Best of the blogs, July – on Science-Based Medicine, Jann Bellamy noted that “Rhode Island is poised to become the latest state to succumb to the false notion that licensing naturopathic ‘doctors’ will protect the public health and safety, making naturopathic conquest of New England complete.” Scott Gavura described an Australian report recommending that pharmacies not sell homeopathic products. These present a risk of harm to customers, who may choose them instead of effective conventional medicines. David Gorski discussed a paper “that showed how chemotherapy before surgery can stimulate breast cancer invasiveness and invasion under certain circumstances.” “…when quack-loving entrepreneurs…tell you this study ‘proves’ that chemotherapy does more harm than good, they’re either ignorant or intentionally misrepresenting the results, because the study doesn’t show that at all.” Harriet Hall wrote about “AllerVarx: A Questionable Remedy for Allergic Rhinitis.” It “claims to relieve nasal allergy symptoms, but the only ‘evidence’ is a single disreputable clinical trial with no control group.” Samuel Homola wrote “Chiropractic and Spinal Manipulation Red Flags: A Comprehensive Review.” “There is no credible evidence to support use of spinal manipulation for anything other than uncomplicated mechanical-type neck or back pain and related neuromusculoskeletal problems. Upper neck manipulation, however, is so risky (with little evidence of benefit) that I usually advise against submitting to such treatment.” Furthermore, “I do not know of any medically acceptable diagnosis that would warrant manipulating the spine of a pre-adolescent child.” Clay Jones addressed a variety of water-related topics, including underwater delivery, hydrotherapy, and alkaline water. Recommendations to give extra water to newborns and infants are “extremely dangerous. Newborns and young infants need exactly zero ounces of extra water on top of their breast milk or formula. That much extra free water could dilute the electrolytes in their blood, particularly sodium, and result in seizures, coma, and even death.” Jesse Luke discussed Johrei, which “appears to be a flavor of reiki.” “Johrei, like other forms of energy healing, is clearly pseudo-medicine that wants to be accepted by mainstream medicine and real doctors.” Steven Novella described how “An Amish farmer is convicted of selling a caustic poison [containing bloodroot] as patent medicine (and of witness tampering) and yet is defended by ‘alternative medicine’ proponents.” “On close inspection it becomes clear that, at its root, the alternative medicine movement is anti-consumer. Their goal is to erode the regulations that protect the public from bad medicine, so that they will be free to sell products and services that were once considered ‘health fraud’.” Stephen Barrett also discussed the case on Cancer Treatment Watch. Another post (“Increase In Supplement Poisonings”) also dealt with dangers to the public due to lax regulation of the supplement industry. In a post entitled “Brain Wave Pseudoscience,” he dealt with claims of iSynchrony, which “claims to treat neurological disorders by adjusting your brain waves.” “In short, be very skeptical of any device or treatment that promises to balance your brain waves. Such claims are pseudoscientific nonsense.”
On Respectful Insolence, “Orac” discussed how doctors associated with Gwyneth Paltrow’s goop enterprise attacked a critic. A later post asked, “Are Gwyneth Paltrow and Goop winning against skeptics?” A third post was entitled “Dr. Aviva Romm: Distancing herself from Goop after defending it.” He provided a critique of physicist Paul Davies’s ideas about cancer: “what Davies proposes is nothing more than a 100 year old idea that he resurrected and tarted up for the 21st century… it’s a 100 year old idea that was found long ago not to be consistent with the data.” Another post dealt with companies marketing unapproved stem cell treatments by registering their treatments with the federal database of clinical trials, then charging patients to participate in their trials. (See August 28 items below for additional stories on stem cell clinics.)
Edzard Ernst had two posts dealing with acupuncture. The July 3 post dealt with a meta-analysis of acupuncture for treating psoriasis. The analysis concluded that acupuncture “could be considered” as a treatment, even though the methodological quality of most of the reviewed studies was “not rigorous.” Ernst wrote that “Correct conclusions should read something like this: Due to the paucity and the poor quality of the clinical trials, this review could not determine whether acupuncture and similar therapies are effective for psoriasis.” The July 19 post concerned a trial of acupuncture for menstrual pain. Although the authors interpreted the results as supportive of acupuncture, Ernst wrote: “The best conclusion I can suggest for this daft trial is this: IN THIS STUDY, THE PRIMARY ENDPOINT SHOWED NO DIFFERENCE BETWEEN THE 4 TREATMENT GROUPS. THE RESULTS ARE THEREFORE FULLY COMPATIBLE WITH THE NOTION THAT ACUPUNCTURE IS A PLACEBO THERAPY.” His July 5 post dealt with updated clinical practice guidelines from the Society for Integrative Oncology (see also the post by “Orac” on May 2). He wrote, “The first obvious point to make is that these treatments are not ‘integrative therapies’; they are alternative or complementary and I fail to see what is integrative about them. The second point is that the positive recommendations are based on often poor-quality studies which did not control for placebo effects. The third point is that the negative recommendations are woefully incomplete. There are many more alternative therapies for which there is no strong evidence. The forth [sic] point is the conclusion implying that treatment supported by insufficient evidence should be avoided. I would not claim that any of the mentioned treatments is backed by SUFFICIENT evidence. Therefore, we should avoid them all, one might argue.”
July – Shapiro, Baker, and Wormser published a Commentary entitled “False and Misleading Information About Lyme Disease” (Am J Med. 2017 Jul;130(7):771-772). “…false and misleading information about the diagnosis and treatment of Lyme disease is not new. It is increasing in frequency and prominence, creating much confusion among primary care physicians and their patients….Politicians are attempting to displace mainstream physicians as diagnosticians in the complex world of Lyme disease by passing legislation that encourages the use of unproven treatments and that requires health insurance companies to pay for unsafe remedies with no documented benefit and well-documented adverse effects.”
July – Trogen, Caplan, and Klass wrote “The Ethics of Open-Label Placebos in Pediatrics” (Pediatrics. 2017 Aug;140(2). pii: e20164328 Preview). Also called “placebos without deception,” this practice is supposed to elicit the benefits of placebo effects. The authors see several potential problems: they “would intensify the widely held expectation of ‘treatments’ for every symptom”; the “could lead patients to develop false or misguided beliefs either about the placebo compound itself or the concept of ‘mind-body healing’ overall; “individuals could feasibly attempt to ‘self-prescribe’ inert substances to themselves or their children to lessen their use of other medications,” which in some cases could be serious health risks; “the prescription of placebo treatments could damage trust in physicians” – it “could appear dismissive or delegitimizing of patients’ suffering.” On Science-Based Medicine, Clay Jones agreed with these potential problems, but felt that the authors did not show a good understanding of placebo effects.
July – Hendriks and others reviewed “Effects of Yoga on Positive Mental Health Among Healthy Adults” (J Altern Complement Med. 2017 Jul;23(7):505-517 Abstract). They concluded that “Yoga was found to contribute to a significant increase in psychological well-being when compared to no intervention but not compared to physical activity…Due to the limited amount of studies, the heterogeneity of the intervention, and perhaps the way PMH is being measured, any definite conclusions on the effects of yoga on PMH cannot be drawn.”
July 15 – Asher et al. discussed “Common Herbal Dietary Supplement-Drug Interactions” (Am Fam Physician. 2017 Jul 15;96(2):101-107 Abstract). They concluded, “Some supplements, such as St. John's wort and goldenseal, are known to cause clinically important drug interactions and should be avoided by most patients receiving any pharmacologic therapy. However, many other supplements are predicted to cause interactions based only on in vitro studies that have not been confirmed or have been refuted in human clinical trials. Some supplements may cause interactions with a few medications but are likely to be safe with other medications (e.g., curcumin, echinacea, garlic, Asian ginseng, green tea extract, kava kava). Some supplements have a low likelihood of drug interactions and, with certain caveats, can safely be taken with most medications (e.g., black cohosh, cranberry, ginkgo, milk thistle, American ginseng, saw palmetto, valerian).
July 21 – The British National Health Service will stop providing for prescriptions of homeopathic remedies as part of an effort to save money by not including prescriptions that are “relatively ineffective, unnecessary, inappropriate, or unsafe for prescription” (Iacobucci G. BMJ. 2017 Jul 21;358:j3560 Preview).
July 25 – An article by Chodosh in Popular Science was entitled “The troubling truth about vitamins and herbal supplements.” “There’s shockingly little oversight of the companies who sell herbs and vitamins.”
July 30 – Laetrile, derived from apricot kernels and also known as amygdalin, is a long-disproven treatment for cancer (see our page, Cancer). Lee provided a new report in BuzzFeed News (“These People Are Making Money Off A Bogus Cancer Cure That Doctors Say Could Poison You”). “…this widely debunked theory has taken on a new life as a hydra-headed e-commerce ecosystem that regulators are virtually powerless to stop.” “Orac” provided additional commentary on Respectful Insolence.
July 30 and 31 – Two Cochrane Collaboration reviews dealt with antioxidant vitamin and mineral supplements and age-related macular degeneration (AMD). One review dealt with prevention (Evans JR, Lawrenson JG. Cochrane Database Syst Rev. 2017 Jul 30;7:CD000253 Abstract). It concluded that “Taking vitamin E or beta-carotene supplements will not prevent or delay the onset of AMD. The same probably applies to vitamin C and the multivitamin (Centrum Silver) investigated in the one trial reported to date. There is no evidence with respect to other antioxidant supplements, such as lutein and zeaxanthin.” The other review dealt with slowing the progression of AMD (Evans JR, Lawrenson JG. Cochrane Database Syst Rev. 2017 Jul 31;7:CD000254 Abstract). Here the conclusion was “People with AMD may experience some delay in progression of the disease with multivitamin antioxidant vitamin and mineral supplementation. This finding was largely drawn from one large trial, conducted in a relatively well-nourished American population. We do not know the generalisability of these findings to other populations…Supplements containing lutein and zeaxanthin are heavily marketed for people with age-related macular degeneration but our review shows they may have little or no effect on the progression of AMD.”
Best of the blogs, August – on Science-Based Medicine, Jann Bellamy noted that “For the third time in four years, a chiropractic pediatrics conference will feature anti-vaccination propaganda as part of its program.” “They have no business advising patients about immunization, especially when they are so thoroughly misinformed.” She also reported on the Congressional Dietary Supplement Caucus. “Any organization that is essentially part of Congress and operated with taxpayer-funded resources should not function as the in-house lobbying arm of an industry special interest group, nor should Congressional rules allow this to happen.” Scott Gavura compared red yeast rice supplements to statins for control of cholesterol. “Red rice yeast extract is a natural but crude source of the statin drug lovastatin. If you want to lower your cholesterol and be confident that you’re actually reducing your risk of heart attacks and strokes, take a statin drug. If you want to spend more, prefer products with no obvious quality control, and don’t mind paying more for an active ingredient that may or may not actually be in the bottle, then take red yeast rice.” David Gorski described how "right-to-try" legislation had passed the U.S. Senate.(see Orac’s discussions in our September 2016 News). He also added another post, writing as “Orac,” on Aug. 30 on Respectful Insolence. His Aug. 7 post was entitled "Naturopathy and dubious compounding pharmacies: A deadly combination." This was a followup to an earlier post concerning a death from intravenous curcumin ordered by a naturopath (see several items from March and April 2017 News). Another post discussed a paper showing that “cancer patients who choose alternative medicine have a higher risk of dying from their cancer.” The Aug. 21 post was “No, a Vaccine Court ruling does not show that vaccines cause SIDS” (concerning compensation of parents of a child who died of SIDS). “Never forget that Special Master Gowen’s ruling in the case of Boatmon vs HHS is a legal, not a scientific, ruling… In fact, the ruling is profoundly unscientific in that it turns the methodology used in science-based medicine to determine causation of disease on its head by valuing a plausible-sounding ‘theory’ of how causation might occur over actual existing clinical and epidemiological evidence showing that causation very likely does not occur.” Harriet Hall wrote “ZYTO: An Electrodermal Diagnostic Device Is Tested and Fails Miserably.” “ZYTO is a bogus, illegal electrodermal diagnostic device that claims to evaluate organ function and make dietary recommendations. Repeat testing produced results that were wildly inconsistent. The device produces noise, not meaningful information.” Another of her posts was “Viotren and Other Dietary Supplements for Erectile Dysfunction: Buyer Beware.” “Viotren and other dietary supplements are being illegally marketed to treat erectile dysfunction. Some of them work, but only because they are adulterated with prescription drugs like Viagra (at up to 31 times the prescription dose). Using them can be risky.” Jess Luke discussed “Integrative Psychiatry.” “Modern psychiatry isn’t great, but it helps and it is far better than what we used to have — but that’s the direction integrative psychiatry moves, towards pseudo-science and superstition harkening back to a time when psychiatrists treated their patients on personal whims and theories with no true regard for the patient.”
On Respectful Insolence, “Orac” provided a critique of a paper proposing “A new nomenclature for auricular acupuncture.” “There are no neuroanatomic correlates to suggest that there is any sort of mapping between body parts and organs to specific areas on the external ear. This is the ultimate in Tooth Fairy Science, which is basically doing studies on a phenomenon that has not yet been shown to exist.”
Edzard Ernst discussed a new review on the dangers of neck manipulations. “This article provides little new information; but it does confirm what I have been saying since many years: NECK MANIPULATIONS ARE ASSOCIATED WITH SERIOUS RISKS AND SHOULD THEREFORE BE AVOIDED.”
August – Caulfield, Marcon, and Murdoch examined websites of naturopaths in British Columbia (J Law Biosciences. 2017; 4(2):229-249 Paper). They found that “Of the 330 naturopath websites we analysed, 40 included vaccine hesitancy discourse and 26 offered vaccine or flu shot alternatives.” “Vaccination alternatives offered by these naturopathic websites are, without exception, unproven or disproven, and reliance on these products in lieu of vaccines creates a false sense of immunity while exposing both the individual and the surrounding community to potential harm… It would be wise to roll back the scope of naturopath self-regulation, and to establish third party oversight and management of disciplinary bodies. If naturopaths were truly an evidence-based profession and held to a science-informed standard, one would expect the relevant regulatory bodies to take action on the misleading advertising.”
August – Derwa and others reviewed probiotics for inflammatory bowel disease (Aliment Pharmacol Ther. 2017 Aug;46(4):389-400 Paper). They concluded that “VSL#3 may be effective in inducing remission in active UC [ulcerative colitis]. Probiotics may be as effective as 5‐ASAs in preventing relapse of quiescent UC. The efficacy of probiotics in CD [Crohn’s disease] remains uncertain, and more evidence from RCTs [randomized controlled trials] is required before their utility is known.”
August 1 – Another review on probiotics dealt with the above two plus other gastrointestinal conditions (Wilkins T, Sequoia J. Am Fam Physician. 2017 Aug 1;96(3):170-178 Abstract). Their conclusion was: There is high-quality evidence that probiotics are effective for acute infectious diarrhea, antibiotic-associated diarrhea, Clostridium difficile–associated diarrhea, hepatic encephalopathy, ulcerative colitis, irritable bowel syndrome, functional gastrointestinal disorders, and necrotizing enterocolitis. Conversely, there is evidence that probiotics are not effective for acute pancreatitis and Crohn disease. Probiotics are safe for infants, children, adults, and older patients, but caution is advised in immunologically vulnerable populations.”
August 3 – K. Servick published an Article profiling Paul Knoepfler, a critic of the proliferation of unproven stem cell clinics (Science. 2017 Aug 4;357(6350):441-443).
August 4 – Hu and others reviewed the use of the Chinese herbal remedy Andrographis paniculata (Chuān Xīn Lián) for symptom relief in acute respiratory tract infections (PLoS One. 2017 Aug 4;12(8):e0181780 Paper). They concluded, “A. Paniculata appears beneficial and safe for relieving ARTI symptoms and shortening time to symptom resolution. However, these findings should be interpreted cautiously owing to poor study quality and heterogeneity.” Edzard Ernst discussed the results: “Yes, the RCTs are not all of top quality. And yes, the effect size is not huge. But maybe – just maybe – we do have here an alternative therapy that does help against a condition for which conventional drugs are fairly useless!?!”
August 5 – Hermes wrote “FDA Links Naturopathic Turmeric Death To Contaminated Product” (see David Gorski post above). There are concerns over the purity of castor oil mixed with the curcumin (a component of turmeric) and whether a prescription had been obtained for the patient.
August 13 – A story for Business Insider by E. Brodwin was entitled “The $37 billion supplement industry is barely regulated — and it's allowing dangerous products to slip through the cracks.” Steven Novella commented on the story on Science-Based Medicine.
August 16 – A 2012 Cochrane review concluded that vitamin E supplements produced an increase in mortality. Oliver and Myers challenged the conclusions of this analysis (BMC Complement Altern Med. 2017 Aug 16;17(1):408 Letter). A reply from the original authors was also included.
August 22 – Chien et al. published “Effect of acupuncture on hot flush and menopause symptoms in breast cancer- A systematic review and meta-analysis” (PLoS One. 2017 Aug 22;12(8):e0180918 Paper). They concluded that “Acupuncture significantly alleviated menopause symptoms, but had no effect on hot flush.”
August 23 – A review on “Dietary Supplement for Core Symptoms of Autism Spectrum Disorder” (Li YJ, Ou JJ, Li YM, Xiang DX. Front Psychiatry. 2017 Aug 23;8:155 Paper) concluded, “Most studies were small and short term, and there is little evidence to support effectiveness of dietary supplements for children with ASD.”
August 28 – The FDA took action against two clinics marketing questionable stem cell treatments (News story). In one case, a vaccinia virus vaccine was used to make an unapproved stem cell product that posed potential dangers to cancer patients being treated (News release). The other case, also involving an unapproved treatment, involved “significant deviations from current good manufacturing practice,” also presenting risks to patients (who were being treated for “a variety of serious diseases or conditions”) (News release).
August 28 – A story by T. Chivers in BuzzFeed News was entitled “How Online Filter Bubbles Are Making Parents Of Autistic Children Targets For Fake ‘Cures’.” “…more than half of the most-shared scientific stories about autism published in the last five years promote unevidenced or disproven treatments, or purported causes.”
August 31 – According to a Story by H. Weisbaum for NBC News, “The watchdog group Truth in Advertising wants Goop, the lifestyle website started by actress Gwyneth Paltrow, to stop making what it calls ‘unsubstantiated’ and ‘deceptive’ advertising claims for some of the health and wellness products it sells.” The claims relate to numerous diseases and conditions, without being backed by “reliable scientific evidence.”
Additions to Earlier Months
January, 2017 – D. Maron discussed whole-body cryotherapy (Sci Am. 2016 Dec 20;316(1):22-23 Story). Claims for benefits are unsupported by scientific studies.
March 30 – H. Millar wrote “MTHFR: Hope or Hype?” in Genome. Testing variants in the methylene tetrahydrofolate reductase gene has been promoted by “functional medicine” doctors and others, who then prescribe nutritional supplements to correct presumed metabolic problems. However, “Since they’re so common, most geneticists and genetic counselors have become skeptical that these variants can actually explain the various health problems to which they’ve been ostensibly linked…testing for the MTHFR gene is not clinically useful for most people.”