Brook #25 implied, it's as the regimen was already established before getting the results of the biochemical tests.
That's actually how the tests could be so cheap: since the conmen are expecting a big business deal after the mark has been provided with the tests' results, they could afford the risk of losing money on the tests.
They are not the only ones with this business model.

Also, to emphasize, this argument of "we can not test our medical approach because it's personalized" is pure bullshit.
Alt-meds quacks, if they were honest, could test a procedure by measurable endpoints, like everybody else.

ken surely by now you can grok that anecdotes =/= data.

trying to get past filter, part 1:
@prn: So why don’t you have peer-reviewed publications about the magic of IV vit C? You keep posting how wonderful it is. So prove it. There’s tons of money available from NCCAM (or whatever it is now) available for studies.

uhhh, MID. I am the customer, not the seller or some young Turk that doesn't mind killing lots of rats and patients.
"Hey prn, before we operate we'd like you to prove the 4 color map theorem more elegantly" I just happen to be better at improvised research results from scratch than most drs, like little PhDs. I was never much a paper pusher, somebody else has to plow that s---.

trying to get past filter, part 2:
Standards of care are paid for by insurance because they are proven to work and are cost effective. If you could give insurance company proof that a less expensive treatment : 1. Is AS EFFECTIVE OR BETTER than the current treatment 2. Has the same or fewer side effects and
3. Is more cost effective they would be ALL over it, believe me.
Somebody here may be fool enough to believe in an efficient market hypothesis for Sci/Tech, not me. The patent bureau is littered with unused good technology as well as duds. Marketing is all about ignoring, or destroying, products or technologies your company doesn't own or want to sell.

The IV vitamin C story for acute viruses is a great example of that. The most thorough summary is Tom Levy's Curing the Incurable: Vitamin C, Infectious Diseases, and Toxins. An interesting historical sampler is McCracken's Injectable Vitamin C

PRN: mCRC patients on chemo are usually blood tested every chemo cycle, every 2-3 weeks.

But didn't you say you weren't on chemo? My point is, normal healthy people do not voluntarily get blood tests that often. Also, that seems kind of like a short interval. Wouldn't once a month be better, if the cancer seems to be holding steady?

prn @32: I don't know what being in the US has to do with how much the reagents for the machine cost. I mean, based on the number of languages on the box this machine is used all over the world. Then again, it does require more than a drop of blood. Usually a whole tube. But then again I'm doing a complete blood count with cell differentiation.

PGP @26: Have you tried asking to lie down for draws? I'm a terrible fainter (it's not the sight of blood, it's having someone deliberately take it away) so I always ask to lie down. I might have to wait a few minutes more, but it really helps not feeling terrible. Also, pointless chit-chat with the tech helps too.

Justatech: I'll try that next time. I'm not big on pointless chitchat, unless it's about birds.

As a former phlebotomist, I can tell you we'll do anything to keep our victims from fainting.
Nobody likes getting their blood drawn, some of us just don't mind it. (Although I had a hard time believing the folks tattooed all over - and I mean in their ears all over - telling me they're afraid of needles).
Trust me, I have talked about professional sports (and I am so not a sports fan this was really hard), prayer and faith healing (patient's fear trumps my beliefs), dogs, books, mean siblings, favorite halloween costumes, music and birds. Please please please tell the phlebotomist you get queasy. So much easier to have you lying down than do the paperwork if you faint/throw up.

The important thing for me is not seeing ANYTHING: not the needle (before OR after they go in), tubes, vials, anything. I just have to face away from all that stuff.

Brook: That's good to know. I don't get queasy* thankfully, but I do get a little faint, and it doesn't help that I have skinny veins, so they have to do a lot of poking. I should also schedule tests in the middle of the month, since that should give my iron levels time to go up.
*My inner ear is ridiculous. I have been known to go on three spinning rides in a row and never throw up. I've also never been seasick or motion sick.

systems-oriented

The guys I confront have taken to sneering that they "like to use a systems approach," not the fuddy duddy old reductionist science that gave us DDT and Subaseals and oral polio vaccines. Allow me to roll my eyeballs as these people would not recognize a system if Chestnut hisself return from the grave to get funky in their ears.

@Brook

One time when I was sick with Cthulhu-knows-what I, for some reason lost to me to this day, needed to have my blood drawn. Not only did I pass out for a second or two, but in doing so I apparently lost whatever control I had over my stomach and up-chucked all over myself and the poor lady drawing my blood.

I don't have a problem with needles in general nor do I ever faint (this was the one and only time) but being sick with flue-like symptoms combined with the drawing of blood was a bad, bad combo!

PGP@47: ...didn’t you say you weren’t on chemo?
No.

My point is, normal healthy people do not voluntarily get blood tests that often. Also, that seems kind of like a short interval. Wouldn’t once a month be better, if the cancer seems to be holding steady?
Cost, convenience, predictive qualities, and response options, have an impact an independent, rational maximizer's decision for blood testing.

If the Theranos single drop concept had matured, and if I were a wealthy CRC stage III with biomarkers indicating proneness to metastasis, I might do a fingerstick every week at a Walgreen'sif it was around a corner, then reviewed monthly or monitored by an expert outside provider to maximize sensitivity, statistical power and medical responsiveness without disturbing me everytime.

However, I deal with a case of mCRC that had somewhat disseminated targets - many lymph nodes and other organ locations ranging 2-30mm, along with biomarkers that correlate with a metastatic character.
That typically means "chemo forever", something I probably view more literally than oncologists.

JustaTech@48:
prn @32: I don’t know what being in the US has to do with how much the reagents for the machine cost. I mean, based on the number of languages on the box this machine is used all over the world. Then again, it does require more than a drop of blood. Usually a whole tube. But then again I’m doing a complete blood count with cell differentiation.

I assume regional price variations or cost cutting practices for consumables.
Also, I've paid ca $1.75 - $2.10 per CBC with dif from a retail lab outside the US with same day turnaround during these years.

PRN: I hate to break it to you, but internal vitamin c doesn't count as chemo. Besides, I thought you hated and despised actual medical doctors? Why bother with medical treatment?

" However, we’re not so unique that our bodies don’t all work pretty much the same way. In other words, in terms of biology, physiology, and yes, systems biology, human beings are far more alike than they are different. If that weren’t the case, modern medicine, developed before we had the tools to probe our genetic individuality, wouldn’t work as well as it does."

What an interesting statement. If we are so much alike in terms of biology, physiology, and yes, systems biology, why do some get cancer, whilst others do not? Why do some get auto-immune disease and some not? Why do some become addicted?

And just how well does modern medicine perform? How do we establish the parameters by which we adjudge that performance and compare it to other forms of medicine?

Gus@58:

And just how well does modern medicine perform? How do we establish the parameters by which we adjudge that performance and compare it to other forms of medicine?

Why yes, if only we all had some sort of methodical, objective, reliable system for repeatedly testing stuff to determine if it's any good or just a giant steaming load of horseshıt. We could even call it something like "science" and make more progress in a couple short centuries than blind faith and superstition could achieve in ten millennia.

Perhaps if we pray really hard to the gods of homeopathy they will one day tell us how.

PGP: PRN: I hate to break it to you, but internal vitamin c doesn’t count as chemo.
Even the hardest core here will count 5FU as chemo. I suspect there will be multiple opinions about various off label adjuncts in combination. Don't forget leucovorin is a vitamin too.

Besides, I thought you hated and despised actual medical doctors?
That's just what less sophisticated readers here may presume.

Yes, I can be annoyed if someone is rude, nasty or obstructive despite careful request or presentation.
Yes, I can be critical.
Yes, I may not spend more money on drs that don't contribute much value to the project.

I do several drs consults on various items and tasks every year, just not medical oncologists.

Why bother with medical treatment?
You may mistake a discussion over technologies, approach, insistence on measurable performance, and cost effectiveness for total rejection of medicine. I don't.

Your own preconceptions may be distorting your views.

has@59

I acknowledge what your are inferring with your response here. However, my first question remains unanswered. Not just by yourself, but by all who enter this debate. And this question MUST be answered before one quotes "a sound methodology" by which we judge the validity of that knowledge.

I could have asked why those who are the proponents of science (both sides here purport to argue from this perspective), only use the scientific method to furnish proof of their conviction. And no disrespect to those who carry the burden of the belief theirs is the correct conviction.

Let me ask this then; How much does modern medicine know about breast cancer? About any cancer for that matter? What does FM know about breast (or any) cancer?

I know that is not the subject of the article, but it is the very core of the disagreement between two apparently opposing schools of thought, (the very core of why there is debate where there should not be). Neither side is offering anything of value to the argument because all they do is bicker about who is right or who has the right to be right. By doing this, everyone loses sight of what is REALLY important here.

What mindset lays the foundation for such loss of direction?

Let;s say I have cancer. For my doctor, what is the most important thing to consider when I am first diagnosed and first presented? If you think this is an obvious question, then you have no right arguing this topic, let alone arguing the correct course of treatment, no matter how many and what type of letters follow your name.

At this point I am willing to wager very few people here could answer me (just me, not the next cancer sufferer) correctly.

Gus@61: No need to infer: I'm calling you out as a disingenuous JAQ-off asking bad-faith extremely trivial questions that anyone with a room-temperature IQ can quickly and easily answer for themselves instead of demanding others do all the work. (Or a several nights' reading, if you fancy a longer pop sci rundown.)

But okay, I'll play a little. IANAD, but straight off the top of my head: some folks get cancer while others do not because: random chance (particular combinations of genetic mutations accumulated during cell division), aided and abetted by lifestyle choices, parental genes, and increasing age.

Now go do your homework for yourself, and then come back and tell us what the rest of those answers are**, and if there's specific points on which you'd like clarification or wish to discuss further then perhaps folks here will be a bit more disposed to engage with you on a good faith basis.

(** Protip: This does not mean spamming us with Natural News/Whale.to/GreenMedInfo excreta, as those are well known and repeatedly debunked lying liars who are not a reliable source of anything except Big Alt Med profiteering, so quoting those as sources will get you laughed out the room. Ditto dangerous loons like Simonici and Young who've been torn apart here and elsewhere for their lethal BS.)

Gus@58:
"What an interesting statement. If we are so much alike in terms of biology, physiology, and yes, systems biology, why do some get cancer, whilst others do not? Why do some get auto-immune disease and some not? Why do some become addicted?"

Because while we are more similar than different we aren't all exactly the same. Also, we do know some things that increase the risk of developing certain cancers like smoking, HPV, gene mutations like in BRCA1 & 2, etc.

PS How do I format block quotes on this site?

@Secret Cisco:

How do I format block quotes on this site?

Use HTML tags:

<blockquote>How do I format block quotes on this site?</blockquote>

Then pray to the gods of SB IT that you typed them right too, cos Preview and Edit is for weakings only.

Don't know if I'm doing this right

Editing is for the weak, I only write in ink.

has@62.

Please let me be clear with you. I have no bias toward scientific-based, modern medicine, ANY alternative medicine, in fact ANY form of activity which espouses ANY method of treating the ill. Perhaps if you explained to me why you think I denigrate one and worship another, I can explain to you why you are wrong. But you are wrong.

(My reference to scientific debates using science methodology to justify the the credibility of the knowledge being argued,: The scientific method is based upon both positivism and empiricism, meaning; the only knowledge humans can have is based on experience, and it is susceptible to unintended bias because of frequent skepticism and a sometimes contentious tendency to deny, oppose or resist possibilities which contradict the paradigm in question.

When I asked by what parameters we should adjudge any particular form of medicine, and your answer is "the scientific method", I have to ask how can you justify using the method by which you come to your conclusion as proof your conclusion is correct. That is somewhat, at the most basic level, the same as devout Christians claiming the existence of the bible as proof of the validity of events chronicled within. I am not saying scientific proof is invalid, I am saying using the theory of it's own method to qualify data means it lacks bias.)

I'm simply asking questions, so I'm a little disappointed in your responses. I don't know who anyone here is. I followed a link to the story whilst researching for facts myself.

"But okay, I’ll play a little. IANAD, but straight off the top of my head: some folks get cancer while others do not because: random chance (particular combinations of genetic mutations accumulated during cell division), aided and abetted by lifestyle choices, parental genes, and increasing age."

In my opinion, only some of the things you mention here are valid and, for me, your answer is incomplete. I'd like to discuss this further, along with a couple of your other points, so I can try and understand where our differences are. But only if you are inclined to the discussion.

"Now go do your homework for yourself, and then come back and tell us what the rest of those answers are**, and if there’s specific points on which you’d like clarification or wish to discuss further then perhaps folks here will be a bit more disposed to engage with you on a good faith basis."

I could be a bit wrong, but I am struggling very hard with the temptation to maintain the sarcastic level of this conversation. Common sense and experience dictates I am bound to get nowhere if I do. I'm honestly just seeking answers and this response is plain rude and incredibly condescending.

Having said that, I guess I must apologize here, because you have the impression I was asking a rhetorical question regarding how much each of the medical "camps" know about cancer. I was asking the questions of both parties and I'm asking because I don't know the answer. No disrespect, but your answer shows me not how much you know, but how much you don't.

I am more than happy to "go do my homework" elsewhere. Have been for a number of years prior to this conversation. I certainly would not be able to match most here on subjects such as biology, genetics, pathology, immunology, oncology, chemistry, nutrition/diet etc. I am no expert, but I could certainly engage on these subjects and more.

And I'm still asking "The Why" question because I have not found the answer.

I, perhaps erroneously, expected if I asked questions of people who appeared to have a level of intelligence which would equip them to help educate me, I was on the right track. It appears to me the possibility there is some serious conflict here between intelligence and intellect.

I'm sorry, I do not know who these dangerous loons are. Nor would I try and quote you from sources you clearly hold, carry no credence. Just as I have read this article, these comments, I have read opposing points of view with as much an open mind as I can muster and I have done so from the prospective of a relevant ignorant.

"No need to infer: I’m calling you out as a disingenuous JAQ-off asking bad-faith extremely trivial questions that anyone with a room-temperature IQ can quickly and easily answer for themselves instead of demanding others do all the work. (Or a several nights’ reading, if you fancy a longer pop sci rundown.)

[With respect, the google results for "causes of cancer", at least the first 4326 of them ( I haven't got any further because the links just got further from the question), have not answered my question. If you think they do, you have not understood my question.]

Again, incredibly rude. Perhaps my expression of doubt about whether any of you could answer my question, (what the most important thing my doctor should consider), has hit a nerve. I am in no way surprised if this has upset you and given you the impression I am some crank, quack, know-it-all who is set to rub some alternative, harsh quackery truth in your face. Most in their respective fields have reacted the same. I'm sorry to disappoint if that is indeed what you think, but this is MY question. Relating to me. So be very careful what you refer to as "bad faith, extremely trivial questions". As I have said, I have been looking for answers for a number of years. If you can supply what I asked in "several nights reading" please point the way.

I have asked that question so many times. Of doctors. My doctors. Doctors trained in scientific-based medicine, homeopathy, acupuncture, osteopathy, iridology, reflexology, psychology, psychiatry, palmistry, even astrology and some other "ologys" I don't remember. No one has been able to answer me. I have asked that question as a patient who is reduced to doing my own research into my illness because no one has answers.

I don't really give a damn about who has the better "ology". I'm tired of having medical experts treat me with a sneering disrespect because I do not hold the same opinion nor level of education as they. I'm tired of sifting through literally thousands of articles, research papers, feedback and forums trying to discern any worthwhile information.

If this is a "wrong" place to search for answers, if my questions are deemed somehow inappropriate, offensive or if you just plain don't like me, just say it. But don't drag me into a contest about who has got it right and who has not. In my opinion, (one you have elegantly and with great linguistic wit pointed out is of no consequence), if you consider my questions trivial, if you all have to argue your side of medicine and belittle another, rather than answer a question or pursue a truth (even if it contradicts an established paradigm),perhaps you should consider another vocation..

Gus: "I, perhaps erroneously, expected if I asked questions of people who appeared to have a level of intelligence which would equip them to help educate me, I was on the right track."
Gus: "I’m tired of having medical experts treat me with a sneering disrespect because I do not hold the same opinion nor level of education as they."

Based on these conflicting statements I gather that you have a great deal of resentment towards medical experts and evidence-based standards of care.

Unfortunately, you'll find that most everyone here is familiar with the Just Asking Questions meme (from people who are convinced that woo is equal to or better than science-based medicine), and equally, nauseatingly familiar with Tell Both Sides (as if there was any remote equivalency between quackery and medicine) and You're A Bunch Of Meanies.

If you (as is evident from your "research") think there are diagnostic methods and treatment successes used by wooists that work as well or better than the standard of care in medicine, present them and the evidence you think supports them. Can you do that?

Just asking the question. :)

tendency to deny, oppose or resist possibilities which contradict the paradigm

Kuhn has a lot to answer for. His stuff was just a couple of commonplace ideas dressed up in pretentious language. How it ever became mainstream defeats me.
The myth of the unsung hero battling against the establishment is the daily bread of frauds and charlatans everywhere.

I'm not sure how you see those as conflicting statements. Let me explain.

I expect people who have studied at university and continued education in the medical field, practiced the medicine, possibly researched and become a specialist in their chosen field (add the fact they place themselves in the public domain as a representative of authority on a given subject) to be equipped to answer questions about their field. I chose to ask the questions here, because there is evidence of intelligence in those who are making comments. This was in response to a suggestion "I go do my homework and come back..."

The second statement has nothing to do with the first. It is reference to the medical experts (in any area/discipline/branch/fairy tale of medicine, and I've been to a lot, not just your quacks, but also your medical doctors who practice evidence-based standards of care) who have extended this attitude. I do not direct the comment at the many in all those fields who have treated me with respect. I'm sorry I did not qualify this. But as I said, I'm sick of swimming through the ego shit. It comes from all sides of medicine. The negative connotation of this statement is echoed in the rude and condescending response which comes from someone in the modern medicine field. I do not judge this person's colleagues and the validity of his medical belief by basing my judgement on his attitude toward me or his response.

And I'm sorry, but you are making the same sort of assumption has@62 made when he accused me of denigrating modern medicine. I'm not sure how you can conclude from my "research" my opinion of anyone's diagnostic methods and treatment successes, quacks or MD's. You have no idea what I have researched. I'm not questioning diagnostic methods or treatment successes either.

At no point have I suggested I know of any diagnostic methods and treatment successes used by "wooists" that work as well or better than the standard of care in medicine. I do know of many with the claim, but have failed under scrutiny. So, just answering your question :- ) , no I won't post any links, nor would I insult your intelligence and bang my head against the proverbial, by doing so.

Gus: "I am more than happy to “go do my homework” elsewhere. Have been for a number of years prior to this conversation. I certainly would not be able to match most here on subjects such as biology, genetics, pathology, immunology, oncology, chemistry, nutrition/diet etc. I am no expert, but I could certainly engage on these subjects and more."

The first thing you need to do is log on to your community's library website. If you do not have a library, then apply for one. Then put a hold on The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee.

It is a big book, so there no reason you should be forced to buy it. The reason it is a big book is that cancer is not one disease, but thousands. In other words, you question is more complicated than can be answered in one blog comment. It is a well written book.

Why do some get auto-immune disease and some not?

Well, there are somatic hypermutation and molecular mimicry, off the top of my head. The immune system was slapped together out of different bits and pieces over time, after all.

Gus:

In my opinion, only some of the things you mention here are valid and, for me, your answer is incomplete. I’d like to discuss this further, along with a couple of your other points, so I can try and understand where our differences are. But only if you are inclined to the discussion.

Pray tell, what particular issues do you have with this statement?

But okay, I’ll play a little. IANAD, but straight off the top of my head: some folks get cancer while others do not because: random chance (particular combinations of genetic mutations accumulated during cell division), aided and abetted by lifestyle choices, parental genes, and increasing age

Merely saying, "I don't agree" isn't something that can really be responded to effectively.

Gus: For my doctor, what is the most important thing to consider when I am first diagnosed and first presented?

How is 'what kind of cancer is it?' not the obvious and intelligent answer? Just saying 'cancer' doesn't work, as others have pointed out elsewhere. It's a classification of literally hundreds of different diseases, just as influenza serves as a catch-all description for everything from a seasonal nuisance to the 1918 pandemic.
A doctor who prescribed the same course of treatment for a leukemia patient and a breast cancer patient would probably lose his license, and rightly so. Why? Because despite both being cancers, they behave differently. Again, 101 stuff. No wonder you get rudely treated by doctors if you insult their intelligence with this stuff.

Gus:When I asked by what parameters we should adjudge any particular form of medicine, and your answer is “the scientific method”, I have to ask how can you justify using the method by which you come to your conclusion as proof your conclusion is correct.

So, what method do you think is superior and more likely to yield a better result? Divination? Reading entrails? Prayer?

Thanks to you all for your replies.

Gus,

Perhaps you'd be better served by asking a philosopher teaching about the philosophy of science. They are the ones working on the method themselves and we use it in science because, so far, there's no better method for doing science. The specifics, they know it why.

Alain

here's your referal, Gus:

http://www.forbes.com/sites/janetstemwedel/

Many thanks, Alain.

Gus@66: Okay, now you sound like a postmodernist sophomore rehearsing for his first exam. Just because you are ignorant of how things work or how knowledge might [and might not] be reliably acquired, it does not mean that nobody else does either. Frankly, the only way your claim of impeccable neutrality holds up is if you've dedicated your entire life to scrupulously not educating yourself in any of the intellectual or practical tools that would equip you to make any sort of qualitative judgement on the world around you.

So which is it? Either you're being deliberately deceptive about your true motives, or – despite an apparently perfectly good set of neurons – you intentionally keep yourself dumb as a sack of spanners.

Never mind Mukherjee's cancer book for now; I recommend you start on the fundamentals: something like Philip Ball's Curiosity that lays out exactly why and how the knowledge-finding system we now call "science" evolved in the first place, raising humanity from watching the shadows in the cave to golfing on Fra Mauro. (Or: "If Science evolved from Philosophy, why are there still Philosophers?")

Because until you understand simple things the distinction between knowledge acquired by divine assertion and knowledge acquired through rigorous testing, failure, and self-correction – and have a basic awareness of the tools and techniques for the latter – intellectually you ain't going anywhere. And folks round here generally have better things to do than play comfort blankey to children who never grow up.

has: "Never mind Mukherjee’s cancer book for now; I recommend you start on the fundamentals: ..."

Or perhaps he could go really old school and start with Paul de Kruif's 1920s era book Microbe Hunters, mostly for the lengths Pasteur had to go to disprove spontaneous generation. I actually suggested Mukherjee’s book because it was specific to cancer and very thorough.

Thanks letting us know about Curiosity, it looks interesting.

@ Gus

I expect people who have studied at university and continued education in the medical field, practiced the medicine, possibly researched and become a specialist in their chosen field (add the fact they place themselves in the public domain as a representative of authority on a given subject) to be equipped to answer questions about their field.

There is a joke about engineers and scientists: if you ask them a question, any question, their answer will take the form of a standard 20-min* long conference lecture.

It's in part a self-derogatory joke about our tendency to pontificate.
It's also a

* or 30 min or 40 min. Whatever.

@ Gus

Continued...

(hit the submit button by accident)

This joke is also a wise reflection on how our fields are complex and a complete answer to most questions is difficult to summarize in layman terms into a simple paragraph.
We have to explain the context,the variations, and so on.

So, when hoping of finding easy and complete answers here, you are asking too much.

But try to meet us half-way.

Because throwing drugs at people fixes everything...functional practitioners take time to listen to patients and see what is going on under the surface, including toxicities, nutrient deficiencies and food sensitivities, among others. The 5-10 minutes you get at a regular MD doesn't compare to the hour or more at a time a funcitonal MD will spend with you - there can't be any individualization as there is not enough time. I don't agree with everything every functional doc does (e.g. treating exclusively based on genetic testing, which I have seen NDs do), but see the biggest value in its mindset. As a dietitian, I've seen the greatest overall impact on health with eliminating food sensitivities using LEAP MRT testing. Another huge area is vector-based diseases, which can take decades for regular MDs to find with lots of prodding, if they ever do. TriLife Health in Colorado is well-known largely on the work they do with vector patients. I want to see more research in the area of functional medicine, but most of it does not get funded because it doesn't fit the goals of the health industry.

Helianthus@82: This is true: modern knowledge is complicated; but I think the problem is it's so easy to get lost in the complexities of specific information set that one forgets the importance of having a basic understanding of how that information was arrived at in the first place. Because until you've got that you've got nothing, and – as comments like Gus's demonstrate over and over again – this is an appallingly common failing in our so-called modern educated world.

I'll happily give anyone who wants a 20-hour lecture on the failings of modern junior and high school science and math education that teaches students to master the form without ever explaining how that form was arrived at or why they should give a damn. Thus a hard-won scientific insight like "V=IR" becomes nothing more than a cheap mindless party trick: a means to an end where a student obediently punches in numbers and gold stars come out; instead of being recognized as an answer itself: an elegantly concise and robust description of how one part of our universe actually works.

Understanding the history of science – how and why it came to be in the first place, and thus why it is the shape it is – is infinitely more valuable than rote reciting its answers, not least for the personal insight that comes from seeing all the ways in which our predecessors got it tragically or hilariously wrong, only to check themselves and work painfully and slowly towards being less wrong over time.

But alas, I guess that sort of approach to learning doesn't slot neatly into standardized testing or popular political soundbites so, as I've already said to Gus, if he really gives a damn and isn't just out to make us dance a merry jig for his own entertainment, he's going to have to roll up his sleeves and make some effort to teach himself first, because the rest of the world ain't going to do it all for him. As someone who breezed through high school science lessons and exams without ever learning a single damned thing, only to discover decades later a genuine, if no more than pop-sci, desire to learn how and why it all works in the first place, it's never too late to start.

HDB:As someone who breezed through high school science lessons and exams without ever learning a single damned thing, only to discover decades later a genuine, if no more than pop-sci, desire to learn how and why it all works in the first place, it’s never too late to start.

Most of what I learned in high school is conveniently non-applicable to real-life, except for the hours of programming powerpoints and finding out ranch dressing can in fact, get grosser. (My health teacher had a bottle he'd been culturing for years.) It is nice to know that the fire department will show up when people play with magnesium, but finding out that songbirds should not be flung is not very useful as an adult.
I still would like to know what Gus thinks is more useful than the scientific method.

Looks like main stream medicine is feeling the pressure from the success of FM. It doesn't treat symptoms it treats the cause of symptoms. Lab work and body chemistry adjusted with pure supplements.

It looks like Heather has severe reading comprehension issues.

OK Heather, please tell us how "functional medicine" treats cancer better than medicine and provide the literature to support your claim.

I wonder if Heather could tell us what lab work and body chemistry would provide the information on which pure supplements would help obstructive hypertrophic cardiomyopathy.

As someone who is a student in a traditional academic medical program, let me say that the editorializing of this "scienceblog" does not make me inclined to take you seriously. Why not leave the name-calling behind and just state your case if it is so clearly right? It scares me to think that a respected physician provided me with a link to this site as EVIDENCE to support his judgment.

As someone who is a student in a traditional academic medical program, let me say that the editorializing of this “scienceblog” does not make me inclined to take you seriously.

Could you be more specific? Did you notice the title of the blog? C'mon, get out the blue pencil.*

* I have no idea where this trope came from; I started editing in the paper-and-pencil days, and there was no blue involved until proofs, to distinguish ee's from aa's (red).

Narad, many decades ago blue pencil were where notes could be made, but not copied on a copy machine. I knew this happened with some reports done in our engineering group during the early 1980s, and then the copiers got better and the blue showed up.

Then the Wang workstations staffed by the typists disappeared, and we were supposed type our own reports in what was a very pitiful word processor that existed on a VAX minicomputer. I did learn LaTex over thirty years ago, but did not need it after giving birth to a child with multiple medical issues.

Jack's comments reminded me of a review in the Wall St. Journal this weekend of a new book on Lysenko (the scientist* who set back the study of genetics in Soviet Russia by many years and aided in the persecution and jailing of scientists who disagreed with his tripe about inheritance of acquired characteristics).

https://www.amazon.com/Lysenkos-Ghost-Epigenetics-Loren-Graham/dp/06740…

The reviewer held up the Lysenko case as an example of how scientists should never become impassioned advocates for a cause (the not-so-subtle undertone being that Experts Can Be Wrong, and thus it's wrong for climate change scientists to become involved in public advocacy because it compromises their scientific objectivity or somesuch).

By that logic, it's wrong for Dr. Paul Offit to have become a strong advocate for vaccines (he should've just stayed in the lab and invented them), and early nuclear scientists should've avoided warning about the dangers of nuclear proliferation.

Since Jack is averse to editorializing and taking a stand on important scientific issues, he should probably stick to his textbooks, and whenever he gets a degree in his chosen field, be very very careful not to attempt to be influential about any aspect of it. Just a neutral recitation of facts, please.

*resisting the temptation to put "scientist" in scare quotes. Ooops.

Jack,

There is a number of people on this planet who have visited this blog and commented their opinion of most subjects with a view contrary to the science included in said post. We tend to use appropriate language and tone for such commenters to get our point across. If you have evidence that a more cautious tone should be used to successfully get our point across, please do post that evidence (from the psychological science body of knowledge, that is); otherwise, we might be inclined to think that you posted such tone trolling comment for your own benefit without considering the net benefit of using the appropriate tone to get across fence-sitters and have the regular laughing from time to time.

It's a big bad world out there ;)

Jack Henly,

To paraphrase the usual response from Fark.com:
Welcome to Respectful Insolence.

Fair enough. I concede that this blog is a place for those who already hold a certain opinion, and therefore my comment should be met with a certain amount of indignation by the regulars. We're clearly all trying convince one another of something and will end up turning in circles.

Mr. Henly: "Fair enough. I concede that this blog is a place for those who already hold a certain opinion..."

Usually an opinion based on evidence. If you have actual factual evidence that the modalities being criticized above actually are safe and effective then present the PubMed indexed studies by reputable qualified researchers.

"...therefore my comment should be met with a certain amount of indignation by the regulars."

You do have a rather high opinion of yourself, and seem to be armored with a very very thin skin covering a noodle spine. The reaction was not indignation, but a bored invitation for you to present your evidence. Bored because you are one of many who make the same lame name calling claim, and think we would just acquiesce to your tone trolling.

"We’re clearly all trying convince one another of something and will end up turning in circles."

If you present some actual evidence that the protocol used on the case report had any proved efficacy on breast cancer, we would be convinced. Until then go whither in the corner and whine about how asking for evidence is bullying, mean and full of indignation.

Because most of us really think that protocol amounted to just torturing the elderly sick patient for no reason (giving the woman diarrhea with massive Vitamin C really is torture). That is something that makes us indignant, not your whiny tone trolling.

And that is your Respectful Insolence for the day, I hope you found it useful.

“…therefore my comment should be met with a certain amount of indignation by the regulars.”

A slight twitch in lieu of eye-rolling should not be mistaken for indignation.

If you'd care to expand on your apparent belief that scientists should not engage in advocacy, a conversation might be possible. On the other hand, hitching up your metaphorical skirts and scurrying away while making tch-tch noises would not be productive.

@Jack (100),

Thanks for stopping by again.

Most of the readers here already have an opinion that we should make medical choices based on the best information available, which is science. They are also opposed to attempts to replace that with centuries old hearsay and similar handwaving arguments.

Nevertheless,we find this a valuable forum for sharing evidence, discussing the pros and cons of various approaches,and educating our BS detectors.

And sometimes we even learn something that changes our preconceptions.

But, first of all, thus us a blog, jot a science journal and not even a formal op-ed column. It reflects the interests and opinions of the primary author.

So, please, stick around, read some more articles, and participate in the discussion.

I am perfectly happy to believe that Jack Henly is a student in a traditional academic medical program, in the sense that "traditional academic medical program" is a euphemism for "has locked himself in a cave and actually believes himself to be fed filet mignon every day by his loving professors." Low level munchkins are fond of their self congratulatory delusions.

Anyone think we should tip him off about life in the wild? He doesn't appear to understand that crazy people really do exist in this world, stupid and dishonest but ever so persistent, and the day is fast approaching when his first kook steps up to declare "Johnny Weissmuller is not really dead." The more documentation he presents that Weissmuller really did pass away, thirty years ago, the more impassioned his buddy will become on the secondary thesis that Jack Henly is a bought and paid member of the Government/Pharma/Big-Bleach conspiracy to poison our children and control our minds.

Mr. Bell: "Anyone think we should tip him off about life in the wild?"

Ah, yes. This is making me remember when I first stumbled onto UseNet and encountered John Scudamore about fifteen years ago. I got a wee bit of a shock.

The real revelation of how far Scudamore was removed from reality was when he linked to something that had to do with smallpox, and I read a 19th century screed from some Army doctor that referred to the Native Americans as "savages." And then it got worse.

I learned, and earned my whale.to tribute page.

Jack Henly@100: "therefore my comment should be met with a certain amount of indignation by the regulars"

Protip: Don't bring glittery unicorns to a knife fight. Them scientists, they will slash you up real bad.

@ Dangerous Bacon

The reviewer held up the Lysenko case as an example of how scientists should never become impassioned advocates for a cause

Tangentially related, a non-scientific* very recent case is the Brexit.
* well, mostly non-scientific.

The "Remain" parties were more about facts, the "Leave" parties were more (if not all) about emotions. The "Leave" won.
These buses with the lying slogan about funding NHS with the EU contributions? The information was available that it was a lie before the vote. The voters didn't care.

Maybe more impassionate advocates would have tipped the balance the other way.

(the not-so-subtle undertone being that Experts Can Be Wrong, and thus it’s wrong for climate change scientists to become involved in public advocacy because it compromises their scientific objectivity or somesuch).

It's funny how, when you dig it up, tone trolling amounts to "shut your clap".

OK, to be fair, I get it. A number of people, me included, will react negatively to acerbic comments about them being wrong.
That will alienate some. OTOH, for some people, and sometimes me included, they need to be shocked to start the process of re-evaluating their opinions.

The reviewer held up the Lysenko case as an example of how scientists should never become impassioned advocates for a cause.

Impassioned advocacy is not quite the same as encouraging the authorities to have your scientific opponents killed or imprisoned. Dr. Offit is in no way similar to Lysenko.

reading the comments in this article its obvious that most people are just here to feed into their confirmation bias

it seems the author stacks everything against ONE WAY of info gather/result manifestation and clearly has not looked at alternatives forms with any objectivity

Go ahead and stack up your evidence, Roland. Whatcha got?

There is a Roland Pankewich who teaches at the Toronto campus of the "Institute of Holistic Nutrition".

This outfit offers courses involving such subjects as Ayurvedic mind-body medicine, holistic food preparation, herbal medicine and "detoxification". Here's a course that sounds especially valuable:

"Professional Co-op Placement

A 100 hour co-operative placement is part of the diploma program. Students are placed in settings where they have a keen interest. Settings include, but are not limited to, holisitic nutrition clinics, chiropractic offices, spas & other fitness organizations, health food stores, homeopathic/naturopathic clinics and senior facilities* involving individual and group therapy. The Co-operative placement allows students to build confidence and become familiar with a clinical/practice setting in the alternative health field."

http://www.instituteofholisticnutrition.com/our-program/faculty/faculty…

Maybe Roland could share with us the insights he provides to prospective homeopaths and naturopaths (in a completely unbiased fashion, of course).

*(shudder)

#20 from Dangerous Bacon :...the same NN “staff writer” (Julie Wilson)..., has another current article on NN proclaiming that “Women with larger behinds are healthier and more intelligent, study finds”.

Bad news for Sir Mixalot.

Quackademic medicine: "Wildly successful" at the Cleveland Clinic?

oracknows — Wed, 02 Mar 2016 05:00:20 +0000

Quackademic medicine: "Wildly successful" at the Cleveland Clinic?

It's no secret that my odds of ever landing a job at the Cleveland Clinic are probably slim and none, at least if anyone there ever Googles my name, particularly if they Google it with the words "Cleveland Clinic" added. The reason, of course, is that I've been very critical of the Cleveland Clinic's wholesale embrace of what can only be described as pure quackery. I first noticed this a long time ago when I perused the Cleveland Clinic Foundation's (CCF) integrative medicine page, in particular its farcical acceptance of the magical mystical reiki master definition of reiki. It got worse when the Cleveland Clinic did something it seemed to view as incredibly innovative, namely when it opened a traditional Chinese medicine herbal medicine clinic in 2-14, staffed by a bona fide ~~naturoquack~~ naturopath. The CCF's embrace of quackery then reached its zenith later that same year when it hired "functional medicine" guru and antivaccine collaborator with Robert F. Kennedy, Jr. to open a functional medicine clinic.

Unfortunately, if a recent report is to be believed, this last endeavor has been a swimming success:

The Cleveland Clinic’s Center for Functional Medicine (CFM) will be doubling its physical size and patient care capacities in the coming year, to meet what medical director, Dr. Patrick Hanaway, characterizes as “unbelievable pent up demand for this kind of care.”
Since opening in late 2014, CFM practitioners have handled nearly 5,300 total appointments, quickly reaching maximum capacity. People seeking care at CFM in 2015 came from 36 states, and 12 countries.

The center now has a waiting list of over 1,100 individuals.

“This has grown much faster and much more profoundly than we expected,” says Dr. Hanaway, CFM’s medical director and co-founder. “We have a great number of people who want to receive services from us, and the demand far outstrips our current resources and capacities.”

Hanaway says the center has secured a financial and administrative commitment from Cleveland Clinic to build a new center that would more than double the physical size of the existing clinic, and to extend the functional medicine model into several community-based sites located off the main Cleveland Clinic campus.

In other words, functional medicine at CCF is invading and metastasizing.

Longtime regular readers have seen what I've written about functional medicine before and therefore understand why I'm not particularly a fan of it and in particular why I'm not a big fan of Mark Hyman. For one thing, he mangles autism science in so many ways that it's depressing to read. For another thing, he embraces Alzheimer's disease quackery. For yet another thing, he willfully misinterprets the scientific literature to justify his woo. He also mangles systems biology in the service of justifying his "functional medicine." Finally, he seems to value anecdotes above rigorous clinical studies. I could go on, but perhaps I should discuss just what "functional medicine" is first.

The problem with so-called "functional medicine" is that it's pretty darned hard to define. I suspect that this is not entirely unintentional. Being too specific constrains freedom, of course. Perhaps the most definitive discussion of what "functional medicine" is came from the late great Wally Sampson, who did an entire entire series on it, starting with Functional Medicine (FM) What Is It? It's a good question. In fact, it's the best question when it comes to functional medicine, given that its definitions tend to be so vague as to border on being meaningless. If you don't believe me, check out Wally Sampson's followup posts, Functional Medicine II, Functional Medicine III, and Functional Medicine IV.

Personally, when I want to look at the ridiculousness that is "functional medicine," I like to go straight to the source, namely Mark Hyman himself. For example, there is a post entitled Why Diseases Don’t Exist and What Really Makes You Sick!

Check it out:

Functional Medicine is an ecological view of the body where all the networks of our biology intersect and interact in a dynamic process. When out of balance, this process creates disease, and when in balance, it creates health. Functional Medicine takes all the component parts of science, all the puzzle pieces, all the data about how we get sick and what makes us well and reorganizes it in story that makes sense, a story that has the capacity to solve our health care crisis nearly overnight if it was understood and applied widely.

Medicine is the youngest science. There is no theory of medicine, no organizing principles that helps us navigate the territory of chronic disease. Functional medicine is that breakthrough theory, the biggest breakthrough idea in medicine since the discovery of the microbe and antibiotics. It is a cataclysmic shift in our view of biology.

There are moments of awakening in science that are not incremental but transformational: Columbus proving the earth was round, not flat; Galileo showing us the earth was not the center of the universe; Darwin explaining that species evolved and didn’t arise fixed in their current form; Einstein shattering our notions of time and space. Functional medicine is a paradigm shift of equal magnitude and significance.

Whoa.

No, I mean double whoa.

This is some serious stupid. For instance, Columbus didn't prove the earth was round. It was known that the earth was round at least since the time of the ancient Greeks, and heliocentric models dated back just as far. As for there being no "theory of medicine" and "no organizing principles that help us naviaate the territory of chronic disease," so what? Hyman assumes that there must be such a principal, but his assuming that doesn't make it so.

If you want to get an idea of just how quacky "functional medicine" can be, take a look at this article by Hyman, entitled Why Diseases Don’t Exist and What Really Makes You Sick!:

The true cause of depression may be a leaky gut caused by gluten that activates the immune system, producing antibodies against the thyroid leading to low thyroid function and depression. It may 10 years of an acid-blocking drug for reflux that led to vitamin B12 deficiency, or a gene called MTFHR that leads to folate deficiency, or inadequate sunlight caused vitamin D deficiency. It may be a diet high in tuna that has caused mercury toxicity, or a diet low in fish that has caused an omega-3 deficiency, or a high-sugar diet that has caused pre-diabetes. It may be the use of antibiotics that have altered the gut flora, which have in turn altered brain chemistry. It may be a life trauma or stress.

Each of these factors – dietary, environmental, lifestyle — creates a different imbalance, yet all cause depression. Thus knowing the name of a disease tells us nothing about the true cause, not does it leads us the right treatment.

Notice how evidence-free Hyman's assertions are. Mercury "toxicity" causing depression? Where's the evidence? "Leaky gut caused by gluten" causing toxicity? Again, where's the evidence? MTFHR leads to a folate deficiency that leads to depression? Again, where's the evidence? Alterations in gut flora due to antibiotics have altered your brain chemistry? Again, where's the evidence? There is none, at least no convincing evidence.

Basically, in this particular article, Hyman is praising a book by another functional medicine guru, Jeffrey Bland, whom he praises as the "father of functional medicine," and laying down howlers like:

Disease appears real and fixed, just as the earth seems flat, and time and space seem linear and solid.

You got that, you unimaginative old doctors, you? You're the past! Functional medicine is the future! At least, so Hyman is arguing in his not-so-subtle and grandiose fashion. Of course, during Columbus' time the earth didn't even really seem that flat, as it was widely accepted that the earth was a sphere dating back to the ancient Greeks (as I've mentioned before). As for his invocations of Einstein and Darwin, there's a difference there between Einstein and Darwin compared to Hyman's "functional medicine." They convinced the scientific community the old-fashioned scientific way: With data and evidence. Then their theories were found to have a great deal of predictive power, with evidence accumulating in the decades after the theory of evolution and the theory of relativity were first published. Heck, Einstein's theory just received another boost last month with the report describing gravitational waves.

Hyman bemoans the lack of a general "theory" of medicine equivalent to these, but there is no real reason why one would expect such a theory to exist. There does exist the germ theory of disease, but that only really describes infectious diseases, diseases for which the cause is more easily identifiable. It might be that one day there is some sort of theory of chronic disease, but if such a theory is developed it will come from scientists and physician-scientists, not self-promoting "visionaries" like Mark Hyman, who can't even really describe what "functional medicine" is. Get a load of his attempt:

Functional Medicine is not simply about improving diet, or getting more exercise or managing stress or even reducing exposure to environmental toxins, all of which are critical foundations for creating a healthy human. It is a personalized method of getting to the roots of symptoms and restoring balance. Above all, this is the science of creating health. When we do that, disease goes away a side effect.

How the "personalized medicine" of "functional medicine" is any different from what homeopaths do when they "personalize" your homeopathic treatment is unclear. How the "personalized method" of "functional medicine" is any different from what naturopaths do when they make it up as they go along and come up with a plan to "detoxify" you and give you various supplements is any different is not determinable. What is determinable is that Hyman practices anecdote-based, not science-based medicine. He proudly recounts the anecdote of a girl with psoriasis that had been refractory to conventional treatment that he supposedly cured by putting on a gluten-free diet. (Of course! What else?)

Basically, there is what Grant Ritchie once called a "major unstated premise" to functional medicine, namely:

When it is claimed that FM “…addresses the underlying causes of disease,” or “Functional medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease,” the unstated premise is that “regular” doctors don’t do any of these things; they must be only symptom-oriented, not preventive in their outlook, and don’t take all of a patient’s personal, medical, and social factors into consideration before arriving at an invidualized course of action. This, of course, is false, and is what any good physician will do. I know mine does, and he does not identify as a Functional Medicine physician. This dubious technique is employed by most if not all CAM providers in an attempt to set themselves apart from the crowd.

Basically, functional medicine is a lovely new buzzword to describe a form of "integrative medicine" (i.e., "integrating" quackery into medicine) that sounds progressive and cutting edge, and that's the way it's sold, as you can tell from Hyman's own words and countless other examples of him and other functional medicine mavens hyping their woo on their websites, in books, and in videos. If you believe the hype, functional medicine is a "new paradigm" that "empowers" the patient. It's very big on "biochemical individuality," which in the hands of functional medicine doctors means lots and lots of lab tests (e.g., hormone level panels0 in which "imbalance" can be found to be corrected. How does one know what tests to order or how to correct these "biochemical imbalances"? It's not always clear. Indeed, that's the very issue that lead Wally Sampson back in the day to ask just what the hell functional medicine is. Sadly, he went to his grave without an answer, and certainly I still don't have one.

Meanwhile, apparently although the CCF administration has bought into functional medicine completely, there is still resistance:

Not everyone in Cleveland is a fan of the functional medicine paradigm. Curran says there is still considerable resistance toward functional medicine in many sectors of the Cleveland Clinic system. She attributes that to “a lack of understanding among certain physician specialists.”

No, I rather suspect that the resistance to functional medicine comes from physicians who, as I do, understand all too well that the emperor has no clothes. Still, that's just a problem for functional medicine evangelists to overcome with ~~propaganda~~ "education":

In response, CFM is embarking on an ambitious education program aimed at introducing the core concepts of functional medicine to the widest possible spectrum of specialists.

“One idea is to have an open forum, so that other doctors can meet with our functional medicine doctors, and have open discussions. We will try to get the naysayers to show up, and let them know they can come with their concerns and questions.”

Curran says the CFM team is collaborating with the Lerner College of Medicine—the medical school established in 2002 by the Cleveland Clinic and Case Western Reserve—to weave a nutrition education thread into the school’s core curriculum. Students at Lerner will now get nutrition-focused didactics as well as case studies throughout the 5 years of their training.

And that, my friends, is how quackademic medicine co-opts the valid science of nutrition and turns it into woo.

Interestingly, despite its massive growth, the functional medicine clinic at the CCF is not yet profitable, although it is cost-neutral. The main reason, it would appear, is that because functional medicine is not its own specialty and its visits can only be billed to insurance companies as internal medicine office visits. Indeed, I tend to view functional medicine as basically "integrative internal medicine," where a whole lot of quackery is "integrated" into standard internal medicine practices.

Sadly, if you believe the CCF experience, the "bait and switch" that is functional medicine is the wave of the future. Given how thoroughly quackademic medicine has infiltrated many medical schools, i can't even necessarily say categorically that this isn't correct.

oracknows Wed, 03/02/2016 - 00:00

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Cleveland Clinic Foundation

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Mark Hyman

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http://www.greenvilleonline.com/story/health/2015/10/21/bout-illness-le…

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Or you can come to Australia where you can get a Naturopathic consultation at just about every major pharmacy.

What I want to know is why don't these functional medicine doctors work in hospitals. Where are they when the patients are really sick? Why aren't the there on the weekends or late at night? Why are there no functional medicine docs in ICUs?

If only they were as good at treating sick people as they were at patting themselves on the back for their ability to treat people.

For example:
http://functionalforum.com/march-2016-functional-forum/

And finally, why do docs like Hyman criticize pills and Big Pharma while simultaneously selling really expensive pills in their own Little Pharmas.

For example:
http://store.drhyman.com/supplements/targeted-kits.html

"Wildly successful" must mean it's generating a lot of revenue, not getting dissed on social media, and not creating any liability exposure. That's all that matters to the bean counters who run medical centers today. Who cares if a few old-fashioned doctors don't like it?

That last sentence is what worries me most. Too few doctors either understand and/or care about what's happening concerning quackademic medicine. Are physicians simply too overloaded with patient care duties to have time to speak out? Were physicians not taught the ability to see through this bunk during their undergraduate and medical school years? Do more physicians than I'd like to think actually believe this woo?

This isn't central to the discussion, but one rather reliable "tell" that you're dealing with an ignorant, intellectually lazy person is if they uncritically repeat the falsehood that Columbus proved the earth is round.

This had been known to all educated people since antiquity, and Eratosthenes even measured the circumference by noting how the sun's maximum elevation varies with latitude.

Chris Hickie asked: "Do more physicians than I'd like to think actually believe this woo?"

Some do. More are willing to go with the flow to keep a proportion of their patients happy. And some see $$$ in that there functional medicine.

The opportunities exist, especially if you sell yourself as a leader in the field training others. Take Ron Grisanti, Chiropractic Physician, who reportedly began hauling in more than $1 million a year after starting Functional Medicine University.

(for fun, check out this thread on another message board where Dr. Grisanti's interventions did not end well):

http://boards.straightdope.com/sdmb/showthread.php?t=596520

Right, there are no diseases..
according to Hyman, people suffer from conditions like rust and sludge**.

** and three more, described in just as cavalier terms, in one of his books which I seem to have misplaced or discarded.
People bring me stuff like this. The title was something like "Ultra- Health" or related balderdash.

Also, isn't "balance" often an important code word for mystical concepts like soul, spirit, personal choice and other woo-friendliness?

How is functional medicine different from naturopathy? You could go through all of these statements and replace "functional medicine" with "naturopathic medicine" and never know the difference. Seems like the same woo in different wrapping.

As for there being no “theory of medicine” and “no organizing principles that help us naviaate the territory of chronic disease,” so what? Hyman assumes that there must be such a principal, but his assuming that doesn’t make it so.

And even if such principles did exist, there is no reason to think that Hyman is anywhere near the right track to find them. Just as there have been many attempts to come up with a self-consistent theory of quantum gravity, none of which have been successful. The difference is that in the case of quantum gravity we know that there is something to find, because quantum mechanics and general relativity as we understand them are mutually incompatible. As Orac notes, there is no guarantee that such a thing exists in medicine.

@palindrom: The Columbus thing is a tell, almost as much as the Galileo gambit he tries in the very same sentence. What Galileo did was provide evidence from a new kind of instrument, the telescope, that Ptolemy's geocentric model could not explain how the universe works; heliocentrism was hardly original with Galileo, as Orac mentions.

addendum:
the book is called " Ultra Prevention"

Mark Hyman never ceases to make make me SMH. As most of y'all know, I think IM, if done 'right', could be at least benign, but Hyman is far to quacky. I thank Orac for posting Hyman's definition of Functional Medicine, as I had no idea what that meant, and now I know it's utter nonsense and I should run in the opposite direction.

The tell for me isn't the pop-culture-mythology false attributions of Columbus and Galileo, but his bonzo misunderstanding/misuse of Kuhn, complete with WTF religious overtones. It seems he expects HIS name to be added to the list of 'paradigm shift' messiahs. Let's just say I have a gut feeling that won't happen.

FM might well become an empty buzzword, much as IM is already — a marketing term applied to widely divergent programs of varying value and/or promise. What's in a name? Not much. My takeaway for the day: Whatever Mark Hyman calls what he advocates – 'IM', 'FM' 'Arthur' — it still stinks like a BM.

Palindrome

The Columbus thing is a tell

I am fine with Hyman claiming the mantle of Columbus since the real reason Columbus had hard time getting someone to finance him was because he was wrong. Columbus thought the circumference of the world was a third of what it actually was. If he hadn't blundered into the new world he and his crew would have died at sea. Columbus is an example how history is made by stupid people.

On Kuhn, I'm fond of a sight gag in which I pantomime the birth of quantum mechanics, or the Copernican revolution, or other Kuhnian revolutions, by taking two ten-cent coins, placing them on a table next to each other, and pausing a moment dramatically; I then place a finger on each coin and emphatically move the two coins to a new position.

What this is called, is left as an exercise for the student.

Militant - precisely right. They woulda died long before they got to, say, Hawaii.

Incidentally, there's a very interesting book by Charles Mann called 1493 which details the incredible cascade of historical and ecological consequences of the Columbian exchange, in which he devotes quite a bit of time to the trans-Pacific trade in the 17th century, which I'd been completely unaware of. Spices, fabrics and so on from China were shipped to Spain by way of Mexico!

Darwin explaining that species evolved and didn’t arise fixed in their current form

Yep, Hyman is clueless about Charles Darwin as well.

http://www.aboutdarwin.com/literature/Pre_Dar.html

The gobbledegook that defines Functional Medicine could serve nicely as a definition of Holistic (or Wholistic - make up your mind already) Medicine, which was hot stuff when I was graduating from med school in the mid-seventies.

Same old shiat, different bucket.

Holistic?

As the Holy Book says in the Book of Holes, "And they knew not their holes, from an ass on the ground".

-- Firesign Theater

"Darwin explaining that species evolved and didn’t arise fixed in their current form"

Even that is imprecise. By Darwin's time scientists had enough of the fossil record to (mostly) agree on the "mutability" of species. The how and the why were where Darwin came in with his theory of natural selection. That and genetics.

"Functional Medicine is an ecological view of the body where all the networks of our biology intersect and interact in a dynamic process."

I don't think 'ecological view' means what he thinks it does. It is a fundamental misunderstanding of ecology to try to apply it to any single species, let alone individuals of that species.

The Columbus is a big tell, as he did not prove the Earth was round (though he thought he did). It was known much prior to that in Classical science. They could at least name Magellan's expedition (his slave, acquired in Malaysia, Enrique, who could speak with the yet unknown (for Europeans) Filipino tribes in their native tongue, and may have been the first man to circumnavigate the globe...in fact he deserted there), which was the first to go around the planet.

Spices, fabrics and so on from China were shipped to Spain by way of Mexico!

It was a two-way trade, as well. The hot peppers we associate with the cuisines of southern and eastern Asia only became part of those cuisines about 300 years ago--peppers are native to the Americas.

Chris Hickie asked: “Do more physicians than I’d like to think actually believe this woo?”

Some do. More are willing to go with the flow to keep a proportion of their patients happy. And some see $$$ in that there functional medicine.

The highly regarded fertility clinic we used to conceive recommends/refers out to TCM/acu in conjunction with ART, if the patient desires. Why? Because, when I asked, "some patients want it." Shiny brochures at reception, in the waiting rooms, right beside the leaflets on IVF, success rates...

I wanted a smoking area, and I asked for it. I didn't get it.

But seriously...it rankled that you have a patient population who on average spends thousands out of their own pockets...yeah, let's let them bleed a little more, regardless of the fact that the evidence on acu/IVF success is...underwhelming. But hey, we're desperate for a baby, and there's nothing quite like preying on desperation.

"Functional Medicine takes all the component parts of science, all the puzzle pieces, all the data about how we get sick and what makes us well and reorganizes it in story that makes sense, ..."

In my day, this was called lying.

CCF anesthesiologist here. I can tell you there are a good many of us here that don't buy this nonsense. I won't be practicing any reiki or acupuncture based anesthetics in my practice. Just saw my first patient that actually receives herbal conditions from the Chinese bs clinic. No talking her down from the brainwashing they did in a ten minute pre-op evaluation!

Duke University now is selling "integrative medicine". They tout the WHO report, "Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials". Can anyone point to an evaluation of that report? It shows up all over the place.

Gregor, since that review, from the outset, dismissed and excluded sham controlled trials with negative results as irrelevant, you might like to make your own valuation of it.

How does this go so far without meticulous records of presented symptoms leading to diagnosis and treatment path, cost, and outcomes per patient? Especially as a pilot program.
The claims he makes aren't a paradigm shift, they're hundred plus year old proven bullshit.

I suppose it's theoretically possible to go on about a "personalized method of getting to the roots of symptoms" and stroke one's clients' special-snowflake sense of uniqueness without being a shameless grifter.
Are there any cases of this?

There are moments of awakening in science that are not incremental but transformational: Columbus proving the earth was round, not flat; Galileo showing us the earth was not the center of the universe; Darwin explaining that species evolved and didn’t arise fixed in their current form; Einstein shattering our notions of time and space. Functional medicine is a paradigm shift of equal magnitude and significance.

That's some serious self-aggrandisement. The sort of grandiosity I expect from a mad-scientist super-villain just before he explains his plan to extinguish the sun and reawaken Cthulhu.

@HDB
Actually, the earth was round before Columbus, revolved around the sun before Galileo; species evolved before Darwin and time and space existed before Einstein. Only functional medicine is new to me. The guy is modest.

@#8
Functional Medicine seems to me to be to Naturopathy what Intelligent Design is to Creationism; a rebranding and reboot to avoid the (rightful) criticism of the former.

Amethyst @31 -- That's pretty much a perfect parallel, I think.

Hyman says the "leaky gut" (*not* a real medical term) is connected to the thyroid, which is connected to the brain, but I fail to see one tiny thing: proof. Assertion is not proof. I've taken and lectured in biochemistry classes, and none of what Hyman claims has ever shown up in that body of work. New claims require new proof, not hand-waving and stories.
Secondly, Hyman wants to 'tell me a story'. What? If it was fiction, sure, I'd be willing to sit back and enjoy it. When it's being sold as reality, then my suspension of disbelief is turned *off*. Show me hard proof or shut up, and deserve to be called a snake oil salesman and quack.
Finally, when someone uses words with entirely new meanings, that's a sure sign that you're being baffled with bullshit.
The problem is that medicine and biology are complicated, and most people don't understand any of it. They naturally assume that a physician, or someone who calls her/his self a doctor like naturopath quacks, will tell them the truth. This is why snake oil salespeople have always called themselves "doctor" in their sales pitches, right before they fleece their victims / clients.

Oy Vey....its always about the shekels.....
I wonder if they're giving out team member tee shirts with Larry Ellisons 80's mantra..."G.T.M.... G.T.F.M
"Get the Money!" "Get the Fu$&!ng Money!"
if you can "Do no Harm" in the process.... even better.....if we dont take it someone else will.

@ palindrome:

I'd assume whether or not the students were familiar with Firesign was predictive of their ability to recognize the pair o' dimes shift.

I figured it out, it's all about this quote:

"Above all, this is the science of creating health. When we do that, disease goes away as a side effect. "

The ultimate disclaimer! Disease goes away as a side effect, not as the main effect. We always get our main effect because creating health means whatever we want it to mean!. (Because we're Galileo and Einstein, that's why!)

"We're not claiming to cure disease. We're only claiming to create health. Health means physical wholeness, body/mind integration, and spiritual wellbeing. If you walk out of here with all your limbs and appendages intact, and you're not having out-of-body experiences such as by temporarily flatlining on us, and our woomaster tells us that your spirit and being are well (BTW don't ask us to define what your "being" is), then don't complain if you still have a high fever or chronic pain or a tumor that's still growing. OK?"

These comments are so woefully behind the most current understanding of disease/illness. Functional medicine is not hard to define - it is looking for the root cause of illness as opposed to treating illness with symptom blocking medicine - the current pharmaceutical driven model. Your commentary is stuck in a Newtonian model way of thinking that elevates rational thought, scientific method above all else. (the scientific method by the way is constantly manipulated and frequently does not represent truth) We have failed to incorporate the understandings of quantum physics into our collective and individual psyches yet - although the awareness has been around over 100 years. Your ignorant comments reflect a what I don't see cant be true paradigm - but guess what - it is an energy world more than a material world. Someday the manipulation of energy (e.g. reiki etc) will be common wisdom. It is arrogant to be so dismissive of something that you do not understand. Check out the studies of the microbiome and physical and mental health. Be willing to search for the hundreds of stories of those who have cured themselves of supposedly incurable diseases (according to our current allopathic model) using a functional medicine or naturopathic medicine approach to healing

Jennifer Klein,

Rational thought and the scientific method are very effective tools that we've developed to help us figure out how the world around us actually works, including quantum theory and the various forms that energy can take. By jettisoning them, you're dooming yourself to perpetual exploration of ideas that aren't true, such as reiki and the various brands of "energy medicine" BS. Good luck with that (not really), but don't expect anyone with a science background to take you seriously.

Quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quis custodiet ipsos custodes?...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...quantum...mmmmmmm

I feel better now.

@Jennifer Klein - What's the current success rate of reiki (or other "manipulation of energy") for, say, anthrax compared to the success rate of antibiotics and atitoxin? How about compared to antivenin for coral snake bites?

Thanks.

The scientific method is whack ... check the studies
-Jennifer "Internal Consistency" Klein

I guess with quantum thinking it can be both good and bad and the state isn't determined until you observe whether or not you agree with a study's conclusion.

These comments are so woefully behind the most current understanding of disease/illness.

Oh noes, all this time I've been using the 2014 current understanding of disease / illness, rather than the most current 2016 fashions. No wonder my more fashion-aware friends have been laughing at me.
Stupidity is the new black, or something.

We have failed to incorporate the understandings of quantum physics into our collective and individual psyches yet

"Understandings", plural? Does Jennifer Klein expect us to incorporate the matrix formulation of quantum physics into our individual psyche, as well as Dirac's Bra-ket notation? Heisenberg's time-dependent operators picture as well as Schroedinger's time-dependent-state picture?
This seems unreasonable.

Jennifer, you say "it is an energy world more than a material world". According to Einstein's Special Theory of Relativity E=mc^2. According to you E>mc^2. Relativistic Quantum Mechanics has provided us with an unparalleled understanding of the atomic world. On what basis do you claim that yours is the correct equation and not Einstein's?

Were columbus einstein darwing and so on MD?
In the name of science. Iatrogenic illness

Assuming that the standard model of cosmology is correct, the best current measurements indicate that dark energy contributes 68.3% of the total energy in the present-day observable universe. The mass–energy of dark matter and ordinary (baryonic) matter contribute 26.8% and 4.9%, respectively, and other components such as neutrinos and photons contribute a very small amount.

https://en.wikipedia.org/wiki/Dark_energy
Ahh so, Leigh Jackson #44. Perhaps it is so that Jennifer Klein #37 is an Energy Girl; A spirit in the material world.

Does Jennifer Klein expect us to incorporate the matrix formulation of quantum physics into our individual psyche, as well as Dirac’s Bra-ket notation? Heisenberg’s time-dependent operators picture as well as Schroedinger’s time-dependent-state picture?

Why not so, herr doctor bimler #42? Is it that there are not 'dimensions' enough to accommodate such all-inclusive unshallowness?

Assuming that the standard model of cosmology is correct, the best current measurements indicate that dark energy contributes 68.3% of the total energy in the present-day observable universe. The mass–energy of dark matter and ordinary (baryonic) matter contribute 26.8% and 4.9%, respectively, and other components such as neutrinos and photons contribute a very small amount.

https://en.wikipedia.org/wiki/Dark_energy
Ahh so, Leigh Jackson #44. Perhaps it is so that Jennifer Klein #37 is an Energy Girl; A spirit in the material world.

Does Jennifer Klein expect us to incorporate the matrix formulation of quantum physics into our individual psyche, as well as Dirac’s Bra-ket notation? Heisenberg’s time-dependent operators picture as well as Schroedinger’s time-dependent-state picture?

Why not so, herr doctor bimler #42? Is it that there are not 'dimensions' enough to accommodate such all-inclusive unshallowness cheep cheep?

Check out the studies of the microbiome and physical and mental health

Now I am wondering whether the microbiome belongs to Jennifer's realm of matter, or of energy.

@ herr doktor bimler:

Welllllllll...
I'm not sure about Jennifer but according to TMR, kids with ASDs have intestinal 'bugs' that go wack-o whenever there is a full moon which sounds like energy f@cking with matter.

It's the opposite of energy MEDICINE- which fixes things up.

Does Jennifer Klein expect us to incorporate the matrix formulation of quantum physics into our individual psyche, as well as Dirac’s Bra-ket notation? Heisenberg’s time-dependent operators picture as well as Schroedinger’s time-dependent-state picture?

Don't forget von Neumann, Wigner, and Weyl and all the pesky group theory they tossed into the mix.

Don’t forget von Neumann, Wigner, and Weyl and all the pesky group theory they tossed into the mix.

So; You are like a crazy person??

Don’t forget von Neumann, Wigner, and Weyl and all the pesky group theory they tossed into the mix.

Those are Lie algebras so it's not to be trusted.
I remember studying all this a lifetime ago as part of my first degree. Imagine my glee every time some shabby intellectual purse-snatcher like Jennifer tries to appropriate quantum theory for the cause of the Higher Irrationality.

@ Mitzi.
Perhaps dark energy is what Jennifer has in mind. Granted mass-energy equivalence then what? Supposing that hitherto undiscovered homeopathic and reiki energies do exist, then those energies are equivalent to mass. There's no alter-ego Jekyll and Hyde scenario involved when one converts into the other. Mass-energy does not equate to evil-good. I don't get the impression that Jennifer would agree with that.

""Mass-energy does not equate to evil-good

But could it equate to gamma-chocolate?

Breit and Wheeler suggested that it should be possible to turn light into matter by smashing together only two particles of light (photons), to create an electron and a positron ...

... This ‘photon-photon collider’, which would convert light directly into matter using technology that is already available, would be a new type of high-energy physics experiment.

http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssumma…

^^That sounds perfect for the 3-d matter printer** should highly tuned OLEDS be used for something other than space heaters, Netflix, spelunking, and growing pot.

** And really. Star Trek predicted food replicators some 47 years ago. Whatsamatter, science dudes? Carbon credit hokey sticks got ya down?

I beg to disagree with this article. Functional medicine is the future for treating chronic disorders because they focus on PREVENTING disease.

The reason we are all walking around with fat hanging off every part of our body, lack of energy, digestive issues, skin conditions, etc etc is because we are not taking care of our bodies. We eat low or zero nutrient foods, we sit around all day, we ladder our skins with chemicals, we drink, smoke, breath polluted air and we expect our bodies to take care of it all without supporting it.

Traditional doctors send you home with a few pills and that's about it but that's not the solution.

I am not a fan of supplements, a major scam but I am a fan of taking care of your body and staying away from pharmaceuticals that just mask symptoms and don't cure them.

There is a place for traditional medicine. If I break a bone trust me I am rushing to the hospital and not a functional doctor but if I have irritable bowl disease, even autoimmune disorders or cancer I will go to a functional doctor. My mom is dying of cancer. Docotors KNOW tumors feed on sugar do you think any doctor has talked to her about her diet? Of course not.

Listen the microbiome will soon change the way we practice medicine whether you believe in functional medicine or not it will be a part of it period.

Connie: "Functional medicine is the future for treating chronic disorders because they focus on PREVENTING disease."

So what is the functional medicine prevention for measles, Type 1 Diabetes, and obstructive hypertrophic cardiomyopathy?

"Traditional doctors send you home with a few pills and that’s about it but that’s not the solution."

Except that is not true. A balanced diet and exercise have been part of real medicine longer than "functional medicine" has existed.

"Docotors KNOW tumors feed on sugar ..."

Citation needed in the form of a PubMed indexed study by reputable qualified researchers.

"(Doctors) know tumors feed on sugar"

Physicians know that the sugar-feeds-cancer meme is a fallacy.

http://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-ca…

"...many cancer patients are led to believe they must follow a restricted sugar diet for fear of causing cancer growth in themselves if they do not adhere. This fear and rigidity often promotes a very stressful experience. The stress will actually lead to an increase in blood sugar as well as compromised immunity. These negative health effects are actually the exact opposite of the purported benefit of such a plan."

http://www.dana-farber.org/Health-Library/Sugar-and-Cancer-Cells.aspx

Is it a principle of "functional medicine" to spread false information about diets for cancer patients and deprive them of healthy, enjoyable foods? If so, count me out.

I would love to see how many who have so eloquently commented here actually work in healthcare. And by work I mean, see patients regularly and manage their care.

I would love to see how many who have so eloquently commented here actually work in healthcare. And by work I mean, see patients regularly and manage their care.

I don't, but why would you love that?

@Connie #55

"Five years ago, if you had asked me about bacteria in your gut playing an important role in your systemic immune response, I probably would have laughed it off," Daniel Chen, head of cancer immunotherapy research at Roche’s Genentech division, said in a phone interview. "Most of us immunologists now believe that there really is an important interaction there." ...

Efforts are under way to turn bacteria into regulated pharmaceutical products to treat illnesses of the gut, where the microbes reside.

http://www.bloomberg.com/news/articles/2016-03-14/how-gut-bacteria-are-…

^^Naturally. There goes legal homemade kefir, kimchi, kombucha, sauerkraut, natto, ..., yogurt, federweisser, and dirt.

Ohh. And cow chip tea.

The day is coming when telling someone to *eat shit* would be incitement toward violation of DEA edicts regulating use of schedule II substances.

justin: "And by work I mean, see patients regularly and manage their care."

I spend quite a bit of time in medical facility waiting rooms, including times when my son was hospitalized, and done three trip in the ambulance with him. One of the conditions that I asked Connie about the effectiveness is the cause of two of the ambulance trips and two out of the eight hospital stays.

Any reason why my question to Connie was a problem?

Alternative medicine practitioners lionized in Cleveland

oracknows — Tue, 29 Sep 2015 07:30:21 +0000

Alternative medicine practitioners lionized in Cleveland

I've spent a lot of time in Cleveland. Indeed, I lived there for eight years in the late 1980s and early 1990s, during which time I completed my surgery residency training, completed my PhD, and, even more importantly, met and married my wife. Even though I haven't lived there for nearly 20 years—I can't believe it's been that long—I still have an affinity for the city, which is perhaps why I've had a tendency to come down hard on venerable Cleveland medical institutions that turn to quackademic medicine, one where I trained (I'm talking to you, University Hospitals of Cleveland) and one where I did not (you, too, Cleveland Clinic foundation). Both are hip-deep in quackademic medicine, but of the two, the Cleveland Clinic appears to have embraced woo far more tightly. For instance, it achieved notoriety for opening a traditional Chinese medicine clinic staffed by a naturopath who uses homeopathy (but I repeat myself) and then followed up that bold foray into quackification by hiring Dr. Mark Hyman, arguably the foremost proponent of the "holistic" specialty dubbed "functional medicine." Add to that the CCF's enthusiastic promotion of "complementary and alternative medicine" (CAM) including acupuncture, in pediatrics, and truly you have a paradise of quackademia. Clearly, pseudoscience is now "baked in" to the CCF's DNA.

Unfortunately, it goes beyond just the CCF and UH. Indeed, I was annoyed to see an article yesterday in a publication I routinely used to read when I lived in Cleveland, The Cleveland Scene, where Brandy Schillace, the public engagement fellow at the Dittrick Medical History Center and Museum and the managing editor of Culture, Medicine and Psychiatry. wrote a credulous fluff piece entitled On 'Alternative Medicine' in Cleveland, Where 'Hospital Medicine' is the Prescription of the Day. Starting out by tracing the history of hospital medicine in Cleveland back to the founding of the City Hospital in 1837 to the evolution of medical powerhouses like the CCF and UH, Schillace tries to put alternative practitioners smack in the center of things:

These days, Cleveland medicine brings to mind the Cleveland Clinic, University Hospital or Metro, but the history of Cleveland—once a wild and wooly western town—includes far more mavericks and bold independents than many realize. And while these institutions get a larger share of the press, alternative and independent practice continues to thrive.
How does this enclave support the Cleveland community? And in what ways has it captured the enterprising spirit that brought Cleveland from swampy Cuyahoga backwater to thriving medical center?

I have little doubt that some of these "alternative medicine" practitioners have an "enterprising spirit." So did Kevin Trudeau. The question is not the go-get-'em entrepreneurial spirit, but rather what they do, which ranges from the benign (yoga and Pilates) to the quacky (acupuncture and myoskeletal alignment):

Tom Ockler, an alternative physical therapist, hails from Buffalo but has been practicing in the Cleveland area for 37 years (Alternative Healthcare Solutions).

Anne Kinchen of Cleveland Acupuncture began her practice in 1999 as one of the first 10 acupuncturists in Ohio. They represent those working longest in our community, but they are joined by some relative newcomers.

Marque Garaux, a climber and former Marine, practices, teaches and leads Mysore Ashtanga yoga at Harmony Studios in Willoughby (Yoga Marque). He has studied at the K. Patthbi Jois Ashtanga Yoga Institute in India, where yoga is understood as a whole body health practice.

Newest to Cleveland are Joseph Watts (Watts Integrative Manual Therapy) and Kari Watts, relocated from Lexington, Kentucky. Joe practices a unique form of manual therapy; more than massage, he uses techniques from lymphatic drainage to myoskeletal alignment. Kari works as a small-class Pilates instructor.

For example, Anne Kinchen is an acupuncturist who uses acupuncture and traditional Chinese medicine to treat infertility, claiming, "Traditional Oriental medicine offers infertility patients much more than just adjunctive before and after acupuncture treatments" and that "TOM has a long and established history for the regulation of the woman’s menstrual cycle, as well as treatment for various male infertility issues." Neither of these are, of course true. Acupuncture does not improve, for instance, in vitro fertilization (IVF) success rates. No matter how much acupuncturists claim that acupuncture assists IVF, the very studies they cite do not support the hypothesis, nor does acupuncture help for polycystic ovary syndrome, one of the most common causes of female factor infertility. Yet, thanks to anecdotes and bad science, acupuncture is frequently offered not just at CAM and "integrative medicine" clinics but at actual fertility clinics. It doesn't work.

Then there's Joseph Watts. One thing that a quick Google search revealed was something that wasn't revealed in the article. Watts is Schillace's brother:

My brother, proprietor of Watts #Integrative Manual #Therapy has arrive in the twittersphere! Give him a follow: @JosephWatts19 #orthopedic

— Brandy Schillace (@bschillace) September 7, 2015

She's also not shy about promoting her brother's business on Twitter:

Wise words! And if you overdo it... You know where to find help #integrative #therapy http://t.co/YuXVvdorBd https://t.co/eWjLhti1mG

— Brandy Schillace (@bschillace) September 8, 2015

She also re-Tweets a fair number of his Tweets.

Personally, I think that disclosing that two of the people interviewed in the article are your brother and sister-in-law would not be just appropriate, but mandatory, but nowhere in the article does Schillace state that Watts is her brother. In any case, Watts offers everything from lymphatic drainage (which can be a legitimate technique to treat lymphedema but is often infused with serious woo) to myofascial release, the latter of which which is quackery. In any case, these "alternative" practitioners are presented as brave maverick practitioners. Naturally, they were quick to expound on the "individualization" of their treatments:

So what is this unique difference? As soon as I asked the question, I felt the energy of the room shift. Leaning forward in their chairs, the five practitioners eagerly shared: “Individualized attention.” “Getting to know the patient.” “Treating them as they need to be treated, not as time or insurance companies dictate.” Joe considered the difference to be threefold: Individual Orthopedic Testing, Time, and Self-Care.

Of course, without a sound scientific basis to "individualize" treatments, what "individualization" of therapies in alternative medicine usually means, more than anything else, is making it up as you go along.

They also expressed concern about the large hospital systems (such as the Cleveland Clinic and University Hospitals) offering alternative therapies now. What do you think their concern was? Basically, it was a fear of rules telling them what they can and cannot do:

Anne and Tom were quick to point out that alternative practices have been thriving elsewhere, as well. “Clearly, there are more people interested in medical alternatives,” Anne said—but the hospital systems have taken up that cause, too, which is a kind of double-edged sword. Physical therapists and acupuncturists who work within the system necessarily have to abide by the rules of that system, and that means potentially compromising on a patient’s needs.

In other words, medical centers, whose leaders delude themselves into thinking that the quackery they are "integrating" into their "integrative medicine" clinics and centers, is evidence-based, use what they perceive that evidence base to be to limit the true alt-med practitioners from making it up as they go along unfettered by concerns about evidence. I know, I know, that's not what they say, but it is what they very likely mean—other than the delusion about the quackery being evidence-based given that it's a delusion they share. This idea pops up again in a different form here:

Today, with the advent of Cleveland Clinic’s Center for Integrative Medicine, “alternative” therapies have become better accepted by the mainstream, and yet by mainstreaming the therapies such centers have overshadowed what was originally “alternative” about them. The received narrative becomes potentially one-dimensional, and, after all, a practice that evolves in the hospital system will necessarily take on the character of that system. Moving out of that system provides freedom, but can be isolating. “I miss sharing with colleagues,” Tom explains—adding “I also miss days off!” We laugh. But it’s true. These independents work long hours to make what they do transparent, translatable, and understood. And yet, they are the unheard voices.

It depends on what you mean by "unheard." Personally, I think such voices are, unfortunately, heard all too well. For instance, I once looked at how many alternative medical practices are just within a mile or so of my house. There are at least four chiropractors, one of which is a one-stop shop for quackery that offers everything from chiropractic, to infrared saunas, to "detox foot baths," to "energy healing." Then there are at least three or four other alternative medicine practices, including a reiki practitioner; a practitioner who offers naturopathy, traditional Chinese medicine, DNA activation (yes, DNA activation), homeopathic drainage, and cranial sacral therapy; and a practitioner within walking distance of my house who advertises her reiki and TCM services on cable TV. I'm sure I've probably missed one or two, and I also know that if I expand the search radius to five miles from my house there are probably a dozen such practitioners. Count the run-of-the-mill chiropractors, and the number is probably at least double that.

Quackery is everywhere. From the standpoint of economics and competition, I can understand why quacks might be afraid that the big guns are moving in on their action. For example, if I want to drive 25 miles or so, I could be treated with anthroposophic medicine at the University of Michigan. It's in Cleveland as well, big-time. Just the other day, Mark Hyman posted a picture of himself in a shelled out office space, exulting in the 18,000 sq. ft. space that will be the new home he Cleveland Clinic Center for Functional Medicine:

Standing in the 18,000 sqft space that will be the new home for the Cleveland Clinic Center for Functional Medicine. In...

Posted by Mark Hyman, MD on Thursday, September 24, 2015

Yes, the highly dubious "integrative" medicine known as functional medicine is a centerpiece of the Cleveland Clinic's integrative medicine center, which already offers reiki, acupuncture, craniosacral therapy, traditional Chinese medicine, and more.

Not surprisingly, Schillace concludes with what I like to call the "they thought this was quackery, but now it's becoming accepted" appeal to popularity:

As Cleveland continues its rise as a medical city, some of its most foundational and hardest working members have been strangely overlooked. Some people likely don’t even consider massage—or yoga and Pilates—as therapies. Others might think acupuncture and physical therapy only work for the “believers.” And still others view independent practice with suspicion: surely “real” medicine belongs in a hospital…

History tells a different story. Looking back at the bizarre and brilliant tales that built our city—on doctors who took chances, who knew their patients as they knew their neighbors, and who sometimes went against the grain—I see Cleveland’s finest moments. Looking at this room of alternative practitioners, men and women working to heal the human at the center of medicine, I see our greatest inheritance.

I also can't help but point out that she also sees her brother.

When I see a room of such practitioners, I do not see the best Cleveland has to offer I see a part of medicine that is not supported by science and is thus far from the "greatest inheritance" of Cleveland medicine.

oracknows Tue, 09/29/2015 - 03:30

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https://www.pureencapsulations.com/education-research/newscaps/newscap-…

And they complain about Conflicts of Interest among skeptics, even when none exist. Here is a major COI - the writer indeed should have noted that the one practitioner and his wife are related to her, and that she is also a patient of theirs.

This is bad journalism.

Another well written article Orac!

I have tried acupuncture and it was....WORTHLESS.

My princess does it all the time and she is...PRICELESS.

Humans are wonderfully complex!

" I felt the energy of the room shift"
Oy.

One thing that a quick Google search revealed was something that wasn’t revealed in the article. Watts is Schillace’s brother

Bad enough that the author did not disclose the relationship, but where was the editor? Schillace wasn't the only one who violated journalistic ethics here. The editor(s) should have known, as well.

And yet, they are the unheard voices.

If these voices were truly "unheard", why is there such a demand for their services? I'll go farther than Orac here: the author and editors knew, or should have known, that this statement is false.

Others might think acupuncture and physical therapy only work for the “believers.”

I hate that she lumps these two together. It’s sad that people don’t know that PT is valid with solid training behind it and is prescribed overseen by an MD . It’s similar (though not as egregious) with psychology and psychiatry. Loads of people don’t know the difference.

The more mainstream institutions adopt this sort of thing, the more people start to believe there's actually something there, the more demand there is, the more institutions feel pressure to adopt it.

So the alternative practitioners go along, taking money and delivering nothing in return, and all the while, the evidence that there's nothing there continues to pile up.

Personally, I think that disclosing that two of the people interviewed in the article are your brother and sister-in-law would not be just appropriate, but mandatory,

Hell to the yes. That requires disclosure.

@Eric Lund --

The editor(s) might not have known. In fact, assuming the publication has any kind of claim to journalistic integrity at all, they must not have. It's obviously a COI.

"They also expressed concern about the large hospital systems (such as the Cleveland Clinic and University Hospitals) offering alternative therapies now. What do you think their concern was? Basically, it was a fear of rules telling them what they can and cannot do:"

Fear of competition and angst over supplement industry money flowing to big-time institutions probably play a role in their "concern" as well.

Cleveland Clinic's "functional medicine" operation is getting a big cash infusion from a supplement company:

I doubt that Bozo Health Care and Yoga Solutions has access to the kind of money Cleveland Clinic is getting from Big Supplement.

A brand new 18,000 square foot office is one heck of a powerful placebo. That's even a testable hypothesis if there's any reliable way to keep track of the outcomes from that place, as compared to the dingy scruffy ones that have been around Cleveland since before the germ theory of disease.

COI: Time for everyone here with M.D. after their name to bombard the editor and publisher with email, and don't forget the postal mail on your office letterhead.

Yes it really did read like a puff piece. Whatever he was puffing on must have been strong. The only dead giveaway that's missing is a phrase that abuses the word "experience," as in, "a powerful healing experience." Sorry if that made anyone here queasy.

I am truly at a loss to understand how this dreck has oozed its way into every nook and cranny.

For example, if I want to drive 25 miles or so, I could be treated with anthroposophic medicine at the University of Michigan.

I'm still p!ssed off about this.

Remember, you can't spell "Schillace" without "Shill"!

homeopathic drainage

Does this involve the memory of shit?

Not to quibble, but seeing that the NFL season is underway, shouldn't alternative medicine be "lionized" in Detroit?

The Cleveland Clinic is into "brown"-nosing the purveyors of woo.

It's un-"bear"-able.

(sorry about that)

I think the people responsible for this nonsense should be lionized...like the Romans lionized the Christians.

...and yet by mainstreaming the therapies such centers have overshadowed what was originally “alternative” about them.

So it's only good when it's fringe? That lends credence something I've long suspected: that for at least some people the draw of alternative medicine is the feeling of superiority that go along with knowing "secret knowledge".

Physical therapists and acupuncturists who work within the system necessarily have to abide by the rules of that system, and that means potentially compromising on a patient’s needs.

Those pesky rules like infection control. Everyone knows it's hard for acupuncturists to detect meridians through gloves.

I’m still p!ssed off about this.

As am I. I did, after all, graduate from U. of M. twice, once with an honors undergraduate chemistry degree and then again from U. of M. Medical School. Let me tell you, there was none of this quackery there when I attended.

A co-worker's daughter is now attending the Northern School of Medicine. I was sent the link to the textbook site, and one of the textbooks you can download is Rakel's Integrative Medicine.

I scanned through some chapters. They recommend homeopathy for headaches because there are little side-effects(!), they have some chapter authors claiming such-and-such herb is good (e.g. ginko) because "my patients" benefit from it (anecdotal evidence), the ginko studies which showed no effects on Alzheimer's were rejected as the people were too "old" to show improvement, yet the chapter author accepts one study that showed people could improve even though it too had "old" people.

There's a lot of nonsense from the chiropractor side too, some specific meditation techniques that elongate telomeres, which in turn promote a variety of health improvements,...

...and just read about reiki: "Although no specific
studies have been conducted in children with RAP (recurring abdominal pain), this therapy
has no serious side effects and is considered safe".

Craniosacral therapy is also given recommendations, and long-distance healing and prayer are also recommended for some situations (again, because there's little possibility of harm as long as more "traditional" medicine is adhered to.

Even the parts where they took a stand were weak. E.g. little evidence for link between mercury and autism, although some subgroups may be susceptible.

Some chapter authors seem to be a bit more evidence-based so the final book appears to be a conflicting mass of evidence vs anecdotes. Bad studies vs good studies but with no way of distinguishing between them (Geir and Geir are cited, btw, and not to debunk either).

I don't know how much the school will rely on the book, or what context they'll put it in, or even what courses they'll be teaching, so maybe they'll be using it sparingly or will skip over the alternative modalities.

…and yet by mainstreaming the therapies such centers have overshadowed what was originally “alternative” about them.

So it’s only good when it’s fringe? That lends credence something I’ve long suspected: that for at least some people the draw of alternative medicine is the feeling of superiority that go along with knowing “secret knowledge”.

I was into alternative medicine before it was cool, man.

Does ICD-10 have procedure codes for woo treatments?

Alternative medicine lionized
Wait, it was shot by a sociopathic dentist?

If Alternative Medicine turned off one of its X-chromosomes, it would be Lyonised.

a minor point worth consideration:

The use of the term "alternative medicine" implies that there is medicinal value to these treatments.

A better phrase would be "alternative TO medicine."

Bad studies vs good studies but with no way of distinguishing between them

Oh, it's easy to tell the difference. "Good studies" are the ones that show the kind of results the textbook authors/editors want, and "bad studies" are the ones that don't. As far as this textbook is concerned, methodological flaws or failures to replicate are irrelevant. Any questions?

True, that's not how it works in the reality-based community. But since when are these woo-pushers members in good standing of the reality-based community?

If Alternative Medicine turned off one of its X-chromosomes, it would be Lyonised.

If Alternative Medicine were sliced thin and pan fried with butter, caramelized onions, and parsley it would be Lyonnaised.

If Alternative Medicine were set to music by The Eagles, it would be Lyin' Eyesed.

https://www.youtube.com/watch?v=WIzQeSJKA1c

While I don't "believe" in acupuncture, I can see that some temporary relief MIGHT be caused simply by stimulation of endorphins. The mystery to me is that I have seen close to "instant" improvement in HORSES after acupuncture that had long-lasting effects. I just don't get that. Obviously, the horse has no confirmation bias. The solution for many lamenesses/injuries in horses is simply rest, so had the horse(s) in question improved a week or a month after the acupuncture "treatment," I would simply ascribe it to, well, that's how long it took for the injury to heal. But this was an immediate and complete/long term improvement. I would not choose to use such treatment for my horse (the horse itself is a sufficient vehicle for spending $$$ without useless therapies). I don't know where the ALT canon using acupuncture with a TENS machine fits, but the cases I saw did have TENS hooked up to the acupuncture needles.

I was under the impression that lymphatic drainage was pure woo. Are there any sources about how it can be used in genuine therapy?

And if altmed were whisked together with an egg yolk, lemon juice and olive oil, would it be mayonnaised?

(I'm waiting for Groucho to make an appearance).

@shay --

I'm not sure.

But if it became part of the international banker-communist global conspiracy for world control and domination, it would be zionized!

It looks to me like ICD-10 will have coding for woo. And there's some feeling that ICD-11 (which probably is only a few years away from adoption in the U.S.) will be more woo-friendly:

"ICD-11 also will include more non-traditional vocabulary. Western science does not represent the world’s only approach to health and wellness. Terms such as “prana” and “qi” (meaning “life force” in yoga and one form of Asian medicine, respectively) may be found alongside items like “blood pressure” in future code sets, since they are considered to be of equal importance in many parts of the world."

http://www.icd10monitor.com/news-articles/48-icd10-enews/916-icd-11-ide…

Nice.

Of course, this doesn't mean that insurers will be paying out for treatments to enhance your qi. But they'll be under increasing pressure to do so.

And it if caught Bovine Spongiform Encephalopathy, it would be prionized.

If it got a little abscess in its eye, it'd be stye in eyes'd.

If altmed were recharged it would be LiON-ized.

Lions are negatively charged. Because cat-ions.

And if altmed was a giant huntsman who was killed by a scorpion and elevated to the stars by Zeus, it would be Orionized.

That's my last one, I swear. Maybe.

If it were run through a toxin-sucking footbath, it'd ionized.

If the future timeline of altmed were set down in a long-form calendar which was later hilariously misinterpreted, to the disappointment of New Agers everywhere, it'd be Mayanized.

To Erik1986: In 1984 I took a horse to a highly respected equine vet for another problem, and in the course of our long conversation he confided that he was quietly using acupuncture on some of his thoroughbred patients in training. He also said that he was not seeing an effect that coincided with recovery from rest. The results were sometimes immediate.

I've never read any compelling evidence for using acupuncture on any human problem, but people who study affective behavior and placebo in animals are beginning to talk about another perhaps unknown dimension to their response to such treatments.

I saw this dramatic improvement for myself in one of his patients who had a fetlock strain. It was remarkably fast and obvious--and very puzzling.

If altmed were a Vibrava that evolved it would be Flygon-ized.

I am all for dissolving Alternative Medicine in caustic soda so it is lyeonised.

Sara @38: How exactly was this "dramatic" improvement measured though? Was it something like length of stride or speed of walking? Or did it just look "improved" to everybody?
Also, was it pure acupuncture - i.e. just needles - or was it accompanied by something extra, such as massage or TENS?

I’ve never read any compelling evidence for using acupuncture on any human problem, but people who study affective behavior and placebo in animals are beginning to talk about another perhaps unknown dimension to their response to such treatments.

"Beginning"? Acupuncture on horses has been as common as dirt for years,* and been less valuable in the long run.

The real question is when someone will finally take serious note of anantine chiropractic.

* Oh, wait, you know this, as the quiet communication was 31 years ago.

If altmed was baked and served with pineapple slices and maraschino cherries on toothpicks, it would be Hawaiianized.

And if it was the lineal descendant of a wealthy or notable family, it would be scionized, though still not science-based.

Alright, enough. Any more "lionize" jokes, and I will change the title of this post. I mean it. It was amusing at first, but now it's starting to irritate me.

Well, now I can't use my one involving two meanings for "unionized". Dang.

Interesting reading.

http://www.sciencedaily.com/releases/2012/09/120910161548.htm

Erik1986 @ 26 and Sara @ 38: Most interesting.

I'm highly skeptical of quackupuncture, but what you've described has two elements needed for a decent research project:

a) The horses have no beliefs about acupuncture so there is no issue of unblinded treatment or belief-related effects.

b) Presumably there are objective means to measure improvement if any in horses' conditions via standard tests of performance at movement tasks.

Ideally have five groups/conditions for testing: No treatment aside from rest, sham acupuncture (those pressure things that aren't needles), acupuncture only, TENS only, and acupuncture plus TENS.

Have skeptical observers watching closely, and take video of all treatment conditions.

Have independent, unrelated, blinded veterinarians diagnose each horse pre-treatment, and evaluate each horse post-treatment.

How to get sufficient N of horses remains to be seen, but not impossible.

I'd support a project like that getting funded. I'm inclined to think that if there's any benefit to be found, it would be in the TENS groups. If there's no "there" there for the acupuncture, this should put another "mysterious claims about animals" myth to rest. And if acupuncture actually does produce an improvement, that would be surprising but interesting enough to go looking for a mechanism.

@IKZ: Discussed when it came out.

http://scienceblogs.com/insolence/2012/09/12/can-we-finally-just-say-th…

And when the corresponding author was unhappy at criticism:

http://scienceblogs.com/insolence/2013/03/08/author-of-the-acupuncture-…

@Orac --

I sincerely apologize.

FWIW, none of what I wrote was intended to reflect on, mock or otherwise criticize the title of the post in any way whatsoever. In retrospect, I can see that it was thoughtless in that regard. But it was honestly just idle wordplay.

Nothing to apologize for. It wasn't your fault it got out of hand or that for some reason when I started perusing the blog this morning the "lionized" jokes started to irritate me enough that I thought about changing the title of the post.

@ Gray Squirrel

a) The horses have no beliefs about acupuncture so there is no issue of unblinded treatment or belief-related effects.

To nickpick, horses (and any animal cared for by humans in general) do have beliefs about human intervention: they know/have been conditioned to expect that whenever one of their caregivers is approaching them, something is going to happen.
This something could be good (food, petting, going for a ride) or it could be bad, of course. Either way, approaching an animal is not a neutral event for the animal.

Hence the need for a proper placebo, i.e. a sham treatment, which you appropriately included in your proposal, so I am somehow belaboring the point.

The story of Clever Hans is here to tell us that, if a horse "wants" to make us believe into something, it has a good chance to succeed in fooling us. Including skeptical and trained veterinarians.

It's just a matter of mutual expectations meeting midway: the animal wants to please his caregivers with the proper behavior, and the caregivers expect the animal's behavior to improve.

Regulars know by now the supposedly lack of placebo effects in animals is a trigger button for me :-)

Another regular remarked that a number of animals are good at hiding pain, especially out of fear, so if "pretending" to be better allows Fluffy to avoid being stuck again with a few dozens annoying needles...

Just a quick update on that Integrative Medicine textbook I mentioned in this thread. It isn't necessarily used by the medical school as students are able to upload any textbooks they have to the site providing they're relevant textbooks that have the potential to be used by the students. That is, the school doesn't strongly vet the books, and maybe the school itself hasn't gone all "integrative" by recommending homeopathy, distance-healing, reiki and prayer because "it will do little harm".

Being a clinical professor for only 3.5 years now all of my efforts to thwart the bs promoted by the Cleveland clinic have been fruitless. Makes me ashamed to work here.

"I could be treated with anthroposophic medicine at the University of Michigan"

Damn, I thought those pages were gone, but maybe you just can't get to them from the Cancer Center's web pages easily anymore. I suppose I will start lobbying again at medical school level, but I don't expect it to die easily. It appears we are looking for a new director of integrative medicine:
http://medicine.umich.edu/dept/family-medicine/faculty-recruitment

Hi there; yes, I wrote the article. My apologies, actually about non-disclosure. I didn't realize that hadn't made it in to the last version. You'll have to forgive me for the oversight--it's a local publication and I've been vocal about the connection round here so I somehow hadn't noted that the disclosure wasn't in the footnotes at least. (I emailed the editor, so thank you for pointing this up--). But: As to quackery: that is partly the interesting bit to me. I study historical quackery or things that were at least thought of as such. Fascinating material--but you have to be conscious too of cultural identification. That is, would you say these alternative therapies were 'quackery' in their own cultural contexts? Or only when they appear in the west? It's a good question to pursue, given how much the West tends to see its medical practice as primary and somehow more legitimate. I am mansging editor of an anthropology journal, and we talk a lot there about cultural blindness and the accidental patronizing of other cultures practices. At the same time, I see the problem of importing such things into our own culture without that crucial context. I think it's worth talking about. But be thing you are definitely right about (and which I mention): the Clinic has embraced much of it. Is that a problem in your estimation? Or just another avenue of care, offered in one place among others? (Or both). Useful discourse I think.

Quackademic medicine tightens its hold on the Cleveland Clinic

oracknows — Mon, 26 Jan 2015 02:30:52 +0000

Quackademic medicine tightens its hold on the Cleveland Clinic

It's no secret to my regular readers that it's highly unlikely that I'll ever be getting a job at the Cleveland Clinic Foundation (CCF) any time soon. After all, I've written posts about the CCF in which I've criticized its promotion of reiki, its establishment of a traditional Chinese medicine (TCM) herbal medicine clinic, complete with a naturopath running it, and its recent embrace of the founder of "functional medicine" (not to mention collaborator with antivaccine activist Robert F. Kennedy, Jr.) Dr. Mark Hyman. A quick Google would reveal me as the author of such criticisms. Such is life as a medical skeptic.

So here's another nail in the coffin of my chances of ever working for the CCF:

Children receiving care for chronic conditions such as anxiety, arthritis, nerve and muscle pain and even post-traumatic stress disorder will now be able to access complementary and integrative medical techniques to help them heal at the Cleveland Clinic Children's new Center for Integrative Medicine.

A team of pediatric rehabilitation specialists will offer acupuncture, biofeedback, guided imagery, hypnosis, reiki, relaxation and breathing strategies, therapeutic touch, yoga, and other treatments.

I suppose this shouldn't come as too much of a surprise. The CCF had already been subjecting children to acupuncture for at least two years now. In fact, we've met the leader of the this new program before, Dr. Benjamin Katholi, when he wrote an article advocating acupuncture for children, which I duly deconstructed in my own inimitable way. As I put it, he was mixing cow pie with apple pie in pediatrics, as he "integrated" quackery with science-based medicine. Personally, I've often wondered how one would get children to lay still and let someone stick needles into them or why one would want to.

So what's going on here? If, as I wrote about a while ago, the CCF has been offering these services to children for several years now, what's the big deal here? Why does it matter if there's a new Center for Integrative Medicine? Well, this is CCF's rationale:

Many of the children Katholi treats have post-concussive symptoms, juvenile arthritis and nerve-related pain, he said. Other children who use integrative services have chronic headaches, back pain, anxiety and other complex medical problems.

Cleveland Clinic Children's has offered many of these services to patients for several years, Katholi said, but did not have a centralized space for kids to receive care. That space will now be at the Clinic Children's Hospital for Rehabilitation on Martin Luther King Jr. Drive in Cleveland.

"The hospital has a lot of medically complex patients who are referred here for inpatient or outpatient care, so it made sense to have the center here to help enhance the quality of life for those patients and to help enhance their recovery." Katholi said.

So now there's an actual building for this woo, and, of course, if there's an actual formal name for the program with an administrative structure, that's a message that it's here to stay. So, curious, I wandered on over to the actual webpage for Cleveland Clinic Children’s Center for Pediatric Integrative Medicine . I knew it would probably raise my blood pressure, and it did. The thought of children being subjected to some of this quackery at an ostensibly respectable academic medical center is depressing to behold indeed. Here are the services offered:

Acupuncture, Acupressure, Laser Acupuncture
Biofeedback
Craniosacral Therapy
Guided Imagery
Hypnosis
Integrated Dry Needling
Microcurrent Therapy (physician or therapist administered)
Myofascial Release
Reiki
Relaxation/Breathing Strategies
Therapeutic Touch (Babies)
Yoga

That's quite a collection, isn't it? I particularly like the laser acupuncture, because, you know, everything's better with lasers. If sharks with laser beams on their head are better, why not acupuncture? Still, it's very, very disturbing to me that any academic medical center anywhere would offer craniosacral therapy for any reason—particularly to children. Doesn't Dr. Katholi know that craniosacral therapy is pure quackery? Basically having been pulled out of his nether regions by William Garner Sutherland, it's based on physiology that doesn't exist (craniosacral rhythms). Basically, Sutherland conjured up the idea that there is a "primary respiratory mechanism" that has five components:

The inherent rhythmic motion of the brain and spinal cord.
The fluctuation of the cerebrospinal fluid (CSF) that bathes and nourishes the brain and spinal cord.
The shifting tensions of the membranous envelope (dura mater) surrounding the brain and spinal cord. This entire membranous structure acts as a unit and is called a “Reciprocal Tension Membrane.”
The inherent rhythmic motion of the cranial bones.
The involuntary motion of the sacrum (tailbone) between the ilia (hip bones).

But wait, there's more:

As the lungs breathe and the heart beats with a rhythmic alternating expansion and contraction, the central nervous system (CNS) also has its own involuntary rhythmic motion. Dr. Sutherland described this inherent activity of the CNS as a respiratory motion with “inhalation” and “exhalation” phases. The hands of a skilled osteopathic physician connect directly with the primary respiratory mechanism to bring about a therapeutic response. Primary respiration is the guiding principle; it is the inherent intelligence within. This Primary Respiratory Motion actually expresses itself through every cell of the body, influencing all body functions. Physicians trained in Cranial Osteopathy can place their hands on any part of the patient to perceive and influence this important mechanism.

Let's just put it this way. The "primary respiratory mechanism" that is based in physiology has little relationship to what Sutherland described. But note the "inherent intelligence." It's very much like what chiropractors like to call the "innate intelligence." Basically, it's vitalism, in which the practitioner is said to assist and facilitate the "inherent healing intelligence to reconnect with its state of balanced health." At its core, the "inherent intelligence" is no different from the chiropractor's "innate intelligence" or the qi (or life energy) of traditional Chinese medicine. By "detecting" (or "listening through the hands"), supposedly the CST practitioner can recognize the body's "subtle rhythms" that indicate "congestion" of cerebrospinal fluid, which they can then correct by various manipulations. In reality, all craniosacral therapists do is to gently massage the head, in order to treat almost anything.

It's utter pseudoscientific, vitalistic nonsense, of course. Unfortunately, it's utter pseudoscientific, vitalistic nonsense being sold to children by the CCF. I suppose that's appropriate, given that the CCF advertises acupuncture on its site by appealing to qi and to nerve stimulation.

Personally, reading the news story, I was intrigued (and not in a good way) by this passage:

The center will also begin research on several integrative treatments — acupuncture, reiki and a form of low-intensity electrical stimulation called frequency-specific microcurrent therapy — to figure out what their potential benefits are for kids.

Amusingly, the abbreviation for this is FSM. (No, not that FSM.) Here's how it's described on a naturopathic website:

The roots of Frequency Specific Microcurrent (FSM) date back to the early 1900's from Dr. Albert Abrams, who was the first physician to use calibrated instruments capable of detecting the radiations of living tissue. Dr. Abrams concluded that: all matter radiates electromagnetic energy; the characteristics of the radiations from any type of matter depend upon the molecular constituents of the material examined; and the radiations emitted by the different organs of living tissues can be detected, selectively differentiated, and the amplitudes measured. Dr. Abrams became convinced that the frequencies involved were radio waves and that electronic equipment could be developed to neutralize and eliminate disease radiations.

Oh, no. It's vibrations! Toujours vibrations! Don't believe me? Then check out how the mechanism behind FSM is explained:

Remember your high school chemistry class. Think about the explanation of the atom. At the center of the atom are the protons and neutrons. This is called the nucleus. The old theory, in the 1960s, was the electrons were spinning in orbits around the nucleus. Modern research has shown that the electrons actually vibrate back and forth in orbits around the nucleus, instead of spinning in continuous, mono-directional circles. This new understanding is the basis of our FSM theory.

Each tissue in the body has individualized frequencies. The individualized and specific vibrational characteristic of each atom, of each tissue type, varies even more specifically for varying conditions, such as: trauma, inflammation, stress, environmental influences, etc. To put the theory of vibrations in a better overall perspective: different vibrations / frequencies of sound, light, radio waves, etc., are responsible for notes of music, colors of light, and radio stations. Vibrations are specific and unique for all matter, inorganic and organic.

When an injury occurs to a tissue, the electrons in the affected tissue take on a different vibrational characteristic, unique to that injury or other abnormal condition. As the vibrations of the electrons change, it is believed the electrons concurrently may also change to a different "orbit" from what was normal for that tissue type.

FSM is "frequency specific" because we match the frequencies of the tissue disruptions with the frequencies we choose for our therapy. The new vibrational characteristics that occur from damage to a tissue are countered with specific microcurrent frequencies that match the exact abnormal frequencies that are present in the damaged tissue. The desired effect is to neutralize those frequencies that are incorrect for the damaged / affected tissues.

Yep. Vibrations again. What is it with woo-meisters and vibrations? Of course, there is no good evidence that when a tissue is injured it takes on a "different vibrational characteristic" (whatever that means). I can sense any physicists and chemists out there (and, remember, my undergraduate degree was in chemistry) cringing heavily. I mean seriously? Injuring tissues cause electrons to go into a different orbit? Don't these people know that that requires energy to do that? Not the kind of "life energy" that acupuncturists and other TCM practitioners believe in, a mystical magical "energy" that does no work and is undetectable to scientific instruments, but real energy! Don't they also know that such higher energy orbital states tend to be unstable, with the energy that moves the electron to its higher energy orbital being released as light. What's being described here is nothing but science-y sounding gobbledygook.

But it goes beyond that. The inventors of this woo seem to think that the vibrations of the electrons supposedly altered by injury can be corrected just by running low level electrical current at various frequencies through the area. It's utter nonsense that's based on, yes, a high school level understanding of physics, and a poor high school level of physics at that.

And CCF is seeking to combine this woo with reiki. I suppose it makes sense in a way. Both are invoking pseudoscientific "energy" as their explanation. Reiki's just a bit more fantastical.

What doesn't make sense is that a respected (fast becoming once respected) American bastion of academic medicine would offer this sort of quackery.

oracknows Sun, 01/25/2015 - 21:30

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I use guided imagery as a thing to half-focus on to quiet my brain-chatter so I can fall asleep, it's great for that. Head massages feel good, so do breathing exercises! Of course, I don't pretend to be practicing medicine while doing any of those this.

I knew a composer of electronic music who wanted to write a piece including very low pitches through big subwoofers to try to set up resonance frequencies with people's bladders -- so the listeners would feel the sudden need to pee. That is all I can think of when I read about treatments using "vibrations."

Laser! Acupuncture! I can't even...

CCF seems to be heterodyning out of control. Their embrace of frequency & other quackery cannot end well - I recall the fate of the Tacoma Narrows bridge. Or have I tortured those metaphors beyond use? Really disappointed to hear that research money will be siphoned off into woo. I was offered a position in a lab there in the 90s; perhaps I dodged a bullet.

I had some hope that CCF's largest local competitor, University Hospitals of Cleveland, would exert some pushback, until a search on the terms alternative & complementary produced this: http://www.uhhospitals.org/search?s=complementary%20and%20integrative%2…

"The old theory, in the 1960s, was the electrons were spinning in orbits around the nucleus..."

WTF? Did that guy learn chemistry from cartoons? The Bohr-Rutherford model (circa 1911) was replaced by the quantum mechanical models of atoms around the mid-1920s. And electrons don't "vibrate back and forth" in any model. They occupy orbitals of discrete energy levels.

Yes, relaxation therapy/ deep breathing, guided imagery, some massage and yoga help patients relax, which is a good thing. The trouble is they mix the stuff that works , such as relaxation training, with complete nonsense such as reiki. Sadly, many patients think relaxation techniques actually prevent or cure or heal serious diseases. As Orac says, the apple pie gets mixed with cow pie.
When I was offered "healing touch" by RNs (they wave their hands over the patient) I said to my husband, "what's next? is the head of transplant going to come in a witch doctor outfit?"

@Argon

S/he means s/he saw a TV science show produced in the '60s. That makes the viewer at least as knowledgeable as those Western reductionist PhDs.

Who pays for this rubbish?

OK, folks, time to triple the amount of hard-science training required of doctors.

I kid, I kid, but still.

The most likely explanation for why these programs are becoming ensconced at CCF is a major donor. Someone with some connection to CCF that has a lot of dispensable money and a penchant for woo probably made a sizable donation (in the 7+-figure range) to establish this nonsense. It's not likely that CCF (or most 501c3 academic medical centers) would turn down such philanthropy.

When I read the part about electrons jumping to higher energy states I got this great image of little sparks of light flashing every time someone gets injured. "Oooh, I see Bob got another papercut! Nice one!"

Seriously though, do these people learn chemistry and/or physics from a cereal box? It's like they took something that is, at bottom, technically true--the resonating frequencies of different types of matter do exist, but they have no therapeutic value whatsoever--and said to themselves, "What's the least believable thing we can say about this, and how much can we charge for it?"

When I read the part about electrons jumping to higher energy states I got this great image of little sparks of light flashing every time someone gets injured. “Oooh, I see Bob got another papercut! Nice one!”

Actually, I got a vision of someone's tissue glowing fluorescently as that new energy put into the orbitals discharges. :-)

@Todd W.:

If it's a big donor, usually that donor is acknowledged, often by naming a center or the fruit of the donation after the donor. I'm unaware of any of this stuff at CCF having been named after anyone, but I could well be wrong.

@ Todd- Yes, wealthy philanthropists are often at the heart of this - I don't know about CCF specifically. What I kept hearing was "it's what patients want". It's MARKETING.

Not wanting to be left behind...the Mayo Clinic has what would appear from their website to be comparable integrative medicine infrastructure, although it's not clear whether there is a dedicated building.

Mayo has a page dedicated to the funding sources for the initiative, which includes ten benefactors, plus NIH/NCCAM, Komen Foundation, and NCI. Collaborators include Johns Hopkins, MD Anderson, Tang Center for Herbal Research at the University of Chicago, and University of Minnesota Center for Spirituality and Healing.

Neither of these two - Mayo and CCF - have much of a presence on the current NCCAM grant list.

@Orac

Generally, the center is named after the donor, yes. However, if the donor wishes to remain anonymous, the info won't be divulged.

Of course, it could also be a lot of smaller donors supporting an initiative started by a doc. If there were several donors, then I wouldn't expect to see a name associated with the center.

This sniplet of the FSM description is very illuminating:

"different vibrations / frequencies of [...] radio waves etc., are responsible for [...] radio stations."

Seems like a pretty theory of everything.

On a slightly more serious note: You _can_ injur tissue by putting electrons in a different orbit. The common name for this is "sunburn". Although you would not want to do something even remotely similar with electricity outside of an execution chamber.

It’s utter nonsense that’s based on, yes, a high school level understanding of physics, and a poor high school level of physics at that.

I'd say Orac's description of this kind of woo is generous. However, I graduated from high school mumblety-mumble years ago, so I may be overestimating the intelligence of current high school students.

This vibration stuff sounds like a horribly garbled interpretation of phonons in bulk materials. I have news for these folks: in a bulk material one has densities of states, so that instead of a few discrete frequencies one has frequency bands. Changing the frequencies would require a chemical change to the material, which could happen as a result of injury (flooding the site of the wound with dopamines, etc.). The catch is that applying these vibrations won't change it back; you need to do some chemistry, not physics, to get the healing to take place.

@palindrom: You may be kidding about increasing hard science requirements for pre-meds, but it deserves some serious thought. It turns out that physics really is useful in medical education--not just because it identifies certain people who should not become doctors, but also because it allows doctors to spot obvious woo like this, and run as fast as they can in the other direction.

Oh, and subjecting kids to this stuff is definitely over the line. It's one thing to offer woo treatments to a consenting adult, who in principle should know better, even if too many choose not to. Kids generally don't know better.

I read how the woosters talk about vibrations and honest to god I think they all did a batch of bad acid.

@ Joe Wear:

Not at all, they are merely more *sensitive* to the unseen world of subtle vibrational energies, spirits of the air and soulful fairies or suchlike than SB folk.

i experienced negative vibrations upon learning that our hospital system has hired an acupuncturist, whose ministrations are touted to not only relieve pain, but also "strengthen immunity' and treat allergies, anxiety and depression.

Better watch out for those negative vibrations, dude. They'll block the healing frequencies of qi from acupuncture and the healing frequencies of FSM...

@mademyday #15:

Although you would not want to do something even remotely similar with electricity outside of an execution chamber.

If you don't mind, I'd rather not have that happen inside an execution chamber either.

@Dangerous Bacon #19:

and treat allergies, anxiety and depression.

Seems more like the acupuncturist may cause anxiety and depression!

The roots of Frequency Specific Microcurrent (FSM) date back to the early 1900’s from Dr. Albert Abrams

Goodness me, it's the old Radionics grift! I remember reading Martin Gardner's description of that in "Fads and Fallacies", and thinking how antiquated and old-fashioned it sounded. But no idea is too stupid or dishonest for Alt-Med.

Is it just me, or do others hear theremin music whenever they think of bad (or good) vibrations?

Correction - Electro-Theremin music.

Do health insurance carriers pay for this stuff? I know that mine will pay chiropractors but I'm pretty sure they would draw the line at reiki. Of course that clinic is out of network so they have other reasons to deny.

@MO'B: I tend to think of the Beach Boys, but maybe that's because of their hit song "Good Vibrations". Although falling in love can mimic certain medical conditions, these "Good Vibrations" are a symptom, not a treatment.

Why not vibrating laser acupuncture? Or would toes get stepped on? Like surgeons doing their own endoscopies?

@ Eric Lund

Conveniently, the song Good Vibrations features an electro-theremin, so the circle is complete.

FREE THE QI

Integration disambiguation:

Vibrations good like Sunkist,
Many wanna know who done this.
Marky Mark and I'm here to move you,
Rhymes will groove you.

Sounds almost identical to what's going on with the GW Center for Integrative Medicine. Mikhail Kogan, the head of the GWCIM, trained for 2 years in craniosacral therapy. The other doctor, Ilana Seidel, is a level 2 Reiki master, who has treated HIV patients with that quackery.

@Mike, yet these are licensed and trained physicians. Trained at real medical schools and passed real licensing boards?

Colonel Tom: Incredibly, yes- They're training medical students in pseudoscience as well. Orac wrote about it a few months ago.

Thanks to a grant from the NCCAM, Georgetown also has a CAM program.

It's interesting to note that in 2002, the Federation of State Medical Boards issued a document titled "Model Guidelines for the Use of Complementary and Alternative Therapies in Medical Practice" (http://library.fsmb.org/pdf/2002_grpol_complementary_alternative_therap…).

A lot of the nonsensical "therapies" Orac describes above at Cleveland Clinic don't meet the guidelines of this document (such as being first effective, but also, as for acupuncture, safe). I've not been able to find a document of CAM guideline on the State Medical Board of Ohio web site. I have found such a document on my home state of Arizona's medical board site (http://azmd.gov/Files/Guidelines/AlternativeMedicineInPhysicianPractice…), but as pointed out by Mike in #32, there are medical schools, including ones in AZ, promoting this ridiculous CAM nonsense--with no apparent calling out from anyone based on these guidelines.

@Chris, as they are model guidelines, there is no guarantee that Ohio has adopted them.

Yet we had to spend two years convincing the VA to allow a free weekly session in focus and cleansing. Sometimes the insanity in this system is madding.

All that time I wasted...So many years working in child and adolescent mental health with bairns suffering things like anxiety or PTSD, the time spent on cognitive and behavioural programmes or exploring the meaning of a traumatic event, when I could have thrown some darts at them and had done with it.

What a fool I have been!

I imagine most of the costs of these treatments are being paid by the parents. Since most insurance won't cover 'elective' therapies unless there is a loophole somewhere. Plus I imagine parents will pay a lot on the promise that it will help their child. Particularly marketed at an actual medical institution. While you might be skeptical of an ad on a webpage or a storefront offering magical healing when your doctor turns down the corridor and points you to this shiny new clinic that will sucker you in. I think this has more to do with making money. As I would imagine most of these 'treatments' are self pay, they are a cash cow for the hospital. All gain and very little outlay of resources. Which is marketing and business at its finest.

Kiiri, your (American) insurance company has wide leeway to pay or not pay for almost any treatment, although restricted a bit with the Affordable Care Act. While chiropract are often paid for, with very good reason, most of those other types are not covered. Practically with a 25% copay and high out-pocket the voodoo treatment will be cheaper than AMA blessed treatment. Acupressure is cheap compared to an real medicine. I've heard from people still in the biz, that the poor insurance is part of the reason for the rise in alternative crap.

However, this is the part that gets complicated, while many voodoo techniques are not "covered" it does not guarantee that they will not go towards your maximum out-out-pocket. This varies greatly from state to state, but it become reasonable on a financial basis to meet your deductible and then your maximum out of pocket.

Say I spend a thousand of a blankety-blank chiropractor. My family deductible is $6500. After the chiropractor fails to improve my outcome, I undergo L2/L3 fusion, run up $100,000 in claims. I now pay $1000 to the chiro and $5500 to the surgeon which is my max out of pocket.

Now, suppose my neural entrap just happens to get better, and to be overly fair we had a chiropractor that suggested some strength exercises and at least didn't hurt the situation. If my L2/L3 situation gets better I've paid $1000. I've not exceeded my max out of pocket.

Now, since your insurance company has little vested interest in your health, their goal is either to pay the minimum outlay possible or if you become a high utilization individual their desire is to see you on the government's tab. This has improved some with the ACA, but not been eliminated.

I am pleasantly surprised that the Cleveland Clinic has not yet added snake oil to their list of services. Perhaps they are waiting for some scammer to rebrand it as a branch of TCM.

herr doktor bimler - perhaps they should consider snake WD-40.

Yet, still the Cleveland Clinic is ranked #1 in cardiology and I settle for a cardiologist that was Cleveland Clinic trained. When getting a second opinion over supposed gall bladder failure, a Cleveland Clinic trained gastroenterologist immediately recognized heart failure and fluid retention in the ab cav as the culprit, even without the oft observed swelling in the periph, and saved me from unneeded surgery. I like my gall bladder, it is my sixth favorite organ.

It is hard to tell the true from the false, the good from the bad.

I have a hypothesis: it's all about administrators building big administrative departments and feathering their nests.

Bear with me for a moment...

Björn Brembs (a neurobiologist at a university in Germany) recently wrote a criticism about the exploding costs of American university education. He believes that the root of the problem is hugely bloated administrations that take over and treat educational institutions like corporations, adding layers of middle management at 'competitive salaries,' driving up tuition to an unsustainable level.

He makes a compelling case based on the rising quantity of students per professor, and the rising quantity of administrators per professor. The way I would put it is, the admins set up a social ecosystem favourable the flourishing of more admins. The admins and their friends include marketeers, sales people, and bean counters.

Thus Cleveland Clinic. Some admin-culture people, whether managers, marketeers, sales, or bean-counters (none of whom know doodley-squat about medicine), get together and say 'let's build a House of Woo and we'll all have high-paid jobs for life.' They hire some woo-meisters, gin up some clever propaganda, and Ta-Daa!, they're 'in business' in more ways than one.

I'm quite sure that's what's happening here and in similar cases. Count up the admins at these places and see what you find.

---

That said, some of that woo might be useful in limited ways, having to do with relaxation. Biofeedback, guided imagery, hypnosis, and the like, are legit for that purpose, as long as they don't claim to tweak peoples' vibrations or twiddle their subtle energies. So I'm with Emma @ 1 on this. Mildly nutritious apple pie.

The cow pie is obvious, such as Reiki and 'electromedicine,' and one can only wonder when they'll add homeopathy to their list of 'healing modalities.' It would be better if the apple pie was 'integrated' with the rest of SBM, but there's more money to be made by fluffing it up with more BSM (I trust you can decipher that acronym).

So now you have naïve kids (and never underestimate: anguished parents!) seeking help with pain or whatever, and the kids do whatever procedure and feel relaxed, so placebo/expectation effects kick in and make the kids more likely to believe that magical hand-waving will also help.

But here's what I think actually goes on in the mind of a smart 8-year-old:

'These silly grownups with their silly emotional stuff, why don't they just learn to play "let's pretend" and have fun? Here comes that one again, she wants to wave her hands over me. OK, I'll sit still and smile, at least she's not going to stick me with needles like that other one! I wonder if I told him his needles made me want to vomit, would he go away? Or maybe they'd just give me another one of those funny cookies that smelled like pine trees and made me see ghosts...?'

I like my gall bladder, it is my sixth favorite organ.

Now that you are hanging out at RI, it helps to have a reliable and controllable supply of bile.

Herr Doktor, for that same reason I will likely tire of this den of rogues, rakes, n'erdowells, rapscallions and reptiles. While my heart is much improved, which I attributed to a combination of my Medtronics Viva™ XT and traditional "medicine", avoidance of stress is a common aspect in both traditions. I truly should retreat.

In fairness, my first gastro did not make a bad diagnosis. His logical conclusion was based was not due to poor reasoning, he even checked my feet to confirm that I had no apparent swelling. Still, I am rather pleased that I did some "doctor shopping" even if I had to pay out-of-pocket for a second opinion.

It is always useful when you find a person that has the talent and experience to tell the difference between the gait of a horse and a zebra.

I've noticed that even the aficionados of complementary/alternative/whatever-they're-calling-it-this-week medicine typically have low expectations for it (though they might deny it of challenged). So perhaps part of the appeal for places like the Cleveland Clinic is that it provides an additional source of profit while having a minimal effect on chances of a malpractice suit. Which started me wondering: Has there ever been a major malpractice suit over CAM treatment? Even if it hasn't happened yet I can't see that it isn't that far off.

Re. Sir Bedevere @ 44:

Most interesting!, and yes I do think you're on to something there. It also dovetails with my hypothesis about administrative types feathering their nests.

What a fabulous business model. High administrative salaries, low risk of lawsuits compared to other players in adjacent niches, a clientele who are happy to be merely 'heard and affirmed,' and a product that isn't much more than vaguely pleasant feelings with no objective correlates.

I saw this and I didn't know where else to put it.
There are actually several references to the placebo effect in this article.
http://www.cracked.com/article_21932_7-creepy-things-your-mind-can-tric…

@Julian Frost. You dismiss the power of "faith". There are times, you need to have the belief that you are going to get better, the need to be reassured that there is hope, that there is going to be path out of illness, that things will get better. Lump it in with the placebo effect, but hope works. When each step is agony, when each breath is a dagger of pain, to know that this too, shall pass. Take all of that away, and you will lay down and die.

Quackademic medicine now reigns supreme at the Cleveland Clinic

oracknows — Tue, 23 Sep 2014 02:00:09 +0000

Quackademic medicine now reigns supreme at the Cleveland Clinic

Quackery has been steadily infiltrating academic medicine for at least two decades now in the form of what was once called “complementary and alternative medicine” but is now more commonly referred to as “integrative medicine.” Of course, as I’ve written many times before, what “integrative medicine” really means is the “integration” of quackery with science- and evidence-based medicine, to the detriment of SBM. As my good bud Mark Crislip once put it, “integrating” cow pie with apple pie does not make the apple pie better. Yet that is what’s going on in medical academia these days—witha vengeance. It’s a phenomenon that I like to call quackademic medicine, something that’s fast turning medical academia into medical quackademia. It is not, as its proponents claim, the “best of both worlds.”

Quackademic medicine has been infiltrating many formerly science-based academic medical centers. Such centers have a seemingly amazing ability to compartmentalize, insisting on rigorous science for most treatments but possessing an amazing blind spot when it comes to anything having to do with “integrative medicine.” Unfortunately, in few places is this tendency as intense as it is at the Cleveland Clinic Foundation (CCF). It’s an institution with which I have some familiarity, given that I lived in Cleveland for eight years from the late 1980s to the mid 1990s because I did my general surgery residency at Case Western Reserve University and University Hospitals of Cleveland just down the street. At least, that’s what it was called at the time. I also worked as a flight physician for Metro LifeFlight, and a frequent destination for cardiac patients that we picked up from outlying hospitals was—you guessed it—the Cleveland Clinic. Twenty years ago, the CCF was Case’s chief rival in terms of medicine, science, and competition for patients. These days, their relationship is no longer as acrimonious as it was when I was at Case, but unfortunately the two institutions appear to have become rivals in quackademic medicine.

It’s a rivalry the CCF appears to be winning. Sure, Case has a big integrative medicine program and sponsored a meeting of the Society for Integrative Oncology and has been caught recommending reflexology, but that’s nothing compared to the CCF’s promotion of “energy healing’ (in particular reiki), acupuncture for children, and, most recently, the opening of a traditional Chinese medicine clinic run by a naturopath.

So what can CCF do to top that quackery? I wish I hadn’t asked. The reason is that I just learned over the weekend that the CCF has ratcheted up the quackery to 11 and beyond. How? Simple. See this article in the Cleveland Plain Dealer:

In its ongoing focus on wellness and disease prevention, the Cleveland Clinic is opening a new Center for Functional Medicine. In doing so, the Clinic is the first academic medical center in the United States to embrace functional medicine, the focus of which is more on identifying underlying causes of illness and less on symptom management.

The center will work together with Clinic specialists to study the impact functional medicine has on certain chronic diseases.

Within the next few weeks, screening will begin for the first of up to 300 patients for one of four clinical trials comparing the standard treatment for asthma, inflammatory bowel disease, type 2 diabetes and migraines with that of functional medicine approaches.

The new center at the Clinic's main campus is a collaboration between the Clinic and The Institute for Functional Medicine. Dr. Mark Hyman, chairman of The Institute for Functional Medicine, whose offices are in Washington state and New Mexico, and founder of The UltraWellness Center in Massachusetts, will serve as director of the new Center for Functional Medicine.

That’s right. The CCF has embraced the quackery that is “functional medicine” and even hired the most famous practitioner of that quackery, Dr. Mark Hyman. We’ve met Dr. Hyman before many times on this blog. For instance, he has argued for turning back the clock and relying on anecdotal medicine instead of scientific medicine, mangled cancer research and systems biology to justify the quackery that is “functional medicine,” and twisted autism science even worse. Most recently, it’s been reported that Bill and Hillary Clinton have fallen under Dr. Hyman’s spell.

So what does this mean for CCF? Quackery. That’s what it means. Don’t believe me? Go back and read my description of functional medicine. Look at Wally Sampson’s multi-part analysis of what functional medicine is claimed to be here, here, here, here, and here. Basically, it’s a vaguely defined “discipline” in which it is claimed that measuring a whole bunch of metabolic factors and other lab values will lead to a “holistic” approach to disease. Never mind that just what “functional medicine” actually entails is kept quite vague. That vagueness is the very thing that allows Dr. Hyman to claim:

“Functional Medicine looks at the underlying causes of disease, while focusing on the whole person rather than an isolated set of symptoms,” Hyman said in the news release. “We look at a patient’s history and the personalized interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease.”

The new center is a collaboration with The Institute for Functional Medicine, an organization also led by Hyman.

Of course, “functional medicine” does nothing of the sort, at least not any better than conventional medicine. According to news reports, Hyman will only set foot in Cleveland three days a month, which makes me wonder how he can be the director of anything there, much less a center at a large institution like the CCF. Of course, there’s been a doctor hired to do the day-to-day grunt work of running this new center: Dr. Patrick Hanaway, was the chief medical officer of Genova Diagnostics from 2002-2012, a laboratory that offers all sorts of tests of dubious medical value, including a saliva adrenal stress profile, comprehensive diagnostic stool analysis, and toxic effects CORE, among others. Of course, Dr. Hanaway is an integrative “holistic” practitioner. After that, he apparently became the director of medical eduction for Dr. Hyman’s Institute for Functional Medicine. Frighteningly, the practice where Dr. Hanaway works offers “holistic newborn and pediatric care,” including what is characterized as “grounded discussions” on vaccines:

Each talk is facilitated by Dr. Susan Bradt or Dr. Lisa Lichtig, board certified family physicians who practice holistic medicine. We cover the hot topics of controversy including links made to autism and asthma, the ingredient thimerosal (mercury), individualizing schedules and current outbreaks of vaccine preventable disease in our community. We review each disease and its associated vaccine and discuss vaccine ingredients, school requirements and legal issues. An extensive handout is provided to supplement the class and serve as a future reference. This class is essential for all families so they can be more informed about vaccinations. It is especially helpful for parents feeling concerned or hesitant about vaccinating their children according to the standard schedule. It provides a grounded explanation of the issues and helps remove fear surrounding the topic thus helping parents navigate decision making from a more balanced and educated starting place. You will walk away with a great foundation on the topic of childhood vaccines and be able to confidently make choices that feel safe for your family.

I recognize the code words, as, I’m sure, do many of you who follow the vaccine manufactroversy from a science-based perspective. The big giveaway is that the clinic website doesn’t dismiss the “links made to autism and asthma” (hint: there are not, at least none that are evidence-based) and claims to discuss “ingredients,” a sure sign that the class involves the “toxin gambit,” a fallacious gambit designed to cause great. It's of a piece with Dr. Hanaway's boss Dr. Hyman's recent foray into anti vaccine fear mongering with Robert F. Kennedy, Jr. One wonders why the CCF would hire someone who spreads such blatant antivaccine propaganda as Dr. Hyman does.

Then there’s this:

For uncomplicated pregnancies we encourage laboring at home as long as possible with the support of a birth partner and/or doula. Once at the hospital we help create an intimate and encouraging atmosphere utilizing low lighting, freedom of movement, homeopathy, vocalization, massage, water, birthing ball and stool to support women in labor as it intensifies. Medications and epidurals are available upon request. Woman birth in a variety of positions including in the water and squatting.

Yep, Dr. Hanaway’s partners practice “natural childbirth” woo.

So how on earth was someone like Dr. Hyman or Dr. Hanaway offered a job at an institution as prestigious as the CCF? Listen to the CEO of the CCF, Dr. Toby Cosgrove. He’ll tell you:

In the release, Clinic CEO Dr. Toby Cosgrove said the new center is “not a departure for Cleveland Clinic, but a continuation of the innovative, holistic approach that we have embraced.” Cosgrove cited the Clinic’s wellness institute, Center for Integrative Medicine, its Chinese herbal therapy clinic and the Center for Personalized Healthcare.

I can’t argue with this. The CCF has been traveling down the road of quackademic medicine for a long time. This new initiative is nothing more than a continuation of the “integration” of quackery into medical practice at the CCF. There’s nothing “innovative” about its practice; it’s just embracing ancient, pre-scientific medicine on the one hand (the traditional Chinese medicine clinic) and a modern version of the same sort of thing, in which the idea seems to be to check as many lab values as possible until something is found to be wrong (as it will be with virtually everyone if you check enough lab values) and then to “treat it,” labeling the “treatment” as somehow “holistic.”

Unfortunately, I can’t argue that CCF isn’t a trailblazer. Unfortunately, it’s a trailblazer in introducing quackery into conventional medicine. Cosgrove ought to rename the CCF to the Cleveland Quackademic Clinic, as sad as it is for me to contemplate the decline of a once-great institution.

oracknows Mon, 09/22/2014 - 22:00

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Could you please explain what you mean by natural childbirth woo? What was so objectionable about that quoted content? It reads as nothing inherently dangerous and basically supportive of the birth experience, with interventions available as required. What's the issue there? (Aside from some nice placebos)

There are issues with "natural childbirth woo", when it includes immersion in water during the first stage and second stage of labor. The joint opinion of the ACOG and the AAP (April, 2014) is here:

Thanks, lilady. It doesn't read as strictly out, at least not for first stage. Perhaps if that is what is sought by mothers (and may be associated with decreased pain and anaesthesia and duration), it is better off being provided in the kind of context of this clinic. The Orac quote is framed as for 'uncomplicated pregnancies' so it does indicate screening and 'integration,' not an entirely separate pathway.

Here, Dr. Mark Hyman, who "collaborated" with Robert Kennedy Jr., who wrote a dreadful book on the dangers of vaccines, claims he is "pro vaccine". He brags about the Cleveland Clinic's adoption of his "functional medicine":

http://blogs.discovermagazine.com/collideascape/2014/08/20/robert-kenne…

Oh, my, this is bad.

I can only imagine how much more difficult it would be to, say, fight global warming denialism if earth science departments were being bribed by oil money into hiring denialist crackpots.

This shows yet again that many physicians don't understand much about science. There are, of course, many laudable exceptions -- present company included.

It looks very much as though Cleveland Clinic, through this new program will be encouraging patients to follow "individualized" vaccine schedules for their children - meaning delaying or even dropping some vaccines.

What's important is that parental decisions will "feel safe" (according to Cleveland Clinic) - not that they _are_ safe.

I know of no other major medical facility that's promoting such a thing.

@Eliot

The idea of 'if people are going to use quackery, isn't it better that they use it under proper medical care?' is one of the ways that quackery creeps into real medicine. Because no one says 'the following techniques are utter bullshit and potentially dangerous, but you can do them here if you really insist'. They dress quackery up with the kind of fluffy language that Orac quotes, and by positioning it next to real medicine they legitimize it in the view of patients who trust their doctors to tell them what works and what doesn't.

Well, whatever vaccine rates are in the Cleveland Clinic area, they are sure to go down. Vaccine-preventable disease rates are sure to go up.

My question is this--where are all the pediatricians who ought to be speaking up and out about Hyman and his scientifically and medically illiterate "holistic" family physicians? The apathy from pediatricians over this surging anti-vaccine movement is so profound that I have to wonder if: (1) pediatricians are just feeling beaten down by the increasing tide of AV parents, or (2) most pediatricians just don't care, or (3) they just don't have time to debate, or (4) there a lot more medical/scientific illiteracy among pediatricians than I'd like to think there is.

Could you please explain what you mean by natural childbirth woo

To sum it up neutrally, there are conflicting views about childbirth, in US as well as in Old Europe.

A majority of physicians and gynecologists would prefer a pregnant woman to be followed by a team of a specialists in a clinical setting - or at least to have these specialists at hand, should a complication occur; which means going to some sort of hospital when the time comes.
Especially for a first pregnancy; complications of pregnancy or delivery are rare, but do happen, and saving the baby and/or the mother and limiting lasting damage is often more likely if the right personal/equipment is waiting in the next room.
For pregnancies after the first, now that there is a baseline, both the mother and her medical staff can do a more accurate risk prediction. In the context of previously uneventful deliveries, I could grant that delivering home does not seem unreasonable.
(gosh, it's obvious I didn't attend many childbirths, isn't it? "uneventful deliveries")

On the other side, there are those who feel that pregnancy and childbirth is over-medicalized. If you look into specific interventions, there is room for legitimate debate - when to use of c-section, when labor should be induced...
Science marches on for medicine, as for all other human technologies. There are certainly things we overdo, and others we don't do enough of. Hopefully, ideally, accumulation of data will allow us to correct and improve.

However, when people start talking about how "pregnancy is natural" and "pregnancy is not a disease", we hit the naturalistic fallacy and veer head-on into "natural childbirth" woo territory.
More precisely, these people are going to take health-related decisions based upon an emotional, and above all, false view of reality. Last time I checked, miscarriages are natural and a pregnant woman is not exactly in her usual physiological state. She may not have a disease, but pregnancy definitively qualify as a medical condition.

In the specific case of this Cleveland clinic, the use of homeopathy, and the word "hollistic", are big woo red flags for Orac and most regulars of this blog.

Disclosure of COI: I was born premature and my sister's delivery had to be induced. My mom didn't have ‘uncomplicated pregnancies'.

The Orac quote is framed as for ‘uncomplicated pregnancies’

Well, that's the core of the issue. Until something happens the wrong way, all pregnancies are uncomplicated pregnancies.

And what is wrong with testing functional medicine treatment for various maladies through clinical trials at CCF?

@Eliot

It reads as nothing inherently dangerous...

You appear to be ignoring this bit:

Woman (sic) birth in a variety of positions including in the water...

Newborns have drowned or suffered aspiration to name but two entirely avoidable complications. There is no evidence that water births have ever been the norm in any culture.

As pointed out by the Skeptical OB, most people would not choose to stick their head in water contaminated with blood and faeces, so why would you force a baby to do so.

http://www.skepticalob.com/2014/03/whats-the-difference-between-waterbi…

Dr. Hickie: I'd be willing to bet on #1. Anti-vax parents are so spectacularly aggressive that it's not even worth engaging with them. I suspect that most peds who have to deal with them just don't discuss vaccines more than once, or look for ways to drop the anti-vaxxers as discreetly and fast as possible. It must be very difficult dealing with people who can't hear anything but their own voices and who absolutely despise the doctor for no other reason then their chosen profession. (I wonder why anti-vax people don't just go all the way and learn to set bones themselves.)

Traditional medicine only treats symptoms, like removing a cancer by cutting it surgically, burning it with radiation, or poisoning it with chemotherapy. Integrative medicine treats the underlying cause, which could be something like congested liver qi. Fortunately, there are now advanced scientific instruments to image conditions like this.

http://www.auraphoto.com/products/auracam.shtml

Install one next to the MRI, and you'll be all set.

re #13 Mark Thorson
You couldn't make this up.

Further thoughts on #13
What could save us from this tsunami of drivel is the fact that its purveyors don't accept any test of its effectiveness other than their own opinions. So one man's woo is as good as another's. All woo must be accepted - or none?
Or am I being over-optimistic?

Point well taken about this disappointing focus from CC. However, I must point out that it is VERY misleading to lump natural childbirth in with VAX/autism and metabolic panel science. Many of the practices they list there ARE evidence based (Cochrane on doula support:

(Sorry got cut off- continued http://www.ncbi.nlm.nih.gov/pubmed/23076901) and many interventions considered standard in OB are not at all evidence based (Cochrane review on continuous fetal monitoring: http://www.ncbi.nlm.nih.gov/pubmed/16856111). A portion of the terrifying increase in maternal mortality in the US has been due to an excess of medical interventions (http://www.arhp.org/publications-and-resources/contraception-journal/ma…) and thus dismissing these alternative practices poses a danger to the health and safety of women. We must used evidence based methods to determine proper procedures for any aspect of healthcare but we also must not throw the baby out with the bath, dismissing interventions that aren't familiar without looking at the solid evidence.

oderb #10,

And what is wrong with testing functional medicine treatment for various maladies through clinical trials at CCF?

Functional medicine appears to me to be more of a marketing strategy than a field of medicine: IMO, to quote the Bard, "it is a tale, told by an idiot, full of sound and fury, signifying nothing". If you want an in-depth analysis you could do a lot worse than read Wallace Sampson's articles linked to by Orac in his post.

There are plenty of desperately underfunded scientists with truly promising new treatments that are far more deserving of being tested in clinical trials than "functional medicine".

And what is wrong with testing functional medicine treatment for various maladies through clinical trials at CCF?

Oderb, what body of evidence supports prior plausibility for function medicine's efficacy--i.e., leads one to expect functional medicine is tlikely to produce better outcomes than current standard-of-care science based medicine?

In the absence of such prior plausibility we're better served committing the resources we'd expend pursuing clinical trials of functional medicine to other potential treatments where there is evidence suggesting potential efficacy--and the community the hospital serves would be better served if they committed the resources going to support ther functional medicine program to hiring more nursing staff, reducing wit tiems at their ER, etc/

So what can the average person do to stop the spread of quackademic medicine?

I met someone this weekend who was a patient at the woo part of George Washington University Medical School. The Center for Integrative Medicine that offers quite the menu of quackery.

Traditional medicine only treats symptoms,

Recommending dietary and life-style changes, promoting exercise, providing support and counseling to deal with the emotional effects of illness, etc., only treats symptoms? Really?

Or are you actually unaware that these are all integral parts of conventional (i.e., 'traditional') science based medicine.

like removing a cancer by cutting it surgically, burning it with radiation, or poisoning it with chemotherapy.

By what rational argument does removing cancerous tumors surgically, administering radiation or chemo therapy as curative or adjunct therapies to reduce tumor burden and prevent the recurrence of cancer only treating symptoms of an illnes, not directly treating the illness itself? Explain that one to me.

"Integrative medicine treats the underlying cause, which could be something like congested liver qi."

And your evidence that 'qi' exists, that congestio of liver qi can cause illness. and finally that integrative medicine is capable of releiving that congestion would be...what, exactly?

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

Fortunately, there are now advanced scientific instruments to image conditions like this.

Please provide evidence that instrumentsyou claim exist (such as at the website you provided a link to) are actually detecting, imaging, and capable of measuring 'qi', and that they allow the accurate diagnosis of qi 'congestion'.

Install one next to the MRI, and you’ll be all set.

All set to do what? make personalized trippy black light posters?

oderb@10: Your question was answered in this part of Orac's post:

Basically, [functional medicine is] a vaguely defined “discipline” in which it is claimed that measuring a whole bunch of metabolic factors and other lab values will lead to a “holistic” approach to disease. Never mind that just what “functional medicine” actually entails is kept quite vague.

Or to put that another way, it's basically an "underpants gnomes" approach to medicine:
1. Measure metabolic factors
2. ????
3. Patient cured!

The Grouchybeast @ 7. My query was framed around my (now disabused) understanding that none of what was listed in the quote was dangerous. I'm not advocating the idea of integrated sham as a 'pragmatic' rationale for its medical endorsement. However, I'd be concerned with blanket dismissal of benign 'treatments' or approaches that contribute to a woman's birth experience and autonomy over that experience (with the boundary conditions of access/concedance to intervention if required).

DrBollocks @ 11. Not ignoring, merely ignorant on that particular point. Thank you for the link.

Helianthus @ 9. Thank you for the response. I'd think that there is a point between the naturalistic fallacy and recognising the legitimate concerns about the cascade of intervention (and perhaps doctors excessive risk adversity contributing to this?) in childbirth. An expectant mother's birth experience is not irrelevant also, and without understanding any specific point of problematic woo Orac referred to, his brief complaint read (and kind of still reads) as deriding efforts focused on that experience (even if within a medical setting).

However, I must point out that it is VERY misleading to lump natural childbirth in with VAX/autism and metabolic panel science.

No. It isn't. Not really, and especially not when homeopathy is mentioned in the same paragraph.

As a healthcare provider with a chronic, idiopathic, and often disabling disease who has seen some of the top specialists in the country, I can attest to the frustration patients feel in the current healthcare system. I've spent thousands of dollars and untold hours of time trying to find something more than a band aid for my symptoms which seems to be all conventional medicine has for many of us right now. I support EBM and only practice evidenced-based nutrition on my own patients. I totally get it. But the "experts" I've had the privledge to see have spent no more than 10-15 minutes of their time to tell me the same thing: we don't know, deal with it. I hear from my friends who pursue treatment through alternative providers that they spend up to an hour with the "doctor", who then heaps on a lot compassion and willingness to explore "alternatives". So I get why the public is demanding this type of "medicine". They are tired of being treated like ignorant cattle. My husband and I are both highly educated in scientific fields, yet no doctor I've met has been willing to engage in anything more than lay-speak about what "might" be the underlying cause of my disease and symptoms. I attribute this to the fact that they are forced to see way too many patients and have no time to stop and get to know or engage their patients in any kind of meaningful discourse. Until this changes, patient will continue to run to alternative provideres who will. Apparently big centers are realizing this and want a piece of that pie.

As a long-time CCF user, I canned my doctor when she transferred to the wooey "Wellness Dept" and changed to a regular, plain-old primary care doctor who is not interested in the woo in the slightest. She is a no-nonsense, "diet/exercise/get your flu shot" kind of Dr. I tend to think that the majority of Drs. there are like this.

Not that this is news to the people who post here regularly, but doing what "feels" safe for your family is one of the worst ideas I've heard in a long time. It's well established that humans suck at calculating risk - even pigeons do it better than we do! Delaying or forgoing vaccines because it "feels" safer would be like driving your family across America instead of taking a plane because driving "feels" safer, even though you're much more likely to be killed in an auto accident than a plane crash.

Argh - repeat comment <i<and tag-closing fail! The link still works if you click the phrase "even pigeons do it better than we do."

"...humans suck at calculating risk – even pigeons do it better than we do!"

Piazza San Marco in Venice is often carpeted with pigeons. While there (as a tourist) I was horrified to see a couple of young children standing amidst the pigeons and repeatedly trying to stomp them.

Somehow as each foot came down there was bare pavement, not birds. Always. Without seeming to even try they always moved out from under the foot as it descended. It was fascinating to watch. At least once I realized the kids weren't really trying to kill them.

I think, perhaps, if they were woo-believers rather than pigeons they'd get stomped. Every time.

JGC @21

You might want to check the connections on your sarcasm meter.

Quackademic medicine is a weird phenomenon, isn't it? It doesn't happen in other professions - the media don't give Dara O'Briain's "Barry who believes the sky is a carpet painted by God" (it never gets stale) the same credence as professional astronomers, and Barry certainly isn't given an office in the astrophysics department of the local university.

Please provide evidence that instrumentsyou claim exist (such as at the website you provided a link to) are actually detecting, imaging, and capable of measuring ‘qi’, and that they allow the accurate diagnosis of qi ‘congestion’.

I suspect that people are missing Mark Thorson's irony.

Unfortunately, the rise of Quackacademia is often paraded about in woo-ville as evidence that we are indeed in the midst of the Great Paradigm-Shift (tm) which they've been predicting these many years.
'
An idiotic woo-meister can say, " See here: even those in the most admired bastions of SBM are coming over to OUR side!"**
and anti-vaxxers can yelp that " The tide is turning against standard practitioners".

** for some reason,I wanted to write that in LOLspeak. Am I tired or just uncannily perceptive?

About the childbirth stuff some posts back --

Back in the old days, women felt an entirely legitimate beef at OBs who put them up in stirrups and did all sorts of other degrading interventions that had no actual medical legitimacy at all. Natural childbirth arose as a reaction to this.

Nowadays any reasonable hospital offers a much wider variety of options, including getting no interventions unless medically indicated. Given how intrinsically risky the whole business is (as a visit to any 19th century graveyard will attest) I can't see any good reason to choose home birth.

The name *O' Briain* spelt that way always makes me laugh ( so why not *Ui'Briain* whilst you're at it?)
as I know people from (both) Ireland(s) who were persuaded to learn Gaelic- one of whom even finds the trad spelling of Maeve -* Medbh* IIRC- which her neice named her daughter- a bit much.

NIECE- since we're spelling

I could get behind every aspect of "natural childbirth" except the homeopathy & "in the water." While pregnancy is a natural state (not caused by a disease, unless you count the invasion of sperm a root cause), I agree with #9 Helianthus, that it definitely qualifies as a medical condition.

Of course, women have given birth for millennia without professional medical involvement, albeit medical involvement has certainly improved the standard of care (but mostly after the acceptance of germ theory).

Of course, imaging the qi only shows you what is wrong. It doesn't guide treatment. A qi imbalance is usually caused by a blockage of the flow of qi, most commonly a subluxation of a spinal nerve. Fortunately, there are advanced scientific instruments for that too.

http://www.subluxation.com/the-insight-subluxation-station/

Get an AuraCam 6000 and an Insight Subluxation Station, and you'll be all set to practice Integrative Medicine!

AnonRD @ #25: I also have a chronic debilitating condition that has forced me to give up some of the things that I love. My regular MD (whom I see every 2-3 months, because I need monitoring at my medication levels) *always* has time for me, will *always* ask how I'm doing, and the visit isn't over until I have no more questions or reports on my condition. Not every doctor is terrible, but *all* of the woo-meisters are money-stealing frauds who take advantage of people when they are dealing with difficult situations.

I would walk out of a doctor's office if they started suggesting the "alternative" non-working therapies I've seen advertised for my particular condition and its related issues. I know there's no cure for what I have, but easing the symptoms properly matters a lot. I don't want a medical center offering me faith healing or needles in my arms, because they don't work, and it's completely unethical to claim that they do.

One person's bad experience, however bad, does not mean that the woo should be allowed in. Ever.

Since we all already know CCF is following the yellow brick woo, can we have some more thought on WHY they're doing this, such that we could build a case against it that goes beyond pointing out of the umpteen thousandth time that this isn't scientifically sound practice? I mean, do you really think the directors of CCF believe Dr. Hyman is the future of medicine (not rhetorical; I don't know...), or even if so that's all that's going on?

There's exactly one hypothesis in this thread so far, posted by AnonRD.

"No doctor I’ve met has been willing to engage in anything more than lay-speak about what “might” be the underlying cause of my disease and symptoms. I attribute this to the fact that they are forced to see way too many patients and have no time to stop and get to know or engage their patients in any kind of meaningful discourse. Until this changes, patient will continue to run to alternative providers who will. Apparently big centers are realizing this and want a piece of that pie."

So, first of all, are woo patients indeed a significant revenue source for CC? This strikes me as a bit counter-intuitive. If SBM has been Taylorized at CC so real MDs are overloaded and have no time to deal with 'the whole patient' in not-scientifically-invalid ways, why would CAM providers be allowed the extra time for appropriate hand-holding, as that would mean they see fewer patients and, I assume, generate less payment from insurance companies. Am I wrong? Is the profit margin in CAM higher in some way? Hit' em up twice: first for the BS, then the real thing when the B fails? Could they really be that cynical? (again, not rhetorical) Have the CC bosses just thrown up their hands, decided X many people are going to seek CAM regardless, and they might as well get in on the action as their cut will help keep the SBM side of the clinic afloat? Is some other financial incentive other than insurance payments involved? Is there some deep pocket funding source backing these CAM initiatives? A Koch-brother type? Hillary's Wall Street pals? Are some wacko State or Federal legislators pushing this stuff, e.g. the laws in Washington State that essentially REQUIRE Kaiser Permanente to offer woo whether they like it or not?

Could it be that scientific medicine finds itself in a pickle posed by questions the community of scientific researchers is not equipped to answer?

More a habit of mind than a rigorous philosophy, positivism depends on the reductionist belief that the entire universe, including all human conduct, can be explained with reference to precisely measurable, deterministic physical processes. The decades between the Civil War and World War I were positivism’s golden age. Positivists boasted that science was on the brink of producing a total explanation of the nature of things, which would consign all other explanations to the dustbin of mythology. Science was the only repository of truth, a sovereign entity floating above the vicissitudes of history and power. Every schoolkid knows about what happened next: Two world wars, the systematic slaughter of innocents on an unprecedented scale, the proliferation of unimaginably destructive weapons — all these events involved, in various degrees, the application of scientific research to advanced technology. All showed that science could not be elevated above the agendas of the nation-state: the best scientists could as easily be bent toward mass murder as toward the progress of humankind.

T. J. Jackson Lears

If science can't separate it's own strings from social agendas, how's it going to cut the strings pulling up pseudoscience? Follow scientists like Rush Holt out of the lab and into the political arena maybe?

Mike @ #20 asks. "So what can the average person do to stop the spread of quackademic medicine?" and the only thing resembling a strategy I see here is "lump natural childbirth in with VAX/autism" because one woo is a bad as another. I mean, couldn't we just advocate cutting out the homeoquackery, putting the birth-tub down the hall from the OR and having an attending on call nearby?

Yeah, great plan! Let's alienate all the women who want to take a more active, conscious role in childbirth. And it's just a Model of how to win-friends-and-influence people when the first woman to join the thread says 'Many natural childbirth practices are evidence-based and dismissing these practices poses a danger to the health and safety of women.' with three supporting scientific citations, and immediately gets rebuked, 'No. It's not. Because homeopathy.' Shut up, honey, and get on the gurney. You're just irrational because you didn't get the Skeptic Gene that comes with the coconuts.

Hey, there's an idea! We'll get Richard Mellon Scaife to back an advice website for expectant and newborn mom where they learn Rational Thinking from Richard Dawkins, Sam Harris and Michael Shermer (the ladies just Love that guy!). It'll be a subscription-based site, naturally, with a webstore offering copies of 'Atlas Shrugged" autographed by Ayaan Hirsi Ali herself for under $100. There has to be some free content of course, so all the moms who sign up will get an email newsletter featuring reasoned commentary from Ali's colleagues at the American Enterprise Institute about such Mom-crucial issues as getting prayer back in schools, exposing that Anthropogenic Global Warming nonsense as a Commie scheme for the redistribution of wealth, and how Obamacare will rob from their children to give a free lunch to a bunch of wetbacks.

That'll show those woo-meisters in Cleveland in the hard light of Truth, and our troubles here will be over very quickly!

@sadmar

You know, I felt like maybe some of the commenters were a bit hasty in assuming that "natural childbirth" is always code for "scientifically unsupported nonsense that sacrifices women's health and safety to a misguided ideology" (but understandably so since that's so often turned out to be exactly what it is ), but your comment was far more sarcastic and condescending than the ones you're complaining about. As far as the accusation of sexism goes, keep in mind that the natural childbirth movement is prone to its own brand of sexism, namely, "its wrong to use artificial means to make childbirth easier and less painful because childbirth is supposed to hurt, its part of Eve's curse/nature (depending on whether you're dealing with fundamentalist bs or new age bs.)

"why would CAM providers be allowed the extra time for appropriate hand-holding, as that would mean they see fewer patients and, I assume, generate less payment from insurance companies."

Probably because the woo-masters themselves are paid a lot less. To produce a good physician takes more than a decade of hard, expensive training. To produce a good Reiki master or homeopathist takes a couple of weekends to learn the patter. And, of course, a physician requires competent supporting staff and science-based (often expensive) equipment.

What supporting staff or equipment does a Reiki master need? A comfortable "treatment" room is about it.

What about a homeopathist? Well, I guess you need a bunch of little bottles of tap-water, or a pile of sugar pills, plus a bunch of blank labels you can print Latiny names on, but that's about it.

@Sarah A: "your comment was far more sarcastic and condescending than the ones you’re complaining about."

Yeah, that was my reaction too. Of course, sadmar has always been sneeringly condescending to everyone who comments here, so it's not really surprising.

No, no, that approach is all wrong. You'll be dismissed as a reductionist who hasn't learned a darn thing that wasn't taught in allopathic medical school. You're so close-minded you haven't changed your mind about anything since the Reagan administration.

The right approach is to ask how do you image qi? Where is your objective, scientific instrument for locating subluxations? You're using your hands? This is the 21st century, and you're using 19th century technology! You're not competent to practice Integrative Medicine! Either do it right, or get out of the business! This department should be shut down!

What, you're still using needles for acupunture?

http://holistic-healing-center.com/Intro-Seminar-Colorpuncture.html

@sadmar 41
"we could build a case against it that goes beyond pointing out ... that this isn’t scientifically sound practice?"

I thought that was the complete statement of the case against it - what more is there? What else needs (or you feel needs) pointed out in this respect?

@Catherine #16 and #17. Reading through the links you provided, it doesn't support the argument that "dismissing these alternative practices poses a danger to the health and safety of women."

First, the arhp link does not do a great job comparing the different causes of the increase maternal mortality. However, it is very clear that a lot of the increase is due to inadequate access to prenatal, intrapartum, and postpartum care, especially for low income areas. This is not really an argument for alternative practices. It is an argument for building a better health care system with equal acces for all, which I'm sure most here would support.

As to the one of the other link and the arhp, they do indicate that there may be too many medical interventions. However, a decrease in medical intervention does not mean an increase in alternative practices. The author's conclusion from abstract of the article you cite to for doula support states "Continuous support during labour has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labour and birth."

This again seems tied to the strained resources of the medical system in the United States and supports the development of a better public health care system where medical professionals can get additional information about the mother in order to avoid unnecessary medical intervention. It does not mean alternative birth practices are good and should be supported.

I have to weigh in on the 'natural birth' thing. I'm sorry but I have found only two types of settings for women to birth their babies. You either go with an OB in a hospital with trained staff or you end up at home or a 'natural' birth center. The OB in the hospital may poke and prod more than you like but the epidural is available when you want it (and I wanted it after the first 20 hours or so) and intervention was close at hand. The 'natural' birth center that I had friends who went too offered all the hoopla above, a ball, a water bath (though to be fair I also had a ball before the epidural and did get an hour in the tub) a doula, and assurances you didn't need any 'nasty' painkillers. I know women who wear the badge of honor that they survived their labor with no painkillers and no OB. I don't know why they do this. I was in labor. It hurt, it hurt quite a lot WITH the epidural. Selling women that it will be magic unicorns farting fairy dust and rainbows while they sit in a tub with a doula or half-trained midwife to guide them through is a bunch of baloney. Yeah, we should talk about C-section rates and we could do a lot to make hospital birth better but I'll take it any day over sitting in a water bath for two days being denied pain medication and hoping my baby doesn't drown in the water or get caught in my pelvis or that I bleed to death after delivery.

Kiiri -- Our local hospital (an academic medical center) offers the option of a nurse-midwife service for normal birth - no poking or prodding except as needed and/or desired, and the midwives are highly trained, with nursing degrees and advanced training (Certified Nurse Midwives).

The moment something goes wrong, in comes the OB to consult -- everyone's on salary so there are no turf wars over patients, and the OBs and midwives have an excellent working relationship. And the moment things start to go seriously off the rails, it's onto the gurney and into the OR, usually within a matter of minutes.

palindrom, as usual, beat me to it.

A birthing center...just down the hall from the OR, attended by advance practice nurses/certified nurse midwife, is the third option.

And, there is no shame if you require pain relief for the delivery.

If anyone is interested in a through dissection of natural childbirth I recommend the blog The Skeptical OB.

I love your blog btw Orac.

As someone who sufferers from CFS I am deeply disturbed by the level of woo around it. I go to an integrative medical clinic that is publicly funded. Its called Integrated Chronic Care Services, I think. There is a lot of paraben free, scent free woo- as well as "the dirty dozen' produce, organic, multiple chemical sensitivity etc. People with CFS shouldn't be treated among people with fake diseases like multiple chemical sensitivity. I go because there is a doctor, a nurse, a dietitian, a psychologist and an OT.

I am not happy at all with the woo though being funded by our tax dollars and I am not happy at being suggested by my GP (more than once!) to see a naturopath. If I was an MD I would be so insulted by naturopaths, trying to pass themselves off as legit health providers and all.

I fear that the woo is part of the reason why there is no drug to treat CFS yet. I miss being able to handle a normal amount of exercise and have gained weight from not being able to exercise as much as when I was healthy due to post exertional malaise.

Does Cleveland Clinic still do legit medicine?

I am imagining it as that you only get alt med if that's what you choose but if they are mixing it into real medicine outside of their little Chinese medicine clinic that is very worrisome. Do they choose the integrated pediatricians or is that just what the patients are given by default? I can only imagine how disconcerting it would be to see a highly rated facility you worked at drown into obscurity.

http://www.skepticalob.com/2014/09/microbirth-an-object-lesson-in-the-i…

Actually I lied, there is one drug to treat CFS called Ampligen, which has a lot of interesting controversy around it. Even if Ampligen does end up working I doubt it will help post exertional malaise. They have claimed it could be used to treat Ebola. Sorry to comment spam you btw.

Has Dr. Oz become antivaccine? The answer would appear to be yes.

oracknows — Fri, 12 Sep 2014 01:00:07 +0000

Has Dr. Oz become antivaccine? The answer would appear to be yes.

ORAC NOTE: I’ve added the links to the video segments, which are now up at the Dr. Oz website. I also did a screen grab of a certain really stupid thing that I noticed when I watched the segment but, because I was watching it on DVR, didn’t have the ability to show you. It’s near the end. Enjoy.

When last we left “America’s doctor,” Dr. Mehmet Oz, in June, he was having his posterior handed to him by Senator Claire McCaskill (D-MO) in a Senate hearing about the deceptive marketing of supplements in which his over-the-top promotion of supplements like Garcinia gambogia, green coffee bean extract, and raspberry ketone. It was an unexpected pleasure, not for Dr. Oz, obviously, but for skeptics who had been concerned when they had learned Dr. Oz was going to appear before the Subcommittee on Consumer Protection, which Sen. McCaskill chairs, that it would turn into a love-fest or a grandstanding opportunity for Dr. Oz. It wasn’t. In fact, even though at the end of his punishment Dr. Oz promised to clean up his act and tone down his overenthusiastic boosterism for supplements, without of course making any specific promises, I had little doubt that Dr. Oz would revert to his old ways as soon as the new season started.

I wasn’t wrong. In fact, I think I can now safely say that, in addition to the quackery and weight loss supplements that he promotes regularly on his show, Dr. Oz has started down the path to become antivaccine, if he’s not antivaccine already. Of course, I had seen rumblings of antivaccine proclivities coming from Dr. Oz before. For example, nearly five years ago, he was interviewed by Joy Behar, as noted on the antivaccine crank blog Age of Autism. During that interview, he admitted that his children had not received their flu shots during the H1N1 pandemic and strongly implied that his wife had been responsible, saying, “I`m in a happy marriage and my wife who makes most of the important decisions as most couples have in their lives who absolutely refuses.” Of course, at the time I knew that Oz’s wife is a reiki master and clearly heavily into quackery. Whether it was she who influenced Oz to go as far as he has into the wild world of woo or whether he discovered it himself, I don’t know. What I do know is that anyone who produces a segment like the one he produced on yesterday The Dr. Oz Show is well on his way to being antivaccine. What do I mean?

Take a look at the thimerosal segment on yesterday's The Dr. Oz Show, and you'll quickly see what I mean:

Dr. Oz had as guests on his show antivaccine loon Robert F. Kennedy, Jr. and his partner in crime against vaccine science, “functional medicine” expert Dr. Robert Hyman, on his show in a credulous segment about the mercury-containing preservative thimerosal that buys into virtually every trope about mercury in vaccines promulgated by the antivaccine movement. The reason, of course, is because Kennedy and Hyman have a book out. It’s a book entitled Thimerosal: Let the Science Speak: Mercury Toxicity in Vaccines and the Political, Regulatory, and Media Failures That Continue to Threaten Public Health that I’ve discussed before in which, as I put it, Kennedy parties about thimerosal like it’s 1999.

To give you an idea what this segment was like, let me tell you how it was advertised and introduced. That’s almost all you need to know. Before the thimerosal segment, there was a somewhat useful segment about heart disease in women. (At least, there wasn't anything objectionable from a medical standpoint in it.) After that segment concluded, there followed a teaser for the upcoming segment that blared:

Flu shots under fire. Why is a toxic ingredient that was banned lurking in your vaccine?

Things went downhill from there after the commercial break, when Oz introduced the thimerosal segment by describing RFK’s and Hyman’s book as a "controversial" new book that asks the question, “Why does the US government allow a toxin to be added to one of your most common medicines?” He then stated that two “world class leaders have come together to write a book that will change the way you think about the flu shot.” Ugh. "Controversy" is the wrong word. "Manufactroversy" is the right word.

Oz then went on to observe that vaccines have come “under a lot of fire in the medical community.” It was at this point that I wanted to reach through the screen and strangle Dr. Oz, its taking a major effort of will not to do so. (Such blatant stupidity has that effect on me, particularly dangerous antivaccine stupidity such as what Dr. Oz had just regurgitated to millions of viewers. Fortunately, I am not a violent person, but I'm sure anyone who's pro-science will understand the momentary urge.) No, no, no, no! Vaccines have NOT come under a lot of fire from the medical community. The medical community is virtually universally supportive of vaccines. Rather, vaccines have come under fire from a number of misguided activists who mistakenly think, despite mountains of evidence to the contrary, that vaccines cause autism. They’ve also come “under fire” from quackery supporters like RFK, Jr., and, yes, Mark Hyman. In any case, in order to “clear the air,” Oz went on to ask Hyman and RFK whether they are antivaccine. I almost laughed when RFK said that he’s “fiercely pro-vaccine,” which, given the level of sheer pseudoscience, conspiracy mongering, and stupidity that he’s laid down over the last nine years on the topic, has to be either a lie or the most amazing case of self-delusion I’ve seen in a very long time or an outright lie. Hyman chimed in, assuring that he, too, is pro-vaccine, which is nonsense. If you've collaborated with a book with the likes of RFK, Jr. that lays down scads of pseudoscience, conspiracy mongering, and misinformation about vaccines, you've lost your right to call yourself pro-vaccine, or at least you've lost any expectation that people won't laugh in your face when you do something as risible as claiming that you are not antivaccine.

Next followed a brief video about the history of the use of thimerosal in vaccines, which noted that thimerosal came to be suspected of causing autism in the 1990s. In fairness, the segment stated that the link between thimerosal-containing vaccines and autism has been discredited, but that was buried under sensationalistic fear mongering, with alarming images, the observation that the government got rid of thimerosal in vaccines because, “Better safe than sorry,” and the conspicuous notation that thimerosal is gone from childhood vaccines with the “glaring exception” of some flu vaccines, not to mention the claim that the EPA considers medical products containing thimerosal to be “hazardous waste,” decorated, naturally, a big picture of a biohazard symbol in the background. At one point, he displayed an Erlenmeyer flask full of what looked like liquid mercury, swirling the liquid metal, and then added the "mercury" into a beaker of water meant to represent a multi-use vial of vaccines to demonstrate how "mercury" is added to vaccines to prevent bacterial overgrowth that can occur as a result of bacterial seeding that can result from entering the vial with more than one needle. It's one of the dumber visual demonstrations I've seen on The Dr. Oz Show, and that's saying a lot. Thimerosal is not metallic mercury. One would think that Oz might have picked up a bit of organic chemistry in his premed courses or in medical school.

After the video, Hyman claimed that children receive just as much thimerosal now as they did in the old days because it’s in the flu shot. This is, of course, utter nonsense. Children get one flu vaccine a year. Many don’t even get thimerosal-containing versions of the vaccine; indeed, many receive a live attenuated influenza vaccine (LAIV) like FluMist, which is given intranasally. The hilarious thing about this segment is how much of a non-issue this is and has been since 2002 at least. RFK claimed that when he gets his flu vaccine he asks for the thimerosal-free version and that his doctor has no trouble keeping it in stock. Unfortunately, Hyman couldn’t resist chiming in to call mercury a “neurotoxin,” which it is, but not at the amounts and in the form received by infants from vaccines. He implied but didn’t explicitly state, that mercury at the level in vaccines could cause neurodevelopmental difficulties, which, as I’ve pointed out time and time again, using citations to large, well-designed studies to back me up, is simply not true.

One thing I do believe is the part where Dr. Oz described how he had polled his viewers with the question, “Do you trust that vaccines are safe?” and found that 65% of them said no. Given that this is a Dr. Oz audience, that’s not surprising at all, although it is still very depressing. This result led Dr. Oz to claim that the reason he did this segment on thimerosal is because he’s all about “restoring trust” in vaccines, as did Hyman, who says that he and RFK are all about getting people vaccinated and also restoring trust in vaccines, to which I say: Bullshit! Using such tactics to "restore trust" in the vaccine program is akin to showing flaming car crashes and dead victims in order to "restore trust' in automobile safety.

You can see this in the part where Dr. Oz briefly reads part of a CDC statement:

The conclusion of the scientific community is clear that thimerosal-containing vaccines are safe and effective and do not represent a public health risk.

To this, RFK had the actual cojones to claim that the CDC statement was “not a scientific statement.” I say again: Bullshit! I particularly call BS on RFK’s claim of spending three years reviewing the literature with a “crack scientific team” with the best research scientists and editors (one wonders if he included Mark and David Geier on that "crack team"). He claimed that he couldn’t find a single “valid, plausible study that said that thimerosal was safe.” Well, here, Robert, I’ll help you out. Here are a few that I’ve blogged about myself over the years. Of course, you probably don’t think they’re “valid” because they conclude that thimerosal-containing vaccines don’t cause all the horrible things you think they cause, but they’re there, and they’re valid. Hyman then pulled the nonsensical gambit that the FDA has banned thimerosal to put on your skin, asking, then, why is it still safe for vaccines? Funny how he neglected this statement from the FDA:

Studies have shown that there is no known harm from thimerosal preservative-containing vaccines. In 1999, FDA conducted a review of thimerosal in childhood vaccines and found no evidence of harm from the use of thimerosal as a vaccine preservative, other than a reaction at the injection site. The Institute of Medicine’s Immunization Safety Review Committee reached a similar conclusion in 2001, based on a review of available data, and again in 2004, after reviewing studies performed after its 2001 report. Since then, additional studies have been published confirming these findings.

I won’t quote what the CDC says about thimerosal, because it’s very similar. The idea that thimerosal in vaccines causes autism is a long-failed hypothesis. In any case, at the very end of the segment Oz concluded:

First of all, pregnant women and babies, and people over 65, you’re at risk. You should ask for thimerosal-free vaccines, like the kind you find in a single dose. As for healthy adults up to the age of 50, it’s pretty simple. Consider asking for a flu nasal spray. That doesn’t contain any thimerosal, you don’t even need a needle, just put it in your nose. It’s just as effective.

While this advice is unlikely to cause harm, it’s also unnecessary. Most children don’t get thimerosal-containing vaccines anymore, and there’s no evidence that thimerosal-containing vaccines are harmful to adults or even to pregnant women. Ironically, research by the “CDC whistleblower” himself, Dr. William Thompson, is some of the key evidence that thimerosal does not cause neurodevelopmental disorders in children or problems when administered to pregnant women.

So has Dr. Oz gone antivaccine? I’m sure that he thinks that he hasn’t. He might even believe that tripe he fed his audience about wanting to “restore trust” in the vaccine program by prodding the CDC to remove all thimerosal from vaccines, even though it isn’t necessary to do so. I don’t believe him, though. If that was really his intent, he sure has a funny way of doing it, instead doing everything possible to play up the fear of thimerosal: Portraying thimerosal as this incredibly toxic compound, going on and on about its neurotoxicity, and likening it to toxic waste, with images of biohazard symbols and closeups of babies being injected, while giving only perfunctory acknowledgment of the real science showing no link between thimerosal and autism, after which he let RFK, Jr. and Mark Hyman basically say whatever they want about thimerosal. I mean, seriously. RFK, Jr. calls himself “fiercely pro-vaccine”? Seriously? If that were true, his supporters in the antivaccine movement would drop him like a rock. Like many in the antivaccine movement, RFK, Jr. might think himself to be “pro-vaccine safety,” but his words and deeds belie that claim.

In fact, the dead giveaway that Dr. Oz has either gone antivaccine or is so irresponsible that he’s willing to put forth a camouflaged antivaccine message in search of “controversy” and ratings is the very fact that he had RFK, Jr. on his show to talk about vaccines. Remember, RFK is one of the key people go really stoked the fear of thimerosal-containing vaccines back in 2005 when he published his misinformation-filled “expose” that popularized the central conspiracy theory of the antivaccine movement. Surely Dr. Oz and his producers must have known this, even if they didn’t know this:

Notice something? (Besides the vacant look on RFK, Jr.’s face?) The caption says “In 1999 thimerosal began to be removed from childhood vaccines like measles, mumps, and rubella.” Apparently Dr. Oz’s staff and Dr. Oz failed to realize that the measles-mumps-rubella trivalent vaccine doesn’t contain thimerosal. It never contained thimerosal. Ever. It’s an attenuated live virus vaccine, which means thimerosal would kill the virus in it. Even RFK, Jr. and Mark Hyman probably know that! Seriously, if Oz’s staff can’t get something that basic about vaccines right, what else did they get wrong? I think we all know: This entire segment and the fear mongering about thimerosal. Dr. Oz kept saying that he couldn't figure out why thimerosal is still in vaccines and that "not one person" could give him a good reason. He must not have looked very hard.

Vaccination rates are plummeting in enough places to produce pockets of unvaccinated and undervaccinated children among whom outbreaks of vaccine-preventable diseases can start, thanks to antivaccine celebrities, the antivaccine movement, and, now I fear, Dr. Oz. Maybe this is the first step of his finally going all in. After all, he’s been criticized as a hypocrite and “vaccine charlatan” by antivaccinationists for telling people to vaccinate while his wife doesn’t vaccinate his own kids.

oracknows Thu, 09/11/2014 - 21:00

Tags

http://www.washingtonpost.com/news/to-your-health/wp/2014/09/09/the-ftc…

Science

Has Dr. Oz become antivaccine?

Why not?

He has bought into most other variants of pseudoscience.

"people over 65, you’re at risk"

People over 65 are at risk of becoming autistic due to vaccines? And people under 65 too I guess, if like me they're asthmatic and can't have the live virus vaccine.

Does Dr. Oz's audience skew older? I know my wife's grandparents watch Dr. Oz and then go out and buy what he says. The elderly tend to die in the largest number from the flew. I wonder how many additional people will die because they don't get a flu shot this year after watching Dr. Oz?

Put simply, Oz is a ratings whore, back to his old tricks.

This is appalling.

If I were

Acting Surgeon General, Rear Admiral (RADM) Boris D. Lushniak, M.D., M.P.H.

I would call up Dr. Oz personally and ask him what the hell he thinks he's doing.

And if I didn't get a really, really contrite answer, and an on-air correction, I would hold a press conference and let him have it, by name, with both barrels. Metaphorically, of course.

Oz, like Bob Sears, are say-anything-for-a-buck physicians who need official reprimanding by their respective state licensing boards (as well an any academic medical societies to which they belong) but are unlikely to get it (with the notable exception of the verbal flogging Oz got from Senator McCaskill this summer as you note above).

Besides the straight talk here about quack physicians, I do like the multimedia beatdown of Oz by ZDogg MD (http://www.zdoggmd.com/sucker-mds2/ , and http://www.zdoggmd.com/dr-house-cards-ep-3/ )

At this point, I think holding out any hope for Dr. Oz is probably a fool's errand. Even if he does not personally believe these things, he is perfectly willing to act as though he does for the sake of ratings.

An aside, the mercury gambit with vaccines has always fascinated me - only because it is truly so short-sighted. I learned a while ago that a single serving of most kinds of fish will contain more mercury than the entire CDC-approved vaccine schedule combined. However, that factoid somehow goes right past the likes of these people. Maybe it's just too much work for these people to troll the frozen food aisles and seafood counters of their local Whole Foods. Maybe vaccine quackery is just easier.

It looks like Dr. Oz is getting some unfavorable publicity. The FTC charged that green tea extract weight loss program that Dr. Oz touted on his program and on his website. That company negotiated a $3.5 million dollar settlement with the FTC.

"A company pushing bogus diet pills touted by Dr. Oz settles with the FTC. Will the medical world weigh in?"

I honestly wonder if the whole McCaskill situation made Oz turn even further to quackery on his show out of spite, a sort of "just you try and stop me now" attitude. Based on the profiles and interviews I've read he seems like just the kind of egotist who would do such a thing.

FYI and entertainemnet:

simply search *Dr Oz house Cliffside Park*-
you'll find lovely aerial photos of his ostentatiously grandiose tile-roofed mansion on the cliffs...which means great views.
Oz lives in an extremely high rent/ real estate district so whatever estimated value pops up in your mind, please multiply by at least 5. Maybe more.

It was still priceless to see his face looking like something from mugshots.com as he had to just sit there and take a very public verbal lashing. But yeah, I agree AdamG it probably completely turned him to the dork side.

Was this taped after the spanking Claire McCaskill gave Dr. Oz?

What the anti-thimerosal crowd seem to forget is that prior to the mid-1990's, mothers were swabbing their kids' cuts and scrapes with the stuff in the form of merthiolate (AKA monkey blood). The autism "epidemic" is supposed to have begun about the time topical merthiolate antiseptic were banned in the US.

I learned a while ago that a single serving of most kinds of fish will contain more mercury than the entire CDC-approved vaccine schedule combined. However, that factoid somehow goes right past the likes of these people.

I would guess they're not really afraid of mercury, they're looking for an excuse for a preexisting aversion to vaccines (perhaps originating in a fear of the "unnatural", or simply of needles). They have no similar aversion to fish, so mercury in fish is not as salient.

Between assassins, compulsive sexual behavior, plane crashes, and mountains of cocaine*, I'd think thimerosal would be the least of the worries for the surviving Kennedys.

*actual potent neurotoxin

What do you suppose it would take to get a segment onto Oz in which a really well-prepared, media-savvy, telegenic expert pointed out how dangerous Kennedy's blatherings are to public health?

That might save a few dozen (or maybe many more) old folks from dying of flu this winter ...

Well....with Oz's reach, I would guess I won't have any trouble finding adequate vaccine supply when the time comes...

they’re looking for an excuse for a preexisting aversion to vaccines (perhaps originating in a fear of the “unnatural”, or simply of needles)

DING DING DING DING DING

They didn't reason themselves into their position, they are trying to rationalize it after the fact. It's understandable to be afraid of needles. Getting one stuck in you tends to hurt. Those of us who get vaccines for ourselves, and any children who may be under our care, do so because we have concluded that the benefits of doing so outweigh the pain of having that needle stuck in the arm. Others (some of them drug addicts, but some diabetics are also in this category) will inject stuff in their arms because the pain of not getting their insulin injection/drug fix is worse than the pain of injecting it. But there are some people who aren't or won't be persuaded that the pain they avoid by getting that vaccine would be worse than the pain they suffer during the vaccination, and they look for reasons, however faulty, to justify their fear of the pain.

I have an acquaintance who's a health professional, and who also has an exceptional talent for anticipating and understanding how people react to different turns of phrase.

She suggests that the word "vaccination" tends to carry more negative connotations than "immunization". I think she's onto something. For one thing, "immuniization" reminds people of the purpose -- to prevent them from getting a disease.

Eric @19 -- I think you're onto something.

Unfortunately, Hyman couldn’t resist chiming in to call mercury a “neurotoxin,” which it is, but not at the amounts received by infants from vaccines.

The trick, of course, being that it's very likely the intact compound that is the neurotoxic agent, with the dealkylated inorganic mercury being responsible for the nephrotoxicity.

If your sale pitch is not usually guided by science, why would vaccines form any part of your marketing strategy?

@ Harold Gaines:

My previous hypothesis was that mercury might have been protective against ASDs because rates went up after it was removed from most children's vaccines in the US: your comment lends additional weight to my supposition

Remember, minions I DID say it first!

@ palindrom:

One of the id... woo-meisters I survey always shrieks that 'vaccination is not immunisation' because he wouldn't want them to associate/ identify this evil with something GOOD..

Orac, you might want to look into this:

http://www.hollywoodreporter.com/features/los-angeles-vaccination-rates/

Why does Dr. Oz do what he does? He's been exposed to a known neurotoxin as well, two of them, actually. Celebrity™ (Immagodil Bowbeformeum) can affect the adult brain even more radically than it does that of children. It causes delusions of grandeur, confirmation bias and has a contact side-effect on other primates nearby Yesman's Syndrome. The other deadly toxin is Affluenzexx™ (Fucheumax Igotmynavir). This deadly toxin causes massive overconsumption, strips compassion, reason and common sense from the addicted. I fear the poor man's been mainlining both.

I would love to ask RFKjr:
Me: Has the number of autism cases increased in the last 15 years?
"Yes", we will say.
Me: Do children receive as much thimerosal as they did before 1999?
"No", he would have to say if he was honest.
Me: Then, by your logic, thimerosal was preventing autism. Shouldn't we put it back into vaccines not removing it?

Maybe someone should point out that antivaxxers are exposing future generations to the risks of vaccination by keeping the diseases from going extinct. Measles and polio should have been a non-issue by now, such that taking them off the schedule would be the most sensible thing to do for the same reason I haven't had a smallpox shot. If they're concerned about "too many too soon," the shot being obsolete because the disease no longer exists would be a non-controversial way to get rid of the "too many" part, after all.

@ Brent Thompson:

You could ask Jake Crosby or Brian Hooker that as well.

Oh no, we've lost Dr. Oz to the Dark Side.

Chris H., thanks for the ZDogg links. That's awesome good stuff! Tuned right to the age group and demo that needs to hear this.

OneOther, excellent! The fish comparison is like the asteroid analogy only better. The regular folks will get it immediately. For flu-shot worries anyway, it's better than 100 scientific studies that prove thimerosal is safe, because it defines the issues in terms of their personal experience: ' I eat fish and I'm fine'. Unfortunately, this won't help with the infant vaccine, as pregnant moms are told not to eat fish, and new moms told not to feed fishy things to newborns exactly because of the high mercury content...

Andreas J. and Eric Lund, brilliant! IMHO, tracing the issue back to a fear of needles is spot on. I don't think it's just a pain issue, though. Think about the 'hard-wiring' we inherit from millions of years of evolutionary adaptation. Creatures who have an aversion to body penetrations are going to be preferred by 'natural selection,' as are creatures who develop the knowledge that ingesting certain things will help them survive. Any oral vaccine is far less threatening than an injection, and a recognition of the naturalness of injection-aversion is a first step to developing effective psychological/rhetorical counter-measures physicians can employ other than just saying 'roll up your sleeve' or 'drop trou and bend over.'

palidrom, OUTSTANDING! IMHO this is the most valuable post I have ever seen on RI.
FROM THIS POINT FORWARD, NO PRO-SBM DISCOURSE SHOULD EVER,/b> USE THE TERM 'ANTI-VACCINE', BUT RATHER ALWAYS USE 'ANTI-IMMUNIZATION'!! In more polemic, less-purely-scientific contexts this could even be pushed to 'anti-immunity.' I BEG ORAC AND EVERYONE HERE TO MAKE IT A PRIORITY TO CIRCULATE THIS IDEA AND WORK ACTIVELY FOR IT'S ADOPTION BY PRO-SBM, PRO-PUBLIC HEALTH ACTIVISTS!!.

(Of course, the hard-core anti-immunizers will babble about 'natural immunity,' and Sears-ites will babble that they just want a 'safer' immunization schedule, but they will be back-pedaling as they do so. As things are now, it's the pro-vaxers who are backpeddling from the natural appeal of "why should I stick a sharp object into my child to inject a foreign substance into its body!" )

With respect, Orac, I think you are asking the wrong question. It should be "has Dr. Oz decided to show that e is antivaccine?"

Is anyone else getting the feeling that this is pure damage control from the antivacine brigade? The timing seems suspicious coming right on the heels of the nova segment on vaccines.

Celebrity™ (Immagodil Bowbeformeum)
Affluenzexx™ (Fucheumax Igotmynavir)

Brilliant! Consider these stolen.

My hunch is that Dr Oz's staff and producers put together most of these shows, and Dr Oz pretty much goes along with the script. (No single person could do the research and put together these shows, so much of the legwork is obviously done by staff.)

Staff has a job to do--put together a show! And, do it everyday. So, whoever is available for on-air, whoever has a new book out, etc., will always be given a featured role.

And, it's always easy to find another "miracle" supplement to fill a time slot.

Most of what is on these shows is just time-filler. It's not that Oz sits down at the beginning of the year and decides what topics, such as "restoring trust in vaccines" are top of his agenda to educate his audience.

It's time filler. The staff does the work. Oz is just the front man.

@ sadmar:

Not only the fear of pointed sticks** and whatnot BUT fear of poisoning:
toxins- whether they reside in vaccines, meds or GMO- and/ or gluten-laden foodstuffs/ bad seafod all frighten the h3ll out of them.

** obligatory Pythonism

For those who only know 'The Wizard of Oz' from the movie, the original book by L. Frank Baum is a Populist allegory, an attack on the Gold Standard and advocacy of Free Silver. Dorothy (the future of America) joins Scarecrow (the Farmer), Tin Man (the Industrial Worker) and Cowardly Lion (William Jennings Bryan) down the yellow brick (Gold) road to Oz (the Capital, named after the measure of Gold) to seek the aid of the Wizard of Oz (the politicians who rule the Gold).

They discover his schtick is empty BS designed to ward off challenges to the established monetary order. In the book, Dorothy returns to Kansas with her new wisdom by clicking her magic SILVER slippers.

(They changed it to Ruby for the movie because it would look better in color, and they weren't doing outdated "Cross of Gold" era anti-establishment politics in a mainstream depression-era family film, either. And after the commercial success of the first Oz book, Baum had eliminated the allegorical angle from the many sequels.)

And here we have the 'wizardly' Dr. Oz (Dr. Goldlove) promising those who follow the Yellow Brick Road (shell out money for 'health supplements') that he has the power to solve their problems, only to hand them empty placebos (diet diploma, weight-loss watch, mercury-consciousness medal) and add more bricks to his own bunker of bullion.

@Uselesstwit
I don't think it's 'damage control.' As Rob notes, scheduling and prepping show topics takes a lot of lead time, and unless someone on Oz's staff had an inside source at NOVA, they wouldn't have known what would be in the program before it aired. In addition, while the NOVA piece was thoroughly pro-immunization, it was boring weak-sauce as filmmaking, totally hamstrung by PBS conventions of 'objectivity' and 'sobriety' and deadly 'voice-of-god' voice-over narration from an anonymous, disinvested narrator. This is why theatrical-release docos that go with voice over use identifiable celebrities with positive public personas -- Morgan Freeman on March of the Penguins, for example. The audience then feels like they're being addressed by a real person, and a trustworthy one to boot.

I would guess they’re not really afraid of mercury, they’re looking for an excuse for a preexisting aversion to vaccines

I think this is right on the money. People who claim they're not anti-vaccine but "pro-safe-vaccine" remind me of a racist I once saw on one of those daytime talk shows. I was quite young at the time so I'm hazy on the details, but at one point an audience member asked him how he could teach his kids racism. His response was, "I'm not racist b/c I don't hate black people for being black, I hate them for what they do" - and started reciting the usual stereotypes about black people being criminals, drug users/dealers, unwed mothers, etc. Reasonable people know these are stereotypes, but this guy believed them b/c they justified his pre-existing racism, not the other way around.

I think in light of the recent CDC scandal where vital information regarding autism was covered up and hidden from the public for 13 years, it makes this article sound a bit ridiculous. There most certainly is a link between vaccines and autism, it can no longer be denied. Taking cheap shots at Dr. Oz and Kennedy by calling them loons just makes your comments that much less credible. Other silly comments like it's ok to eat fish so thimerasol is safe is laughable. Something eaten has to pass through the digestive system and be filtered through the body whereas an injection of a neurotoxin such as thimerasol/mercury or aluminum can and does cause brain damage. People who blindly believe in these toxic poisons injected into newborn babies is mind-blowing to me. Obviously the CDC does NOT have our best interest at heart, to defend them just makes you look uneducated and in denial.

Sarah A @40 -- Your anecdote reminds me of a great T-shirt from The Onion that reads: "Stereotypes are a real time-saver!"

Penny @41 - Don't assume that we're unaware of this. Orac devoted a solid week of posts to the CDC "scandal" as it unraveled, and "unraveled" is indeed the word.

Penny @41 -- a disinterested statistician evaluated the relative strengths and weaknesses of the deStefano 2004 and Hooker 2014 papers, summarized at A Statistician Evaluates DeStefano 2004 and Hooker 2014.

Thanks to the tiny sample and the uncontrolled confounding variable, Hooker’s results are both imprecise and biased. Consequently, my personal opinion is that Hooker’s results have no scientific value at all.

So. No scandal, no controversy, so no "whistleblower", still no evidence that vaccines are in any way implicated in causing autism.

@ Liz Ditz:

Please don't tell Jake**, we'll lack entertainment for months.

** not that he'd listen to you

I had wondered about Oz for a long time, then, about a year ago, I accidentally chanced upon one of his shows as it was beginning. I was astounded to see him and his guest promote numerology, especially the hallucination that we each have a magic number that dominates our lives, including a so-called "life path number" that can be arrived at by adding the numbers in one's birth date. Someone with a mind would have immediately asked, well, what about anyone born in Turkey prior to 1927, when the Gregorian calendar was introduced. Is their magic number calculated using the Julian calendar or the Gregorian one? Certainly one would have to ask whether, in China, where the Gregorian calendar is used for some purposes and the traditional Chinese calendar for others, which calendar one would use to calculate one's magic number. There are literally dozens of other calendars in use here on earth, each of which would reduce down to a different "magic number" for the same day. Which is the "real" magic number? What about people who are multicultural? Would a person here who's, say, part Jewish obtain his or her magic number using the Jewish calendar, or the Gregorian calendar?

I cannot believe that anyone who would put up with such nonsense--and who did not immediately ask the obvious questions--could possibly have an intellect exceeding that of a cucumber (cucumbers, please accept my apology for the comparison.) Oz might well be perfectly capable of stitching up a wound, and he might very well be a fine clinician, but he proves that his judgment is worthless. Oz does have a syndicated newspaper column, but it's in conjunction with another physician, and, from the relative sanity of the column, at least compared with the show, I suspect that he must not have much to do with it. If Oz stated that the sun rose in the east, I'd first look to the west, thinking that the earth must have mysteriously started rotating in the opposite direction while I was asleep. :)

#31 "Oh no, we’ve lost Dr. Oz to the Dark Side."

No. The Dark Side has lost Dr. Oz to the Darker Side. The Darkest Side is biding its time.

Wait a minute...
I thought that WE were the Dark Side.

Once the genetic predisposition puzzle resolves, thus providing accurate baseline information relating to the pediatric genome, this whole argument goes away. Well, maybe for the 65% that don't want to watch me stick a breathing tube in their baby so that the kid can possibly survive the respiratory problems coming from a preventable yet deadly infection. Maybe they survive, maybe, and only after everyone in the family goes through hell by watching a microbe rip a new ass in their little one. At least the parents can say the internet empowered their choice to get the ideal baby coffin.

@Denice Walter
I can't emphasize this enough:
I'm not talking about the loons in any of my 'PR' comments.

Any kind of persuasion campaign begins by identifying a target audience of people-who-don't-have-a-fixed-position-and-are-open-to-opinion-or-behavior-change. The odds of influencing the folks with a fixed-stance against you are so small you don't bother.

In this case, the fear of getting poked with sticks containing any foreign substance is far more primal and potent than fear of 'toxins', a rather abstract concept in comparison.

Now, the general public IS afraid of 'poisons' hidden in the products of industrial society, and rightly so: Love Canal, oil spills, etc. These are common enough that an awful lot of people have been exposed to them.

I grew up daily inhaling the fumes from the creosote plant that treated all the railroad ties used in the Upper Midwest. I didn't know that the creosote runoff was also polluting the water in the city wells. The plant closed in 1972, when I was a sophomore in college. In 1980 the grounds were designated the number 2 Superfund site in the US by the EPA. Later that year the Feds sued the plant's former owners in Federal Court under the Superfund Law, the first suit of that kind.

I relate this because I think my response to environmental or product-carried 'poisons' is fairly typical. There are just SO MANY potential man-made health concerns to residents of industrial society that they don't even get on my radar unless they pass a pretty high threshold of both seriousness and credibility. Even then, I'm likely to just give a so-it-goes shrug, as I have more pressing personal concerns on my mind, though I'm probably inclined to be more vigilant about those things down the road.

Being 60, I'd say I've encountered how enough people feel about these things to have a somewhat valid qualitative sample. I'd say the largest chunk of folks pay no attention to these issues whatsoever, followed by folks like me who have a passive interest in the Big Stuff, followed by folks who have latched onto one (and only one) specific more paranoid issue they talk about often but do little or nothing about, followed by a quite small group of single-issue activists, followed by a miniscule group of multi-issue activists (I've never actually met one of those in the flesh).

And by 'specific issue' I don't mean anything as broad as 'toxins' in general, but one particular 'toxin', say gluten in the current fad-o-sphere. I mean, mercury in fish is a Real Thing, yet the number of non-vegetarian folks who have removed fish from their diets is pretty small.

Anyway, the point is people who have the h3ll frightened out of them by ALL the alleged toxins are not the people we have to worry about in terms of public health issues.

There seems to be some good evidence that anti-immunization and anti-GMO activism correlate with economic privilege, which makes a lot of sense to me. Jo(e) Schmo's are wound up in their everyday lives of work and family responsibilities, and likely to spend their 'free time' on the entertainments of pop culture. They don't have TIME for this stuff. I don't know if there's any formal or even anecdotal study of the demographics of 'Thinking Moms' but I'd make a hypothesis that there's a high percentage of stay-at-home spouses in that group relying on their partners for income, with time available during the day to Follow and Tweet and Like and read AoA and post all over the web.

The audience that actually matters in terms of decision-making is WAY less involved. These are peripheral issues for them. They're not going to come here and read Orac's scientific analyses OR go to AoA and read Dan Olmstead's screeds.

That's why little things like a change in terminology can make a huge difference — those terms circulate where the broader discussion never penetrates. So again, I'll note how horribly counter-productive it is for pro-SBM spokespersons to employ the term 'herd immunity' in any public forum. I have noticed a couple references to 'community immunity' though, which is MUCH better, and hopefully will gain much wider usage.

Other silly comments like it’s ok to eat fish so thimerasol is safe is laughable. Something eaten has to pass through the digestive system and be filtered through the body whereas an injection of a neurotoxin such as thimerasol/mercury or aluminum can and does cause brain damage.

You lose. Ethylmercury has no access to the brain until it's complexed with cysteine in the liver, just like methylmercury.

Was this taped after the spanking Claire McCaskill gave Dr. Oz?

Yes. It was taped in late August, but before the whole "CDC whistleblower" manufactroversy was flared up by antivaccinationists. Otherwise, I'm sure Hyman or Kennedy would have mentioned something about the "senior CDC scientists who proved the CDC has been covering up" vaccine safety problems.

Orac, you might want to look into this:

You apparently didn't notice that I linked to that very article in the last paragraph. :-)

The Oz Show segment was taped on August 20th. Science blogger Keith Kloor has blogged about Kennedy's feeble attempts to market his warmed over theory about Thimerosal-induced-autism:

http://blogs.discovermagazine.com/collideascape/2014/08/20/robert-kenne…

What a sad, sad day for Kennedy's and Oz's fans. Oz will continue to push his particular brand of alternative medicine and Kennedy's next gig will be on the Autism Media Channel.

Oz has not only crossed the Woobicon, I think he's about to lap it.

Please don’t tell Jake**, we’ll lack entertainment for months.

It looks like after about a 10 day absence, Jake has returned to his blog. After Narad and some guy named Larry kept asking Jake about his opinion of Hooker's paper, Jake provides an in depth analysis.

http://www.autisminvestigated.com/biomed-central-brian-hooker/#comment-…

I suspect Jake's comment reflects his depth of understanding of either of the two papers.

Jesus, who let Crosby into an epi phd program again?

@ Johnny:

You know, I expected at least _a little more_-perhaps his professional explication of the secrets of the Dark Art of Statistical Analysis (tm) but alas!
No way, Jose,,, I mean Juan.

One of us should really grill him on that..erm... subgroup-ish thingy. You know. Whatamacallit's correction. Heh. Heh.
And OTHER stuff.

I'm amused, and very disappointed. I expected he'd at least try to appear scientific.....

Oz has not only crossed the Woobicon
Is this one of those rivers that you can only step in once?
Possibly I am getting confused with Empedocles who proved that you can only step in an active volcano once.

Oz has not only crossed the Woobicon, I think he’s about to lap it.

That conjures up an image of Oz on all fours lapping up those sweet woo-filled waters like a poochie. Seems about right!

I just had a nose around at Jake's blog, and the comments. White Rose is a barrel of laughs, isn't she? "The CDC = the Criminal Destruction of Children". If someone posted that here I would assume it was a Poe.

More seriously, the statistical analysis of DeStefano and Hooker that Liz linked to (thanks Liz!) is interesting, though there are no surprises. This passage, in my opinion, sums it up nicely:

Hooker has a small data set in which a known confounder (low birth weight) is over-represented. Other studies have estimated that low birth weights can increase the risk of autism by 5 times! Because Hooker’s analysis does not control for this factor, we must assume that the estimated risk of autism is positively biased for this group. In other words, the estimated relative risk of 3.36 is likely higher than the true amount.

A known serious confounder that was corrected for in De Stefano, but not in Hooker? That alone leads me to agree with Mr. Frost that, "Hooker’s results are both imprecise and biased [and] have no scientific value at all".

Oz and his wooligans crossing the woobicon...

I think it would be interesting if more of Orac's minions dropped by Jake's place from time to time as have L, R, N, P et al. If I do so, I'll probably have to utilise one of my _other_ names as Jake has already declared my commentary tainted and compromised or suchlike.

@ Chris Hickie:

I woo the day his wooligans cross the wooibon.

WOOBICON

Woo-begone? Isn't that in Minnesota someplace?

Woo-begone is the Nirvana we'd all like to attain, methinks... :)

@palindrom - I believe that's the part of Minnesota where all the children (or at least their parents) are below average

I would remind everyone that it was I who first asked whether Oz had crossed the Woobicon. I did it over four years ago:

http://scienceblogs.com/insolence/2010/03/02/dr-oz-has-crossed-the-rubi…

Orac @70 -- You certainly deserve a tip of the hat for that one!

A known serious confounder that was corrected for in De Stefano, but not in Hooker?

Ah, but Hooker has explained why his way is correct, and why "the final study protocol was not followed":

There was a sentence that said "the only variable available to be assessed as a potential confounder using the entire sample is child’s race."

Re. 'immunisation,' check, will update my usage accordingly.

I don't like needles either, but two seconds of minor 'ouchie' is a small price to pay for avoiding the risk of two weeks of misery.

Notice Dr. Oz's adoption of standard conspiracy theory language: 'The Truth About (whatever).' That kind of phrasing has become common in the conspiracy theory subcultures, to the point where rational people refer to CTers as 'Truthers.'

^ Sorry, I already did that.

Wow some people I had the flu shot twice my whole life that was the sickest I have ever been . Almost lost a child due to a vaccine. My children are able to fight things off themselves without chemicals and aborted fetus stem cells and other toxins in their bodies. And my children never get sick since we decided to stop vaccinating . I god didn't I tend for this junk to go into our bodies for a reason. He gave us immune systems for a reason and it doesn't matter if your name is in his book when its your time you will go either way I choose to let my family have the best life they can without being poisoned again. My son is nonverbal and autism from a vaccine a vaccine took things away from him that he shouldn't have had takin away. My choice is to let my kids live a life free from those toxins and free from the corruption that's behind it. Thompson clearly proved there is way to much corruption in the cdc

So e letters left out in my comment I'm not saying I'm god just to clarify that

About that screen grab. Thiomersal has never been in the MMR vaccine.

What were they thinking when they used that headline?

There is a ubiquity of woobiquity. Even my practice name, Cottonwood Pediatrics is not exempts. But cause to woorry?

We are not crazy anti- vaccine people. People have been going to court to speak out against vaccines that they claim injured their children . They are being heard loud and clear and it's just that the media has not been reporting on these cases. I worked for a pharmaceutical in the drug safety department and I saw cases of people who developed a reaction in their nervous system after receiving what you call a simple flu vaccine . Our department was responsible on reporting adverse events occurring after taking a vaccine like the flu one . There are so many ingredients beside Thermisol in vaccines that are proven to be toxic to the body - many are proven cancerous to lab animals . Please read and see all literature on studies and by doctors who are out about how vaccines are harmful . Just google search Dr. Tenpenny and Dr. Thompson - whistleblower of the CDC . There is a video out on the study done for the MMR vaccine that reveals there is high percentage that autism is associated with that vaccine in subjects . The results were misrepresented and now you have a doctor who wanted to be clean and reveal the study's true results . Parents with autistic kids are nerve system - injured kids are fighting to be heard in this county which accepts vaccines so readily when other countries in Europe and Japan do not even market them to their citizens . Read the unbiased literature on both studies . Read the literature from doctors on both sides and hopefully you'll see we're not quacks . We applaud Dr. oz for even looking into the side of anti- vaccine.

Ah, glimpses of woo-topia as seen through other people's websites...

At any rate, Dan ( @ AoA) discusses "Dr Bill's Alternative Vaccination Schedule" ( Bill Thompson, that is) who now joins acceptable one-name doctors like Oz and Bob ( and Andy) in contradistinction to "Doctors of Orthodoxy" Offit and Orac; Dr Jay, may be a "good guy" however he isn't properly worshipful of Andy amongst his other flaws.

Dan aspires to activism such as handing out brochures outside of places that offer vaccinations publicly.

Per the modeling used, I don’t see a problem with it.

That is very scary from a so-called epi PhD student (has he even passed his quals?). How can you so vehemently defend Hooker's rubbish of a study but not be able to comment on the robustness of the methods used? I think there is yet another uni who is going to have a notoriously embarrassing graduate.

Iknowbetter: "Almost lost a child due to a vaccine."

How did your claim with the NVICP go?

"And my children never get sick since we decided to stop vaccinating."

Please thank your responsible neighbors who vaccinate their families because they are protecting your kids by maintaining your community's immunity to diseases.

Badtz: "Please read and see all literature on studies and by doctors who are out about how vaccines are harmful . Just google search Dr. Tenpenny and Dr. Thompson – whistleblower of the CDC ".

No. You are making a claim, therefore you must provide the PubMed IDs to those studies.

"There is a video out on the study done for the MMR vaccine that reveals there is high percentage that autism is associated with that vaccine in subjects ."

Videos are not citations. Just provide us with the study's PMID.

@ Science Mom:

I am still trying to figure out how he has managed to inject his symptomatology ( for lack of a better term) into three reasonably reality-based institutions - actually acquiring 2 degrees in the process.

I work primarily with youngsters and adults who are EFL/ESL and attempting to get a decent standard degrees ( mostly in business and related) and *their* language skills, general level of comprehension and discourse literally runs circles about Jake's- in a good way, that is.

scratch that 'a'

"There are so many ingredients beside Thermisol in vaccines that are proven to be toxic to the body"

Ah yes, Thermisol - the active ingredient in Glade and Febreze. One squirt after an all-night fish fry and and everything smells like Shangri-La.

I just had a flashback to the foulest air freshener/sterilant of surfaces ever invented - Turgasept. It smelled like essence of dead anteater. Nothing could survive its presence. I think they used to spray it in bars at closing time to drive the patrons out.

"Crank scientific team"...

Okay Badtz,
No prodding you with rational questions to goad you into revealing your ignorance. I am calling you a troll and a liar right up front. You are barely able to string together a coherent sentence. I doubt you would have even been hired as a receptionist at the Big Pharma™ company you made up, let alone having worked in the "drug safety department" testing those vaccines, especially "the flue one." That's not how a scientist writes. When they talk about a drug, they go for the scientific name. They speak in specifics, not like a third grader describing a field trip. They do not misspell the name of the compound being discussed. If you're going to come sweeping in here with fables of your damaged child (now totally suspect) and for former life as a scientist, you're going to have to do much better than that. You may now take me to task for being mean and evil. Next troll please . . .

DG: Turgasept is very possibly the most unappetizing name for an air freshener in all of history. Your description of its ghastly scent has triggered memories of some ill-advised, youthful decisions made at closing times past . . .

I am still trying to figure out how he has managed to inject his symptomatology ( for lack of a better term) into three reasonably reality-based institutions – actually acquiring 2 degrees in the process.

I think it's a matter of taking our knowledge for granted; most don't bother themselves with anti-vaxx tosh so people like Jake would be unknown to them upon application. He's an attractive candidate because he can pay tuition in cash up front. It's not until he's there that some may realise it's too late. I am of the mind that if these institutions want to sell diplomas then it's a poor reflection on them. Where I take issue is the qualified (academically) student who has lost a seat in a programme because of entitled numpties like Jake.

He gave us immune systems for a reason

It's a terrible design. There's an excellent case to be made that we'd all be better off if the adaptive immune system never existed in the first place.

Pareidolius @87, to be fair to Badtz, directly quoting #79:

I worked for a pharmaceutical in the drug safety department

Badtz does not claim to be a scientist, nor elaborate on what position Badtz held in that “drug safety department.” As you note, Badtz does not write like a scientist (although I hope you’ll forgive me if I laugh at the idea that none of us misspell words!), and seems to revere those with the title “doctor” without understanding that Dr William Thompson has a PhD. Those aren’t the words of someone who has one (or aspires to it).

Badtz reads to me like a low level employee who got freaked out by working on only the adverse events, without ever putting them into the context of doses given. If all you see day in and day out is the bad stuff, what else is there? It seems to me that Badtz simply had no perspective.

https://www.facebook.com/notes/liz-ehret-re/vaccine-information-at-your…

Hear this well

http://vaxtruth.org/2014/09/hear-this-well-vaccines-do-cause-autism/

Badtz @79 my emphasis

We applaud Dr. oz for even looking into the side of anti- vaccine.

Why applaud? For even looking into ? Where have you been?

The antivaccine side has dominated the discussion for the better part of the last decade and a half. Your side has had its say. How is this applause-worthy? If anything, Dr Oz is attempting to resurrect a dead horse, since he has a guy named Kennedy riding on it.

Before you start talking about how safe vaccines are, please READ THE INSERTS. These are NOT benign products that are 100% guaranteed safe for everyone. These products are NOT guaranteed effective for everyone. They contain ingredients that according to government health agencies can cause cancer (formaldehyde) and brain damage (aluminum). The companies that manufacture vaccines have NO LIABILITY if a child or adult is harmed or killed by these products, which it states clearly on the inserts is distinctly possible for a “small number” of people. We make ZERO EFFORT to screen for children that WILL INEVITABLY be harmed by the vaccines, as is outlined in the adverse events section of the vaccine insert. Thousands of parents regret making this decision after witnessing the harm to their children, and then witnessing this harm be written off by medical professionals and unquestioning fanatics who are just *so sure* vaccines saved us all. The brain damage and death following vaccines is swept under the rug, and those who dare speak out are derided as “anti-vaccine kooks.” Um… hello? I used to be pro-vaccine. You can tell because I GOT MY CHILD VACCINATED AND ONLY STOPPED AFTER DAMAGE WAS DONE! No one told me that the harm we experienced was a possibility… only that they were safe, saved everyone, and were mandatory. I learned the hard way that it is a lie.

Do Not Place Your Trust In Someone Who Faces No Consequence For Being Wrong. Drug companies that manufacture vaccines, public health agencies that recommend and mandate them, doctors, nurses and pharmacists who inject vaccines … NONE of these people is liable if your family is harmed. People on the internet like the author who ignore my family’s experience and would compulsory continue to inject us with products that have ALREADY HARMED my family, also face no consequences for being wrong about vaccines being safe. Neither do I, for that matter. Trust NO ONE BUT YOURSELF.

Do thoughtful research on the Major Medical Decision that is vaccination. READ THE INSERTS… not the friendly little 1 page summary the doctor hands you, the 8-10 page 8pt font insert that describes the what the vaccine is, the ingredients, the studies done, what they know and don’t know about adverse events, long term effects, cancer causing effects, etc. RESEARCH THE INGREDIENTS FOR YOURSELF. Learn the difference between injection and ingestion. Learn the how the immune system is supposed to work (and pay attention to the fact that we do NOT make ANY antibodies AT ALL before the age of 12 mos, so all vaccines before then are patently unable to provoke an antibody response.) Do your own research on herd immunity and learn that it is an unproven theory, also known as marketing, and brilliant marketing at that. Learn about the decline of so-called “vaccine preventable” diseases, and how most of them were in total decline BEFORE the vaccines were introduced. Make sure you start your research prior to the year 1800, so you get a nice clear picture. Official statistics like to start in then 1960’s or so, aftre 90% of the declines had already taken place. LEARN FOR YOURSELF AND MAKE YOUR OWN DECISION.

Do not just follow the herd and damage your own child. You are NOT a sheep. Don’t act like one.

...pay attention to the fact that we do NOT make ANY antibodies AT ALL before the age of 12 mos...

Well, that's new, at least for me. Everything else in that rant was the same old stuff. Anybody have any idea where this silly thing was spawned?

Well, that’s new, at least for me. Everything else in that rant was the same old stuff. Anybody have any idea where this silly thing was spawned?

These are the people making medical decisions for their children...sigh.

aphoenix,

Before you start talking about how safe vaccines are, please READ THE INSERTS. These are NOT benign products that are 100% guaranteed safe for everyone. These products are NOT guaranteed effective for everyone. They contain ingredients that according to government health agencies can cause cancer (formaldehyde)

Has no one ever pointed out to you that we all constantly produce and metabolize large amounts of formaldehyde? One study "calculated that the daily turnover of formaldehyde would be 31-59 g/day", mostly from the breakdown of methylated amino acids and methanol in our diets.

Many foods naturally contain formaldehyde such as apples which contain up to 22.3 mg/kg, pears up to 60 mg/kg and dried shiitake mushrooms with up to 406 mg/kg.

How can the presence of a maximum of 0.1 milligrams of formaldehyde in a vaccine shot possibly be harmful, when we are all producing thousands of times as much, and ingesting hundreds of times as much in our food each and every day? Why is the mother who happily lets her child drink 250 ml of orange juice which contains 105 mg of formaldehyde concerned about a vaccine that contains 0.1 mg? Is that rational?

@ Science Mom:

Actually I wonder how he got through the prerequisites FOR university study. I mean basic sciences, mathematics, testing.

"These are NOT benign products that are 100% guaranteed safe for everyone. These products are NOT guaranteed effective for everyone."

Really? All the inserts on my prescription and OTC drugs have that 100% guarantee. Why are vaccines different?

Orac should do an article on this.

aphoenix,

Do your own research

Like your research on formaldehyde?

on herd immunity and learn that it is an unproven theory, also known as marketing, and brilliant marketing at that.

Herd immunity isn't a theory, it's a natural phenomenon; there is no question that it is real. If I have measles and I'm in a room with ten people who have never had or been vaccinated against measles, they will very likely catch it and spread it to others. If I have measles and I'm in a room with ten people who are immune to measles (whether through getting measles or through vaccination), none of them will catch it and spread it to others. What part of that is theoretical? Surely the 99% fall in measles incidence in every country where routine vaccination has been introduced must tell you something.

Learn about the decline of so-called “vaccine preventable” diseases, and how most of them were in total decline BEFORE the vaccines were introduced.

I'm so tired of reading this nonsense. The diseases we vaccinate against are precisely those that were not eliminated through the provision of clean water, effective sewerage systems and antibiotics. Air-borne diseases like measles were not in decline before vaccination. Look at chicken pox, which is still endemic in the UK where it is not on the vaccination schedule, but incidence has dramatically fallen in the US where it is vaccinated against.

Make sure you start your research prior to the year 1800, so you get a nice clear picture.

A picture completely distorted by the lack of modern medical care and even basic hygiene?

Official statistics like to start in then 1960’s or so, aftre 90% of the declines had already taken place.

Do you really want to go back to 1960 when almost 3 in 100 children died before their first birthday? When infant mortality was 4 times higher than than it is today, when an average of 450 children died in the US from measles, and 48,000 people were hospitalized every year?

LEARN FOR YOURSELF AND MAKE YOUR OWN DECISION.

Judging by the serious errors in your comment here, I suggest you leave the research to the experts.

Do not just follow the herd and damage your own child.

By not vaccinating your child you are greatly increasing their risk of serious illness, permanent injury and death. There is no doubt about this, just look at the number of children who have died of whooping cough in recent years on the US, deaths that could very likely have been prevented if everyone who came into contact with those children had been vaccinated. How many children have vaccines killed recently?

You are NOT a sheep. Don’t act like one.

Can't you see that by parroting nonsense you have read on some anti-immunization site, without even bothering to check it is accurate, you are behaving like a sheep yourself?

Re #92, 93, & 95:

Probably time to invoke Pablo's Law:

What is Pablo's First Law of Internet Discussion?

Regardless of the topic, assume someone else commenting knows more about it than you do.

I worked for a pharmaceutical in the drug safety department

I too have worked as a guineapig.

…pay attention to the fact that we do NOT make ANY antibodies AT ALL before the age of 12 mos…

This is an article of faith in the chiropractic community.

It is so easy to disprove the no/little immune response before [6/12/24] months of age, I have no idea why the myth persists.

Plus--I mean, common sense? No antibody production would mean a dead baby almost immediately.

I found, if not the source, at least a source for the silly statement I quoted above.

http://gaetacommunications.com/site/?p=1092

Later that day, I sat on a panel of four experts to answer questions from conference attendees. Many of the questions were directed at the PhD immunologist on the panel, asking if the statements I had made in the morning presentation were true. To my surprise, the immunologist confirmed every assertion I had made.

The first was that it is pointless to administer drugs intended to stimulate antibody production to babies who are too young to produce antibodies. Infants in their first year mostly depend on generalized, non-specific immunity, including (hopefully) immunoglobulins from breast milk, to protect their young bodies from infection. They do not produce antibodies of their own until about age one. Despite this basic fact, the medical establishment insists administering a total of 19 shots, containing 24 vaccines, to infants on the 2, 4 and 6 month pediatric visits (Source: cdc.gov). Somehow, the basic facts of human physiology and development do not apply to vaccines.

And who is this guy?

Michael Gaeta, DAc, MS, CDN, is a visionary educator, clinician, writer and publisher in the field of natural healthcare. He offers trainings, patient care and learning programs to create a world of resilient, vital people who make a difference through positive contribution. Michael has distinguished himself in the areas of wholistic health, teaching, writing and music. Michael holds New York licenses in acupuncture, dietetics-nutrition and massage therapy, a Colorado license in acupuncture, and is a Doctor of Acupuncture in Rhode Island.

A new loon that doesn't appear to have graced this blog.

I still can't get over the 65% ship of fools poll.

aphoenix: "These are NOT benign products that are 100% guaranteed safe for everyone."

Are measles and mumps 100% guaranteed safe for everyone?

"Learn about the decline of so-called “vaccine preventable” diseases, and how most of them were in total decline BEFORE the vaccines were introduced."

Really? Wow. The following is US Census data from the 20th century showing measles incidence. Can you please tell why measles dropped 90% in the USA between 1960 and 1970? Please do not mention any other decade, any other country and definitely do not mention "deaths." Please show that you know the difference between morbidity (incidence) and mortality (deaths).

From http://www.census.gov/prod/99pubs/99statab/sec31.pdf
Year.... Rate per 100000 of measles
1912 . . . 310.0
1920 . . . 480.5
1925 . . . 194.3
1930 . . . 340.8
1935 . . . 584.6
1940 . . . 220.7
1945 . . . 110.2
1950 . . . 210.1
1955 . . . 337.9
1960 . . . 245.4
1965 . . . 135.1
1970 . . . . 23.2
1975 . . . . 11.3
1980 . . . . . 5.9
1985 . . . . . 1.2
1990 . . . . .11.2
1991 . . . . . .3.8
1992 . . . . . .0.9
1993 . . . . . .0.1
1994 . . . . . .0.4
1995 . . . . . .0.1
1996 . . . . . .0.2
1997 . . . . . . 0.1

Felicia Stanford, you must be new here. Why should we care about those websites? Though the second one has been mentioned on this blog:
http://scienceblogs.com/insolence/2012/06/08/a-misguided-chalkboard-tal…

Perhaps in the future you could grace us with some actual scientific evidence and not random websites.

aphoenix

We make ZERO EFFORT to screen for children that WILL INEVITABLY be harmed by the vaccines, as is outlined in the adverse events section of the vaccine insert.

How would you, aphoenix, propose we do this?

Please do share – I am interested in your thoughts on this.

What I’m thinking is that first we have to establish the frequency with which each adverse event occurs. I’m not sure you’ll find this in those package inserts, since what I recall from the ones I’ve read for other medications they include long lists of just about everything, without numbers. We need to calculate the event rates relative to the total doses given or relative to total recipients. It’s probably worth determining both of those things, to determine if the same adverse event will always recur for a particular individual, or if it was a chance occurrence the first time.

Then we have to decide which events should be studied, in order to focus limited research dollars where they might provide the most benefit. Do you want to do the more frequent ones that may be less serious, or the extremely rare but life threatening first?

I personally would like to see this line of research explored. I’d like to see followup on individuals who suffered adverse effects, and their families. Have other family members suffered similar events? Before that individual’s, or after? Can someone please track this kind of information and make it public?

But I don’t even know how to get the wheels moving on this. Who would pay for this research, and who would participate in the studies?

This is where I lay blame on the Wakefield-Jenny McCarthyites, the Mercury Militia, and their vaccines- cause-autism crowd. They’re taking away both media attention and funding to purse fantasy hypotheses, and they have not accepted that the science does not support them because they don’t understand the science. And they’ve amplified their fears to the point that regular parents have a hard time making a rational risk assessment regarding vaccines.

And that leaves those of who have observed actual adverse events following a vaccination out in the cold.

I don’t know your whole story, aphoenix. I don’t know what happened to your child since you have not shared it, nor if your child’s suffering is ongoing. You are under no obligation to share more than you’d like.

But I beg you, if you are not one of those misguided vaccine-blaming autism parents, please stop regurgitating their talking points. Distance yourself from that fear-mongering crowd, learn some more about science (from professors and textbooks, not websites) and about study design, and lend your voice where it belongs: asking for more expert attention to actual adverse events.

Well, Chemmomo, Badtz was evidently a drive-by, so I'm figuring I was right. Maybe they'll return to make me eat my words with some citations to back up their claims, or at least use some grammar that indicate they are who they claim to be, but don't hold your breath. I can't argue from authority as a scientist, but I'm an advertising creative director, and that gives me a Ph.D. in B.S.

Compelling vaccination plea in today's Los Angeles Times:

http://www.latimes.com/opinion/op-ed/la-oe-harmon-measles-encephalitis-…

"We make ZERO EFFORT to screen for children that WILL INEVITABLY be harmed by the vaccines, as is outlined in the adverse events section of the vaccine insert."

Not true.

http://www.immunize.org/catg.d/p4060.pdf

@ Ernie Gordon: An older cousin was left with permanent neurological sequelae, due to measles encephalitis and a childhood friend succumbed to polio, before vaccines were developed to protect children from these serious, sometimes deadly, vaccine preventable diseases.

A new loon that doesn’t appear to have graced this blog.
Loon or unscrupulous grifter? Hard to decide, I know.

Pareidolius @110
Oh, I agree Badtz is a troll. But it seems Badtz is a fairly creative troll, in that you inferred a position of responsibility from that post (unless you refer to another I missed). And Badtz does spell really well, although punctuation and sentence construction leave a lot to be desired. Is this someone who is desperately trying to be viewed as well informed, or well constructed Poe?

lilady – interesting link #112. That checklist came from Minnesota, and it’s dated May 2014. I wonder how many other areas have something similar?

For what it’s worth, when we go to the pediatrician in CA, question #2 (allergies) is checked at every visit whether there will be vaccines given or not.

And we have had personal experience with discussions about both questions 1 and 3, without any prompting from checklists. I suppose if I had to switch to a new practice, I’d find filling out the checklist reassuring – but on the other hand there’s no way I’d leave out important parts of my children’s medical history regardless.

I'm sorry. I try to read some of the comments above, but I give up as soon as the capitalized letters come around. It's a clear sign that the writer is misinformed. The best way to emphasize a statement is to bold it or underline it. If you don't know the html code for that, then you shouldn't be on the internets. That's the truth.

Chemmomo: I provided a general checklist from the IAC (Immunization Action Coalition) which is based in Minnesota:

http://www.immunize.org/

Here's another list of "Contraindications" and "Precautions" to administering childhood vaccines, from the CDC:

http://www.cdc.gov/vaccines/recs/vac-admin/contraindications-vacc.htm

sadmar @#50:

"Community immunity." I kinda like that phrase. It's catchy, not least because it rhymes. I do hope it catches on.

Why do the anti-vaccine brigade persist with this nonsense about formaldehyde in vaccines being carcinogenic? I would have thought that once someone has pointed out to them that the maximum 0.1 milligrams found in a vaccine is a drop in the ocean compared to the 100 milligrams in a glass or orange juice (or as Oxford University puts it: "A pear contains around 50 times more formaldehyde than is found in any vaccine"), or the 30,000 or more milligrams our bodies deal with quite happily every day, they would never make the same claim again. I would be embarrassed to repeat an obvious falsehood like that.

Or do they not believe our bodies produce it, and that it is in many things we eat and drink? It would require an extraordinary international conspiracy to make it falsely appear as if this is the case. Very few people are going to buy that.

I don't get it.

lilady, to clarify:
I’ve never seen that form from IAC before, and it’s dated May 2014. Do you know where if anywhere it is in fact in use at pediatric offices?

It brings to mind new intake forms I’ve filled out for specialists and the forms required for radiology – a way of making sure you have given your medical provider the information they need to give you appropriate care.

I was not given one at the most recent pediatric appointment including vaccines for my own children, which was just a few weeks ago. On the other hand, my children have had the same pediatrician their whole lives, and the office is well familiar with their medical histories. And that office was proactive with the care we were just provided.

I don’t know that filling out this form is the type of screening aphoenix is looking for. From reading that post (#95), aphoenix wants someone to have gone back in time and issued stronger warnings that an adverse event might occur before the vaccine was administered in the first place, and also find ways of predicting which children might be more likely to suffer from them. Some of those answers may be found through research, but that will take time.

On that point, and with my own biases, I agree. I think we need more information about the likelihood of repeat adverse events both for individuals and within families, in order for us to assess better the risks vs benefits.

Personally, I don’t need to fill out another form in the waiting room, unless it’s going to get included in a study linked to outcomes.

Chemmomo: "aphoenix's" comment was very vague and aphoenix claimed that her/his child was harmed by a vaccine, because the doctor or nurse who administered the vaccine, did not check the contraindications as contained in the "vaccine insert".

Doctors in private practice either administer vaccines or write an order for their nurse to administer the vaccine...and they do follow the recommendations, contraindications and precautions for every vaccine, as contained in the CDC Pink Book and the AAP Red Book...which are based on the current ACIP Guidelines:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm

General Recommendations on Immunization: Rcommendations of the Advisory Committee on Immunization Practices (ACIP)

lilady: "Chemmomo: “aphoenix’s” comment was very vague and aphoenix claimed that her/his child was harmed by a vaccine, because the doctor or nurse who administered the vaccine, did not check the contraindications as contained in the “vaccine insert”."

Sometimes I find it ironic that someone telling us to read the vaccine insert and then claims their child was injured by a vaccine. When we ask them about their claim to the NVICP, they claim they never knew about.

Ironic how they tell everyone to read the vaccine inserts, but ignore the Vaccine Information Sheets with info on both VAERS and NVICP.

@ Chris: It's a common tactic of the anti vaccine group to shout "READ THE VACCINE INSERT" and then fail to tell us which specific vaccine's insert they are referring to.

There's a persistent pest who goes on marathon commenting jags, who claims her child had an "encephalitic cry" as a newborn following a hepatitis B vaccine, yet she never took that child to a hospital emergency room for an evaluation. She also claims she was unaware of the information contained on every VIS sheet about the VAERS and NVICP.

Antivax logic fail # 39692:
Do not trust Big Pharma
Do not trust the CDC
Do not trust the FDA
They are liars and deceivers

Except when listing side effects and vaccine ingredients on package inserts.
These are flawless and perfect.

@ janerella: I'm biding my time, awaiting the return of "aphoenix" to post another comment about those mysterious contraindications for a specific vaccine, that supposedly caused her/his child's "vaccine injury".

I believe that "aphoenix" is referring to one of the two vaccines that are being bandied about the anti-vaccine groupies. If "aphoenix" returns, I expect some specifics, so that I can explain to that person the major difference between Contraindications/Precautions which are listed by the vaccine manufacturer and the unsubstantiated reports of bizarre reactions reported on the VAERS by parents.

Stay tuned.

I lost the comment # way back, but it was with regards to methylmercury vs thimerosal and why the AV camp doesn't fight against fish like they do the flu shot.

It's because of their mantra "Ingestion is not injection!!Eleventyone!!!"

Of course, since their understanding of pharmacokinetics is essentially zero, they don't understand how efficiently our bodies sorb methylmercury from our diets - nearly 100%, which makes our diet the more worrying source of 'mercury toxins'.

You know, I expected at least _a little more_-perhaps his professional explication of the secrets of the Dark Art of Statistical Analysis ™ but alas!

Ask and ye shall receive.

After 'Larry' challenges Jake to "post up his examination of the statistics behind the two studies in question", and links to a takedown of Hooker's paper, Jake responds.

http://www.autisminvestigated.com/biomed-central-brian-hooker/#comment-…

First, he expertly disposes of the criticism of Hooker's paper -

...the blog you linked to is the corporate blog of a company that serves pharma...

Yeah. A company that sells software to thousands of companies around the world is in the pocket of a single industry.

I've used Minitab. I've never been near a Phara facility or company. While the companies I worked for may have had a Pharma contract somewhere along the way, I never heard of one. But you almost can't take a SixSigma class without Minitab. I'd bet almost every company that is even slightly involved with manufacturing uses Minitab. Minitab is everywhere.

Take a look at -
http://www.minitab.com/en-us/company/case-studies/

Then Jake goes on to give an expert analysis of Hooker's results -

And while you repeat the oft-cited talking point that the data was simply “tortured,” don’t forget that the results found in Dr. Hooker’s paper were also found by the CDC researchers who the whistleblower said omitted the data from their paper.

Yep. Thompson told Hooker where to look, and Hooker found what Thompson said was there. Therefore, Hooker's work is correct. After all, it's the same as the CDC results.

Ya can't argue with science like that. And science like that is what Jake brings to the party.

I think Jake knows Hooker's paper is silly. But Jake is rapidly running out of friends. He's alienated AoA, the CP, and "Doctor" Wakefield and associated fans. If he says what (I hope) he truly feels about the "science" Hooker spouted, he'll run off even more.

@ Johnny:

Oh, I know: I saw it earlier.
I think you're correct about Jake: his writing was always about acquiring admirers and placing himself above the crowd of anti-vax believers- in other words, a means of gaining self-esteem but not in the usual manner of study and gaining esperience in the real world which involves occupational skills that agencies and businesses need.
He'll have degrees that will not get him a position like Ren or other epis.

I think that he needs other things than degrees and a blog but I'll leave it to my fellow and sister minions to fill in the blanks about that!

"Do Not Place Your Trust In Someone Who Faces No Consequence For Being Wrong"

Aphoenix - thank you for volunteering to pay for all the costs of measles-related encephalopathy for children whose parents follow your advice. You must have deep, deep pockets. Please provide your real name, address and bank information - or are you one of those people who I shouldn't trust, since you refuse to face the consequences for being wrong?

And while you repeat the oft-cited talking point that the data was simply “tortured,” don’t forget that the results found in Dr. Hooker’s paper were also found by the CDC researchers who the whistleblower said omitted the data from their paper.

He really doesn't know what he's talking about. The same results weren't found and omitted. They controlled for known risk factors which they didn't have information for on the first go 'round. If Jake doesn't understand how studies are done, he's screwed on yet another level.

As an aside, I am getting a "duplicate" message from WP for a comment that won't go through and only had one link.

For those who only know ‘The Wizard of Oz’ from the movie, the original book by L. Frank Baum is a Populist allegory

No it's not.

Off-topic, but I'm fried from travel yet feel the need to share.

I thought I'd settle in with a look at whether Vincent Racaniello had written anything new. I was in luck.

I was also reminded, though, that one of D'Ohlmsed's recent catastrophic attempts at a Thought for the Day blurb mentioned enterovirus 68, although I didn't bother looking at what followed after it overran its little front-page space. Behold this:

Enterovirus 68: Let's remember this virus was mentioned in connection with the cases of sudden paralysis in California children last year, which we speculated might involve a co-factor such as pesticide exposure, like the polio epidemics ... It appears to affect those with asthma the worst. And why do so many kids have asthma? Postponing the DTaP shot by a couple of months lowers the risk of asthma. Just for instance. But they'd rather talk vaccines against Enterovirus 68.

-0-

Yes, it's news that a respiratory virus causes more severe problems for asthmatics.

^ But, hey, at least somebody added the same thing to the W—pedia page.

Make sure you start your research prior to the year 1800, so you get a nice clear picture.

A picture completely distorted by the lack of modern medical care and even basic hygiene?

Also, a bit before 1800, most European countries were sort of busy with either unrest, civil war, or dealing with this pesky French freedom fighters (sorry, I mean regicidal loons). And after 1800, the French again, this time with a little Corsican lieutenant pushing them around.
At that time, there was a hiatus in medical training in France. The existing medical schools had a shortage of their usual upper-class students. The health sector was not exactly a priority for the politicos. Napoleon had to do the same thing Chairman Mao did later: hire as physician anyone claiming to be able to cure warts. Hardly helped to reduce the casualty count on battlefields.
Don't know about the US, although I believe Dr Quinn came by after the Civil War.
On the plus side, we French were good at counting chopped heads, but that's about if, statistically-wise.

@Johnny

Minitab is also used at a number of Universities - it's very handy, what with the ability to block for confounders, etc. I have a student version still running back from my M.Sc days.

@Helianthus,

The late 18th and early 19th century certainly had health problems. But, the modern practice of triage really began with French military surgeons during those wars.
http://en.wikipedia.org/wiki/Dominique_Jean_Larrey

We use Minitab at my company as well for statistical analysis of our engineering metrics. We make computers for aircraft and spacecraft, and have absolutely zero medical connections.

Make sure you start your research prior to the year 1800, so you get a nice clear picture.

Only in the upside-down fantasy world of antivaxers does using 200-year-old data so full of confounders that it's more noise than signal give a clearer picture than looking at incidence in the years immediately preceeding and immediately following the licensure of a new vaccine. Of course, that's because their definition of "clearer" is "supports my forgone conclusion."

I wonder if the attraction of 200 year old data is because things were simpler then. People got better or they died, and medical intervention was usually not a factor.

Off-topic, but could somebody with Tricare experience confirm whether this remark bears any relationship to reality? It would have been less than 15 years ago, and it's being used to bolster a weird-ass claim that somebody broke into Ealey's apartment and stole nothing but medical records that exist in no other form anywhere else.

^ "just less than 15"

@ Narad:

Right. I read that- it would appear that black-ops are PharmaCom's preferred mode of squelching vaccine claims these days.
I think that these people read too mcuh pulp fiction- a few even write their own.

typo MUCH? Fer sure.

#79: I worked for a pharmaceutical in the drug safety department

I know some people complain about their bosses being a pill, but that's just taking it too far...

"a weird-ass claim that somebody broke into Ealey’s apartment and stole nothing but medical records that exist in no other form anywhere else."

Claims that Big Pharma/the government/FDA/Illuminati have stolen treatment records are a staple of altie conspiracy theory (Royal Rife, inventor of the fabulous Rife machine is one of those supposedly victimized by having his life's work confiscated by sinister operatives).

So I'd take such claims with a whole heaping pile of salt.

What with our medical records increasingly ending up online, black operatives need to master skills in crashing computers and destroying servers in order to conceal evidence.

So I’d take such claims with a whole heaping pile of salt.

No, the burglary story I consider to be nonsense on its face. I was curious about the plausibility of the Tricare part, and Shay's leaving a comment prompted me to toss the question out.

About the records, I retired from the Air Force about 20 years ago. At that time, medical records were one (or more) of those bulky, multi-divider folders with the metal folds on the top to slip the pages over. When you transferred from one base to another, you collected your records in a sealed envelope and turned them into the hospital when you processed in at your next assignment.

When I retired, I asked for and received a complete copy which is buried away in my files some where.

The original may still be at the local base, but I understand master copies are (or were) stored in St Louis.

By the time the records were lost, the kid was at least 6 years old. I don't know why they were hauling records back and forth from New Orleans to Houston.

I wasn't using the base hospital system during this time frame, so I'm not sure where they were in the process of transitioning to computerized records.

As for stealing the medical records, I've read that medical insurance billing information like a Medicare or insurance plan number is more valuable on the black market than ID info like a SSN because you use it generate phony bills and get reimbursed without the owner being aware of it.

I would think an ordinary burglar would look for something easier to fence, though.

I noticed Olmsted's interview with Ealey earlier today. Dan's struggling to find an African-American anti-vaccine mommy to prop up the "CDC Whistleblower" story...which has been totally debunked by Orac and other science bloggers.

Sheila Ealey claims only her child's medical records (including vaccination records) were stolen. She had ample time to get copies of her child's medical records, when she instituted a claim for her child's "vaccine injury" in the United States Court of Federal Claims and ample time to produce an expert witness in the intervening years...before her claim on behalf of her child's vaccine-induced-autism...was dismissed by the Special Master:

http://www.cofc.uscourts.gov/sites/default/files/opinions/HASTINGS.EALE…

So, she actually filed her claim with the NVICP two years before the records were stolen. IANAL, but I would think her lawyer would have gotten a certified copy of those records at about that time, since they were likely to be an important piece of evidence in her case.

A burglar ate my homework!

I don't know about Tricare, but active duty folks did used to have to schlepp our medical records with us when we PCS'd. I don't see how dependent records would have been any different.

The burglar took only my child's records part doesn't ring true, though.

I don’t know about Tricare, but active duty folks did used to have to schlepp our medical records with us when we PCS’d.

This I can readily believe; it's the part where the military wouldn't keep a copy of its own that was straining my credulity, on top of the Plumbers.

So, she actually filed her claim with the NVICP two years before the records were stolen. IANAL, but I would think her lawyer would have gotten a certified copy of those records at about that time, since they were likely to be an important piece of evidence in her case.

As the dismissal provided by lilady indicates, Ealey failed to prosecute the case, so it seems likely that there was no lawyer to start with.

^ Sorry, I was just coming to after a nap. I doubt that production of medical records would have been necessary to be included within the Omnibus proceedings.

OK, I was both mistaken and not mistaken. The (obviously incomplete) docket is here.

Thanks Narad. What's with the musical attorneys?

Complete docket.

Ealey's statement still doesn't make sense.

The twins were born summer 1999 and her "vaccine injured" autistic child received two MMR vaccines, HiB vaccine and DTaP vaccine on his mother's birthday on August 2, 2000 at "almost 13 months old".

"Sheila: It was August 2, 2000 – my birthday – and Temple and Lucinda were almost 13 months"

"Lucinda can manage to get herself out of the triple stroller, she did not want the injection, and she was fighting tooth and nail not to have it. I looked down for just a moment -- the nurse had all the vaccinations lined up. She had the HIB, the DTaP and the MMR for each child. When I looked up after taking her twin sister up, she had given Temple both of the MMRs along with the DTaP and the HIB. The next morning, he was not responsive anymore. It took me until he was 18 months to get a finished diagnosis of autism for him."

The claim for her autistic child's "vaccine injury" was filed January 1, 2003.

Ealey and her family fled New Orleans to go to Houston because of Hurricane Katrina, a category 3 hurricane which made landfall August 29, 2005.

Ealey had all the medical records with her when she fled Louisiana for Houston and when she returned to Louisiana on an unknown date (sometime after the 2006 Autism One Conference), only the child's medical records were stolen from her apartment. AT LEAST 3 YEARS AFTER SHE FIRST FILED HER CLAIM ON BEHALF OF HER AUTISTIC CHILD'S VACCINE INJURIES.

"Let me tell you what else happened to me, Dan. After I went to Autism One, I was still living in Houston because we had lost everything to Katrina, but I had his records with me where the doctor had said that he had gotten a double dose of the MMR, and that they should call Merck, and Merck said he doesn’t need to be vaccinated for the MMR anymore.

We came home to New Orleans and we left those records locked up in the apartment. Someone went into our apartment and stole his records. They didn’t take anything but his record.

Dan: Oh Lord.

Sheila: Temple's records were stolen from our apartment. My partner in the school is a lawyer who worked at the time for [a new Orleans law firm]. When she returned in October of '05, by spring of '06 they fired her because they were representing Merck against me. Thanks to Congress, my case was thrown out. I also filed with the vaccine injury program and they dismissed my case because they said I needed a doctor who could without a doubt state that Temple was damaged due to the double dose of the MMR."

Ealey’s statement still doesn’t make sense.

You obviously have more patience than I do. Or D'Ohlmsted, who missed this:

"When I looked up after taking her twin sister up, she had given Temple both of the MMRs along with the DTaP and the HIB."

I also filed with the vaccine injury program and they dismissed my case because they said I needed a doctor who could without a doubt state that Temple was damaged due to the double dose of the MMR.

Or, as the docket puts it:

ORDER: Petitioner shall fiel, within 90 days of the date of this Order, the report of a reliable medical experet stating the opinion that Temple suffers from an injury that was caused by one or more specific vaccinations.

That's not a very burdensome demand to make of someone who's seeking compensation for a vaccine injury.

They seem to have had a little trouble getting their request for medical records heeded as well. But fwiw, at least some medical records were e-filed in 2008.

My partner in the school is a lawyer who worked at the time for [a new Orleans law firm]. When she returned in October of ’05, by spring of ’06 they fired her because they were representing Merck against me.

Does anybody know where this (presumably) state lawsuit is? The story makes no sense whatever without an extreme version of the Chinese Wall approach to potential in-house COIs.

Narad, I think Ms. Ealey is quite confused.

Why would Merck being suing Ms. Ealey?

Why would Merck being suing Ms. Ealey?

I think "against me" is just a description of the usual adversarial process, so it doesn't matter who's suing whom. I still have no idea what the hell she's referring to, though.

So, anti-vaxers can't use photocopiers? I see.

This is Ms. Ealey"s "partner" and co-founder of the school for special needs children, located in New Orleans:

http://www.clcofla.org/#!admissions/c1ylq

If it is a special school and chartered by the State of Louisiana Education Department, why are they charging parents $ 10,000 annual tuition, plus additional fees for therapies?

My son went to a part time infant stimulation program when he was 14 months old through a petition in Family Court. At age three he was enrolled in another special school preschool program, with transportation/aide aboard a wheelchair mini school bus. There was also an 8 week summer program run by that same special school. All the costs associated with all the programs he attended, were paid for by my school district/State Special Education funds until he "aged out" at age 21.

What’s with the musical attorneys?

It's not a good sign when a lawyer quits in exasperation at the glacial pace of the proceedings.

re 'musical attorneys'

On a related note, it seems that the Think Tank surrounding the whistleblower is considering legal action-
on Sunday's Talkback @ PRN, Grandmeister Woo anounced that concerned parties might sue the government / initiate a class action suit-
which he probably thinks are the same thing ( the last 10 minutes of the show IIRC).

If you contemplate those involved recently, you can imagine quite a scene:
Hooker, Thompson, Andy, Farber,Jake, Barry AND these woo-meisters know interesting attorneys like Emord, Fucetola, both Robert K's et al

t seems that the Think Tank surrounding the whistleblower is considering legal action-

Who could have predicted?

/sarcasm.

Do you mean Taxpayers Against Fraud? BTW?

@lilady,

Thanks for the summary.

@Narad,

Good catch. I missed that too.

Does the MMR cause a sex change?

The high-dudgeon condescension the self-appointed “anti-quackery” contingent effects wins over as many converts as the similar-sounding anti-religion atheists convince church-goers to renounce their God. A calmer, reasoned tone would stand a far better chance of causing people to listen to you—that is, if you’re really interested in convincing anyone of anything other than your innate sense of superiority.

We aren't interested in "converting" people who are already antivaccine. The chances of converting people like the bloggers at Age of Autism (for example) is slim to none, no matter how "nice" we try to be. We are interested in preventing those who are "on the fence" from falling prey to the lies promulgated by people like RFK, Jr. and Mark Hyman and becoming antivaccine themselves.

@richard

Did you even read the title of the blog? Also, tone troll much?

@ Richard Handal: How about providing your opinion about Robert Kennedy's book and his appearance on the Dr. Oz Show?

How about providing your opinion about Dan Olmsted's interview with Sheila Ealey? Do try to be specific about that interview, by answering the unanswered (and puzzling) questions we have, about the immunizations her autistic child received at 13 months old, the supposed theft of the child's medical records (more than three years after she filed a claim for his supposed "vaccine injuries" with the Vaccine Court), and the lack of compliance with multiple requests from the Special Master for vaccine records, medical records and an expert witness willing to testify on behalf of Ms. Ealey's claim that her child's autism was caused by vaccines?

Ms. Ealey's claim that African-Americans are ignored by the CDC and other government agencies reeks of rank race baiting.

You do know, don't you, that the Vaccine Court is not a social welfare program?

To reiterate what Orac stated...I don't post comments on this blog or the many other science blogs where I post comments, in order to reach out to the hard core anti-vaxxers.

When you are ready to provide some specifics, I'll be here.

The high-dudgeon condescension the self-appointed “anti-quackery” contingent effects

Just put down the thesaurus before you hurt yourself.

In other news, D'Ohlmsted is still bitching about the Unfairness of It All:

Obama to Atlanta to announce Ebola initiative in West Africa? How about Obama to Atlanta to clean house and begin to uncover the truth about the autism epidemic weakining our national security right here at home?

-0-

In other news, D’Ohlmsted is still bitching about the Unfairness of It All:

Jeebus they're clueless and self-absorbed. There is no whistleblower or omitted data or fraud or ZOMG Dangerz to the little childrenz. Hell even Al Sharpton can't be arsed to worry about this. And not for the lack of trying by the Thunking Moms and Olmsted.

Maybe somebody could get Stephanie Seneff on the blower to use her mad curve-fitting skillz on this one. This bit is all too redolent of the fundamental AoA goal mindset:

Infected individuals’ movement patterns, social interactions, beliefs about disease causation and trust in authorities can all influence the extent of transmission, and hence the scale of control measures required to stop the infection.

Good cripes, Omsted and the AoA crowd is worried about Obama's non response to amalgam fillings and Alzheimer Disease....caused by teh ebil Thimerosal:

http://www.reuters.com/article/2014/09/16/us-health-ebola-obama-idUSKBN…

Well, they're not nearly as offensive as the commenters asking what good the military can possibly do against Ebola (field medical operations and logistics, people, both capabilities the Army has lots of experience with).

CDC Flying Squad and U.S. Military resources, supplies and know how?

The best in the business for setting up field hospitals during an outbreak.

Lilady: Further down, or up the thread, there's a suggestion that enterovirus was caused by-what else- vaccines? How do these people ever get through a day; they don't understand how anything works! Let alone viruses.

And I borked the tags again. Apologies. But seriously, I figured out how viruses worked when I was a kid, and these people are presumably adults. I'm not even going to talk about how badly they screw up whenever they talk about parasites, yeast or fungi. Did some part of their brain just short out when they became parents?

Anti-vaxxers have been invited to allow health freedom advocates to lead them:
Bolen shows up again @ AoA ( Jameson's post) - seems that he and his comrades, Mike and Joe, have millions of followers, available at a click of 'send' .

"Did some part of their brain just short out when they became parents?"

Objection! Assumes facts not in evidence. What basis is there to suppose their brains worked before they became parents?

Somewhat OT but I do need to note this somewhere ...

AoA, in an effort to grab readers' attention, has printed what I believe to b eshameless emotional manipulation of readers at a disabled person's excpense:
Dachel leads off with a photo of Michelle Guppy's 20 year old son in diapers supported by his mother - which AD likens to a well-known Renaissance sculpture by Michaelangelo
People with autism are being crucified by the media's refusal to highlight the Thompson-Hooker affair perhaps.

This isn't the first time either:
AoA keeps a video of Stagliano's daughter struggling to speak at its sideline.

What's wrong with these people? Will they do anything to be seen as a martyr?

What’s wrong with these people? Will they do anything to be seen as a martyr?

I know that coming from you it's a rhetorical question but will answer any way. They have managed to turn martyrdom into a competitive sport and even careers for some of them. And in doing so, have demonstrated how de-valued their children's lives, right to privacy and respect are to achieve their own selfish goals. They're vile, revolting excuses for parents. Oh and let's not forget apologists for "altruistic filicide".

Right, it is rhetorical.

I think that we should turn attention on parents who exploit their children's disability and helplessness in order to push an agenda or their own self-aggrandisation project.
It's awful and WRONG,

I am expected elsewhere. au revoir

Further down, or up the thread, there’s a suggestion that enterovirus was caused by-what else- vaccines

I have it on good authority that both Ebola and D68 were caused by all those refugee children coming across the Mexican border.

Italics fail.

Denice Walter: You also missed the "best part" of Anne Dachel's martyrdom of Michele Guppy...who has her own blog, where the picture of her grown child, clad only in a diaper, post seizure, is shown.

It is the worst form of abusive exploitation I have seen, since Wakefield posted the pictures of Alex Spourdalakis, clad only in an adult diaper on YouTube and in his documentary film.

LW:What basis is there to suppose their brains worked before they became parents?

Most of them are college educated. At college,I was expected to take at least one hard science course (I took two) with lab time, and before that, I had health and science courses in high school. Since these are, presumably, mostly middle-class and upper-class (defined here as not rich, but very close to it) I'd assume that they had much the same education as I did, plus access to lots of books and educational shows. Regardless of money or parental predilections, libraries and PBS exist.
And psych majors (of which there are a few at AOA) have to take a lot of science courses, right? So that leaves three possibilities:
1. A vast majority of those at Age of Autism never graduated from any university or high school.
2. A vast majority of bloggers at Age of Autism somehow got their parents to buy a degree/ diploma for them and never even took high school biology.
3. Everyone at Age of Autism lies.
4. The trauma of finding out their child is less than perfect opened up a black hole in their brains and sucked any scientific knowledge out.

SciMom: They’re vile, revolting excuses for parents

Agreed. They do serve a purpose, in that they show the rest of us what not to do.

PGP,

How do these people ever get through a day; they don’t understand how anything works! Let alone viruses.

They seem to be claiming that the virus is a deliberate vaccine contaminant, designed to reduce the world's population as per Lord Draconis' right-claw man Gates' evil plans.

Perhaps they're not as science-challenged as it first appears, merely reality-challenged ;-)

@ lilady:
I saw it.

@ PGP:

The amount of science psychologists study is dependent upon
-where they study and what type of degree they receive
- but attending any university usually requires some secondary level science
-most liberal arts degrees require some science
-graduate level work in psychology usually requires statistics / doctorates even more

HOWEVER there are ways around this:
- crappy universities
- taking the bare minimum and learning by rote for exams which is quickly forgotten
- getting special grad degrees in school psych, counselling, social work - which can have lesser requirements
- not knowing how to apply what they learn to everyday life-

Some of our faves studied business, education and related.

Hold on thar...I studied business (grad school anyway) and we most definitely has to take statistics.

"Had." I can only has cheezbrgr.

@ Shay:

I didn't mean to implky that they didn't
I would think that USUALLY business grads are forced ro have mathematics and that educational degrees require at least some science.
Doesn't mean that the grads know how to apply them in the real world. -btw- Mark Blaxill is an MBA which doesn't help him in science. Hooker has a PhD.

Kreb: Yeah, they really are reality challenged.

DW: It's just really odd that nothing they learned seemed to stick. And for a group of adults, their tactics are very childish: namecalling, doxxing, spamming and trying to get people fired. It's sad that their *children* probably have better manners than they do.

"And psych majors (of which there are a few at AOA) have to take a lot of science courses, right?"

I didn't. One class on statistics, I think, was the only class even remotely resembling a "hard science" class required for the major. I took some outside of my major though.

@ PGP:

Altho' their tactics may seem childish to you ( and most people), they truly believe that they are fighting a war and are nearly victorious and soon they will see their enemies brought to justice, jailed, shamed, whatever..
Similarly, woo-meisters are riding the wave of paradigm-shift, washing away corrupt, old SBM, clearing the way for the nouvelle vague de woo..
This is how they rally flagging support from their followers.

Just heard a rumor that the Appeals Court in Texas finally ruled on Wakefield's case.....and he lost (again).

Not a rumor:

http://www.search.txcourts.gov/Case.aspx?cn=03-12-00576-CV

NO. 03-12-00576-CV
Dr. Andrew J. Wakefield, MB, BS, Appellant
v.
The British Medical Journal Publishing Group, Ltd.;
Brian Deer; and Dr. Fiona Godlee, Appellees
APPEAL FROM 250TH DISTRICT COURT OF TRAVIS COUNTY
BEFORE CHIEF JUSTICE JONES, JUSTICES GOODWIN AND FIELD
AFFIRMED -- OPINION BY JUSTICE FIELD
This is an appeal from the judgment signed by the trial court on August 3, 2012. Having
reviewed the record and the parties’ arguments, the Court holds that there was no reversible error
in the trial court’s judgment. Therefore, the Court affirms the trial court’s judgment. The
appellant shall pay all costs relating to this appeal, both in this Court and the court below.

That'll teach me not to check my E-mail for a couple of days (I'm subscribed to the CaseMail for it). It's somewhat disappointing for the peanut gallery who would have liked to see the anti-SLAPP reached.

I wonder how the anti-vax contingent is going to feel knowing that their "donations" to Wakefield's Defense fund are now going to be paid directly to Brian Deer (again)?

I'm kind of surprised that, in the Keeton analysis, the court failed to note that the BMJ items at issue weren't paywalled, which further dilutes the "subscribers" argument.

Great news! But now I have to make the rounds to see the instantaneous reactions before I leave the house.

^ Ah, they get to it in the Calder analysis.

Oz also keeps telling pregnant women to get Flumist instead of a seasonal flu shot. LAIV isn't indicated for use in pregnant women. See: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/flulive.pdf

He is a Fellow of the American College of Surgeons, and is seemingly at odds with their code of professional conduct. See: https://www.facs.org/about-acs/statements/stonprin#anchor273982

Perhaps a fellow Fellow could drop ACS a line and ask them to censure him?

Oh the wailing and gnashing of the teeth will be great.

Not much wailing yet- I checked- but statesman.com has an article today. Parrish says that there might be an appeal.
Erm... wouldn't that be a *re-appeal*?

"I wonder how the anti-vax contingent is going to feel knowing that their “donations” to Wakefield’s Defense fund are now going to be paid directly to Brian Deer (again)?"

A few weeks ago, an antivaxxer commented here to the effect that Deer was going to get what he deserved - if he meant Wakefield's money was what Deer deserved, then it's a successful prediction.

@Denise - Dorit might be able to comment on his ability to appeal this decision, but since to reversible errors were found, I doubt this is going to go anywhere....

"no" reversible errors were found

Can someone who is a lawyer explain how many times you can appeal your case?

He can appeal to the Supreme Court of Texas.

@Narad - he can appeal, but I doubt they will take the case (given that both lower courts agreed and no reversible errors of law were found).

More importantly:
how much will he have to pay?
Would that be only for the expenses of the appeal or would it include legal expenses incurred prior to the appeal as well?
( let me get my calculator)
Heh heh heh.

Oh boy, I imagine that we'll be hearing a lot about fundraisers, films being made, lecture series, auctions, bake sales.

Let the gnashing commence:
DanO calls it "nasty".

Wakefield had an appeal "as of right" from the trial court to the court of appeals - the court of appeals will always review a trial court's judgment. But you have to petition for review of the court of appeals decision to the Texas Supreme Court. The supreme court decides which cases to take - it should involve important legal questions, legal questions on which different courts of appeal are split, constitutional issues and so forth - more than just mere error. I wouldn't think that Wakefield's case involves any burning legal questions on which the Texas judiciary needs guidance from their supreme court. He shouldn't bother petitioning for review.

how much will he have to pay?
Would that be only for the expenses of the appeal or would it include legal expenses incurred prior to the appeal as well?

The latter. This is appealable.

I wouldn’t think that Wakefield’s case involves any burning legal questions on which the Texas judiciary needs guidance from their supreme court. He shouldn’t bother petitioning for review.

There may be a question whether the strict timing requirements of the TCPA conflict with other law or lead to procedural uncertainty. In addition, the COA handed them the Section 27.011 argument.

^ Actually, let me revise that. If the judgment is only for court costs, which it may be, then it's not appealable.

Yah, "costs" do not include attorney fees.

From Monday, Sept. 23 Dr. Oz show:

Organic food can cure autism caused by GMOs? More ‘quack science’ from Dr. Oz
Kavin Senapathy | September 25, 2014 | Genetic Literacy Project

Ms. Honeycutt proceeded with an obviously embellished if not totally fabricated story. She claimed that her son had been experiencing autism symptoms. Because her doctor saw no reason to test him for glyphosate levels, Honeycutt used a private lab which detected glyphosate levels “8 times higher than found anywhere in Europe urine testing.” Unfeasibly, she claimed that within six weeks of going “completely GMO-free and organic, his autism symptoms were gone and the level of glyphosate was no longer detectable.”

Make no mistakes – this is utter hogwash. There is no known cure for autism. If it were as simple as avoiding GMOs and pesticides, the affected foods would have been recalled. Furthermore, dietary treatment of autism has no basis in scientific evidence. If and when recommended, dietary approaches are based on adjustment of vitamin and mineral levels, or on avoiding allergens. Elimination of GMO foods is not a recommended dietary approach.

Whew.

Robert F. Kennedy, Jr.: Still an antivaccine crank after all these years

oracknows — Tue, 22 Jul 2014 07:30:30 +0000

Robert F. Kennedy, Jr.: Still an antivaccine crank after all these years

Only really long time readers will remember this, but back in the day (June 2005, to be exact), I discovered Robert F. Kennedy, Jr. and his antivaccine nuttery when he published his epically bad piece of antivaccine conspiracy mongering, Deadly Immunity, both in Salon.com and Rolling Stone (the latter of which doubled down on it a few years later by reposting it). My deconstruction of the logical fallacies, errors of science and fact, and just general silliness of Kennedy’s article was one of the first times I was ever really “noticed” in the blogosphere. Since then, every so often, or so it seems, I’m drawn back to RFK, Jr., just because he can’t seem to stop the conspiracy mongering over the mercury-containing preservative thimerosal in vaccines and his obsession with its link to autism. It’s a link that’s long been disproven by clinical trials, but that hasn’t stopped him from trying to use various cases to “prove” a link between vaccines and autism, insinuate that the CDC is covering up a thimerosal-autism link, out-crank another vaccine-autism crank Sharyl Attkisson, use the case of Poul Thorsen to distract from inconvenient science, and link his environmental activism to his antivaccine activism, thus tarnishing the environmentalist movement as long as the Kennedy name.

When last we visited him, RFK Jr. had been threatening to...write a book! And write a book he had done, a book entitled Thimerosal: Let the Science Speak: Mercury Toxicity in Vaccines and the Political, Regulatory, and Media Failures That Continue to Threaten Public Health. With the book’s imminent release in early August, media attention has been less than stellar, but the attention of the antivaccine crankosphere has been a bit more intense. Indeed, I had considered letting this cup pass because, well, I’m sick and tired of RFK, Jr., and I’m not sure that there’s much that I want to say about him right now. Still, as I say, there are some topics that inevitably drag me in, even as I resist and procrastinate for a couple of days, and RFK Jr.’s antivaccine quackery appears to be such a topic. Also, there has been a bit of mainstream media attention in the form of an article by Keith Kloor in The Washington Post a few days ago entitled Robert Kennedy Jr.’s belief in autism-vaccine connection, and its political peril. There are a few juicy tidbits that I learned in the article, although the article seems a bit more sympathetic to RFK, Jr. than I would like. The article also says little about RFK Jr.’s partner in this endeavor, Dr. Mark Hyman, who has been an intermittent topic on this blog and has been known to mangle autism science and medicine rather spectacularly.

The good things I learned is that, increasingly, RFK, Jr. is being viewed by mainstream politicians and media as the crank that he is. (And, make no mistake, on the subject of thimerosal in vaccines, RFK, Jr. is a crank par excellence.) Remember Senator Barbara Mikulski, for example? She co-sponsored a resolution that declared one week during last October to be Naturopathic Medicine Week, or, as I called it, Quackery Week. She also co-chaired a meeting with the creator of the National Center for Complementary and Alternative Medicine (NCCAM), where Harkin complained that NCCAM had “fallen short” because it hadn’t “validated” enough CAM, completely misunderstanding how science works and supported an amendment to the Affordable Care Act to have it cover CAM practitioners. It goes on and on; she appeared at the anniversary of the integrative medicine center at the University of Maryland and has even appeared on Dr. Oz’s radio show to promote “integrative medicine.” She is among the most woo-friendly legislators out there.

And even she didn’t take RFK, Jr. seriously:

Sen. Barbara Mikulski listened impassively as Robert Kennedy Jr. made his case. He had to talk over the din in the marbled hallway just outside the Senate chambers, where he was huddled with Mikulski, two of her aides and three allies of his who had come to Washington for this April meeting.

Kennedy, a longtime environmental activist and an attorney for the Natural Resources Defense Council, had thought Mikulski would be receptive to an issue that has consumed him for a decade, even as friends and associates have told him repeatedly that it’s a lost cause. But she grew visibly impatient the longer he talked.

[...]

The Maryland Democrat turned from Kennedy without a word. “I want to hear what you have to say,” Mikulski said, looking up at the lean man standing next to her. Mark Hyman, a physician and best-selling author, is Kennedy’s chief collaborator on a then-unpublished book titled “Thimerosal: Let the Science Speak,” which is scheduled to come out next week. The book argues that ethylmercury — a component of thimerosal — is harmful to human health. (Not so in trace amounts, scientific authorities have concluded.)

According to Kloor, Mikulski’s reaction was less than enthusiastic. Basically, she just referred RFK, Jr. to Sen. Bernie Sanders, because he “cares about brain health” and oversees a related subcommittee. Sanders’ reaction was at best noncommittal, perhaps because RFK, Jr. basically made threats if he doesn’t get what he want. His threat? To publish his book! However, his threat was highly disingenuous, coupled as it was with the usual claim from antivaccinationists that they’re really and truly “not anti-vaccine”:

The normally voluble, white-haired senator was convivial, then, as Kennedy got going, fell silent. “We don’t want to publish this book,” Kennedy told him, holding up a copy of his manuscript. “We are very pro-vaccine.” He motioned to Hyman across the table. “Vaccines save lives. We don’t want to alarm the public by showing them the science. We have a publisher lined up, ready to publish it. But we said no.”

I can’t help but contrast this reaction to the sorts of reactions he got nine years ago after he had published Deadly Immunity, which were, except for the science blogosphere, largely laudatory. It’s also interesting to many who follow the antivaccine movement, the better to counter it, to see that Mark Hyman has let his antivaccine freak flag fly more than I expected him to. As you might recall, Hyman is a leading proponent of a form of “integrative” medicine quackery known as “functional medicine.” It’s a medical philosophy that is maddeningly vague in its definition, encompassing a grab bag of various forms of woo that involve environmental inputs, inflammation, hormones, gut & digestive health, detoxification, energy/mitochondria/oxidative stress, and, of course, “mind-body,” whatever that means. No woo would be complete without mind-body, you know. (Actually, no self-respecting woo would leave out “detoxification,” either.) Despite having looked at it for several years, I still haven’t been able to figure out to my satisfaction what, exactly, distinguishes functional medicine from quackery, as functional medicine recommends treatments full of supplements, dietary manipulations, and “detoxification.” It’s the sort of treatment that practitioners of “autism biomed” quackery, chiropractors, and naturopaths love, in which “imbalances” must be measured through a battery of lab tests and corrected with whatever woo functional medicine practitioners can dream up. Most recently, he has been in the news because apparently he’s become the health guru for Bill and Hillary Clinton.

So it’s not surprising that Hyman is antivaccine and would sign on to the thimerosal-vaccine fear mongering that RFK, Jr. has been promoting for a decade now. I’m just happy that Sens. Mikulski, even as woo-friendly as she is, and Sanders both basically listened to RFK, Jr. politely, probably feeling like a trapped animal desperate enough to chew his leg of to escape, then patted RFK, Jr. on the head, and sent him on his way. What’s depressing, though, is that RFK, Jr. would not command personal audiences with various powerful senators to promote his crank views were it not for his lineage, his family name. He would not be able to command audiences with high ranking CDC officials and scientists from the FDA and National Institutes of Health. It’s unlikely that anyone in authority would give this crank the time of day were he not a Kennedy, because he doesn’t deserve it.

Another juicy tidbit from Kloor’s article that RFK, Jr. had shown a copy of his and Hyman’s manuscript to experts, with dismissive results:

Most of those who did respond were dismissive. Philip Landrigan, a leading public health advocate and physician who heads the Children’s Environmental Health Center at Mount Sinai Hospital in New York, offered a reply that stung. “We were buddies,” Kennedy said. “I got a curt note back from him, saying, ‘This isn’t worthwhile, and this is an effort you should immediately abandon.’ ”

Kennedy remained defiant. “The only way I can stop this is if someone shows me I’m wrong on the science.”

That is exactly what science bloggers have been doing since at least 2005, showing that RFK, Jr. is wrong on the science and even the facts, such as the elaborate conspiracy theory about the Simpsonwood conference he embellished in Deadly Immunity, a turd that he’s been polishing ever since. It’s like shooting fish in a proverbial barrel. But, RFK, Jr., being the crank that he is, doesn’t listen. Unfortunately, as described in Kloor’s article, certain misguided scientists, such as Irva Hertz-Picciotto (whose bad science we’ve discussed recently) and Martha Herbert (whose lack of compelling publications we’ve also discussed) give him just enough encouragement to be able to say that “some” scientists support him.

Perhaps the most hilarious development, not covered in Kloor’s article, is the reaction of a certain familiar antivaccine activist to this passage:

Some of the most controversial sections — the chapters connecting autism to thimerosal — Kennedy took out at the last minute, though there are still references to a link to autism. Hyman convinced him that such claims were too combustible and would distract from the book’s core argument, that “the evidence suggesting a link between thimerosal and a large percentage of neurodevelopment disorders … mandates action.”

Or maybe, at some level, even Hyman realizes the “science” cited by Kennedy is bogus. It’s actually as bogus as the “science” linking thimerosal in vaccines to neurodevelopmental disorders, but I guess he’s not bothered by that. Our old buddy, Young Master Jake Crosby, though, clearly is bothered. He’s bothered very much, so much so that he has accused RFK, Jr. of “joining the thimerosal cover-up”:

Except that autism is the most serious of those neurodevelopmental disorders caused by thimerosal. The person who convinced Kennedy – his coauthor Dr. Mark Hyman - is a profiteer of alternative “therapies” for autism. He has even discussed treating a child with autism for elevated mercury levels and has an obvious stake in attracting more patients like that to his practice.

Meanwhile, Robert F. Kennedy Jr. betrayed the very people he spoke about his book to at last year’s AutismOne conference. He kept them waiting for his book to come out while deliberately delaying publication for one year, only to remove the chapters on autism “last minute.” In doing so, he has in-effect joined the very CDC cover-up of thimerosal’s harms that he previously denounced by censoring incriminating evidence on the premise of it being “too combustible.” Thankfully, the unpublished, unedited manuscript of Kennedy’s book is also available.

Yes, apparently somehow Jake got his hands on a copy of the original manuscript. It wouldn’t surprise me if RFK, Jr. himself sent him a copy, as Kloor’s article reports that RFK, Jr. was sending the manuscript to political allies, university health experts and CDC officials. I can’t help but wonder what RFK, Jr. and his publisher will do about his hosting a copy of RFK, Jr.’s manuscript on his blog. No doubt if they protect their copyright and go after him, Jake will paint it as just part of the conspiracy.

Two antivaccine cranks fighting it out in court, now that would be a delicious twist to a not-so-delicious story of antivaccine crankery.

oracknows Tue, 07/22/2014 - 03:30

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