JULY-AUGUST 2019 NEWS

Best of the blogs, July – on Science-Based Medicine, Jann Bellamy:

  • Wrote “Medicare proposal covers acupuncture for back pain study participants: A prelude to full coverage?”

Scott Gavura:

  • Posted “CBD Oil: The new miracle cure.” “CBD oil is hyped as a miracle product to treat virtually everything. What is the evidence to support this?”

David Gorski:

  • Wrote “Facebook, Google, and social media vs. medical misinformation: An update.” A related post on Respectful Insolence was entitled “Facebook joins Google in deprioritizing medical misinformation: Are social media companies finally ‘getting it’?”

  • Posted “A new study reinforces the conclusion that autism is primarily genetic.”

  • Discussed “For-profit stem cell clinics, universities, and 'pay-to-play' clinical trials for autism.”

Harriet Hall:

  • Found no science in support of products to deal with skin pH.

  • Published “Luminas: Unbelievable Claims About Pain Relief.” “If it sounds too good to be true, it probably isn’t true. The claims for the Luminas pain relief patch are not just unscientific; they defy common sense. It’s quantum quackery.

  • Reviewed “Bee Stings for Arthritis.” “Despite the many testimonials, scientific studies have not provided any acceptable evidence that bee stings are effective in arthritis. They hurt. They cause side effects. They can kill. They cannot be recommended.”

  • Wrote “American Family Physician Endorses Acupuncture.” “A CME [continuing medical education] article in American Family Physician misrepresents the evidence, claiming acupuncture has been proven safe and effective. An accompanying editorial gives despicable advice on how to manipulate patients to accept this theatrical placebo.” The article is Kelly and Willis, Am Fam Physician. 2019 Jul 15;100(2):89-96 Abstract, which notes “This pattern supports the notion that acupuncture treatment has a notable placebo response, or meaning response, that may be responsible for much of its demonstrated benefits. For certain patients, especially those who are unresponsive or intolerant to standard therapies, acupuncture is a reasonable treatment option.” The editorial is Ledford and Crawford, Am Fam Physician. 2019 Jul 15;100(2):76-78.

Clay Jones:

  • Wrote “A Canadian Journalist Calls Out Pediatric Chiropractic Again, and the Canadian Chiropractic Association Responds…Again.” “There is no quality evidence that supports the treatment of infants by chiropractors for any reason. They should not be allowed to do it. The response from the CCA is hollow propaganda. If they had any integrity at all, they would join the call to end this pseudoscientific and risky practice.”

Braden MacBeth

  • Posted “Bad Documentary Review: Family Shots,” concerning an anti-vaccination film.

Steven Novella:

  • Discussed why it is inappropriate to conclude that effects of propionic acid (found in processed foods) on cultured nerve cells have anything to do with autism.

  • Posted “France to End Reimbursement for Homeopathy.”

  • Discussed flaws in a study of acupuncture for angina. “After decades and thousands of acupuncture studies, there is simply no reason for these methodological flaws, which have all been pointed out numerous times before.” Edzard Ernst also discussed the study, as did “Orac” on Respectful Insolence. All three writers pointed out that it was not even a study of acupuncture, but of electroacupuncture, which is much different (Orac referred to this as “bait-and-switch.”).

On Respectful Insolence, “Orac”:

  • Had three posts concerning antivaccine activities: “Barbara Loe Fisher cries ‘McCarthyism’ over vaccines”; “Vaccine holocaust: The wildest antivaccine conspiracy ever”; “Marianne Williamson is antivaccine, period.”

  • Wrote “Olfactory mucosa tumors: Another complication of stem cell treatments.” “Even under the auspices of a properly designed clinical trial approved by an institutional review board, there is the potential for serious adverse reactions from stem cells. Now just imagine what could happen as a result of the unregulated sale of unproven stem cell therapies.”

Edzard Ernst:

  • Had four posts on homeopathy: He responded to a homeopath’s points concerning principles of homeopathy research; discussed a recent paper as “A new example of ‘excellence in homeopathic research’”: “This trial is a treasure trove of methodological flaws. Here I want to focus on merely one of them: The idea of conducting a non-inferiority study of two treatments, none of which have previously been shown to be effective.”; reported on loss of status of homeopathy in France; and discussed the many forms of homeopathy in “ Homeopathy? Which one?”

  • Posted twice concerning chiropractic. In “Toward the prohibition of chiropractic spinal manipulation for children, he wrote “there is no good evidence for chiropractic, osteopathic or other manual treatments for children suffering from any condition.” Another post was entitled “Spinal manipulation in children amounts to abuse,” because it is not effective for any pediatric condition and “can cause serious direct and indirect harm.”

  • Wrote “Should Medicare pay for acupuncture?”

  • Provided a critique of a study of wet cupping for back pain.

July – A review on “Kratom use and toxicities in the United States” (Pharmacotherapy. 2019 Jul;39(7):775-7 Abstract) concluded that “Kratom use is increasing and is associated with significant toxicities. Our findings suggest kratom is not reasonably expected to be safe and poses a public health threat due to its availability as an herbal supplement.” (See also July 19 item below.)

July – Palacios and others reviewed “Vitamin D supplementation for women during pregnancy” (Cochrane Database Syst Rev. 2019 Jul 26;7:CD008873 Abstract). They concluded “Supplementing pregnant women with vitamin D alone probably reduces the risk of pre‐eclampsia, gestational diabetes, low birthweight and may reduce the risk of severe postpartum haemorrhage. It may make little or no difference in the risk of having a preterm birth < 37 weeks' gestation. Supplementing pregnant women with vitamin D and calcium probably reduces the risk of pre‐eclampsia but may increase the risk of preterm births < 37 weeks (these findings warrant further research). Supplementing pregnant women with vitamin D and other nutrients may make little or no difference in the risk of preterm birth < 37 weeks' gestation or low birthweight (less than 2500 g).”

July 2 – Another Cochrane review concerned “Acupuncture for polycystic ovarian syndrome” (Lim et al. Cochrane Database Syst Rev. 2019 Jul 2;7:CD007689 Abstract). The conclusion was that “The overall evidence was low or very low quality. There is currently insufficient evidence to support the use of acupuncture for treatment of ovulation disorders in women with PCOS.”

July 2 – Kirkey wrote “'This. Hurts. Babies': Doctors alarmed at weekend courses teaching chiropractors how to adjust newborn spines.”

July 9 – Wilson published “Vitamins and Supplements Are a Waste of Money” (Medscape (subscription required)). Referring to a recent “umbrella review,” he noted that “There is no high-quality evidence that any vitamin or supplement has a beneficial effect on overall mortality.”

July 11 – Jarry posted “Popular Health Guru Sayer Ji Curates the Scientific Literature with His Bachelor’s Degree in Philosophy.” “Making research findings easy to search sounds great, but if you’re filtering out the studies that disagree with you, how reliable can you be?... Ji’s search engine does not list all studies and seems to be biased toward scientific papers that claim natural food and alternative medicine can prevent and heal diseases. Ji, who is anti-vaccination and anti-GMO, has no scientific training.”

July 17 – Chen wrote “Traditional Chinese medicine blisters children.” The treatment involved “application of an herbal paste to the skin” followed by cupping. 92 children treated with the method at the Chinese hospital developed severe skin reactions.

July 19 – Abdullah and others published “Cardiac arrest in a young healthy male patient secondary to kratom ingestion: is this 'legal high' substance more dangerous than initially thought?” (BMJ Case Rep. 2019 Jul 19;12(7). pii: e229778 Abstract).

July 22 – An article by Fischer was entitled “What happens when illness becomes an identity?” It concerns so-called "chronic Lyme disease," which “has grown into a phenomenon often untethered from scientific method or peer review.”

July 25 – Furfaro wrote “Experts question rationale for stem cell trial for autism.”

July 30 – The 1894 Essay “Modern Homeopathy: Its Absurdities and Inconsistencies” was posted on HomeoWatch.

July 31 – UC Berkeley Wellness Letter published “Supplements: We Can Do Better.”

Best of the blogs, August – on Science-Based Medicine, Jann Bellamy:

  • Discussed a bill in Congress that would expand the coverage of Medicare “to cover full chiropractic scope of practice,” defining chiropractors as “physicians” and allowing them to be reimbursed for a wide range of techniques under their own state laws. Salzberg also wrote on Forbes.

  • Wrote “Anti-vaccination ideology in chiropractic continuing education and conference (again!).” “Tropes aside, both the content of Pediatrics 115 and its approval by major chiropractic organizations serve as evidence of the appalling condition of chiropractic education and state regulation of the practice of chiropractic.”

Scott Gavura:

David Gorski:

  • Posted “Is today’s generation of children ‘the sickest generation’?” “Presidential candidate and New Age self-help guru Marianne Williamson has been repeating a claim that over half of our children have chronic illness and implying that the expansion of the vaccine schedule since the late 1980s is responsible. But is it true?”

  • Reviewed “The Vaccine Guide”: “If there is any one reliable indication that a person is antivaccine, it’s dancing around this question and not being willing to name even one vaccine that you consider to be safe and effective enough to recommend. If a person can’t even concede that one vaccine is effective and safe, she’s definitely hard-core antivaccine…In summary, the Vaccine Guide is nothing more than a collection of screenshots of cherry-picked studies and articles, many the typically bad science used to justify antivaccine beliefs, and many just abstracts (which makes them difficult to interpret). Even the studies that are legitimate and decent science are intentionally made to seem to support antivaccine pseudoscience by Ashley Everly’s highly selective use of highlighting.”

Harriet Hall:

  • Posted “Do Acupuncture Points Exist? Can Acupuncturists Find Them?” “Acupuncturists do a systematic review and reveal they can’t reliably locate acupoints. No wonder: they don’t exist.”

Steven Novella:

  • Posted “Gary Null's Attacks on SBM.”

  • Discussed a paper suggesting that IQ can be adversely affected by maternal fluoride exposure during pregnancy. The paper has met with widespread criticism from experts in the field. For example, the reported decrease in IQ in boys but not in girls is difficult to explain.

  • Provided a “Gluten Update.” “The controversy remains over the questionable existence of non-celiac gluten sensitivity (NCGS)… The clinical data is mixed and often subjective. In order to know that a clinical phenomenon is actually real, we would like to see multiple independent lines of evidence. When they are consistent lacking, that should raise skepticism. In this case, when we look at the gastrointestinal lining of those with presumed NCGS we do not see any consistent pathological changes. We have found not markers in the blood. And challenge experiments show preliminary and mixed results. This does not mean that NCGS does not exist, and certainly does not mean that patients with possible NCGS do not have real symptoms. What it means is that we do not know if NCGS exists, and we do not know why those patients have the GI symptoms they do. At present NCGS is a hypothesis, and it is a particularly shaky one given the current state of evidence.”

On Respectful Insolence, “Orac”:

Edzard Ernst:

  • Posted twice concerning chiropractic. One discussed the World Federation of Chiropractic Strategic Plan. “There are some commentators on this blog who regularly try to make us believe that chiropractic is about to reform, leave obsolete concepts behind, and become a respectable, ethical and evidence-based healthcare profession. After reading the appalling drivel the WFC call their ‘strategic plan,’ I am not optimistic that they are correct.” The Aug. 23 post was entitled “Don’t let a chiropractor near your kids!”

  • Discussed his new book, Alternative Medicine, a Critical Assessment of 150 Modalities.

  • Wrote “Vaginal steaming: another SCAM best to be avoided.”

  • Reported on two studies showing no benefits of curcumin (an ingredient in turmeric) for patients with heart disease. “…we can say with a high degree of certainty is this: currently there is no good evidence to show that curcumin is effective in treating any human condition. Perhaps there is a more general lesson here about herbal medicine. Many plants have exiting pharmacological activities such as anti-biotic or anti-cancer activity which can be shown in-vitro. These are then hyped by entrepreneurs and enthusiasts of so-called alternative medicine (SCAM). Such hype fools many consumers and is thus good for business. But in-vitro activity does not necessarily mean that the therapy is clinically useful. There are many reasons for this, e.g. toxicity, lack of absorption. The essential test is always the clinical trial.”

  • Discussed a meeting abstract on “The role of placebo effects in mindfulness--based analgesia.” “Mindfulness is currently hugely popular. It would not be surprising, if the news that it might rely purely on placebo effects would calm down the enthusiasm about this treatment.”

  • Posted “A framework for critical thinking,” discussing an article by Aronson and others, “Key concepts for making informed choices.” (Nature. 2019 Aug;572(7769):303-6 Paper).

August – Vendra and others published “Over-the-Counter Tinnitus ‘Cures’: Marketers' Promises Do Not Ring True” (Laryngoscope. 2019 Aug;129(8):1898-1906 Abstract). “It is troubling that heavily advertised brands profess support by otolaryngologists.”

August – Li and others wrote “Ginger for health care: An overview of systematic reviews” (Complement Ther Med. 2019 Aug;45:114-23 Abstract). “In our overview, most of SRs suggest ginger is a promising herbal medicine for health care, which is beneficial for nausea and vomiting, metabolic syndrome and pain. However, considering the limited quality of included evidence and heterogeneity of different clinical trials, more well-design studies are required to confirm the conclusion further.”

August – A review by Askarpour et al. concerned policosanol for high blood pressure (Complement Ther Med. 2019 Aug;45:114-23 Abstract). “Policosanol could lower SBP [systolic blood pressure] and DBP [diastolic blood pressure] significantly; future long term studies are required to confirm these findings in the general population.”

August – The “Effects of aromatherapy on sleep quality” were reviewed by Lin and others (Complement Ther Med. 2019 Aug;45:156-66 Abstract). “The results showed that aromatherapy can be applied by clinical staff to effectively improve sleep quality. However, because there was a high degree of heterogeneity among studies, the inferences of the results need to be applied with caution.”

August – According to a study by Laukkanen and others (Complement Ther Med. 2019 Aug;45:190-7 Abstract), “Recovery from sauna bathing favorably modulates cardiac autonomic nervous system.”

August – A study of bee venom injections reported beneficial results for osteoarthritis knee pain (J Altern Complement Med. 2019 Aug;25(8):845-55 Abstract).

August 1 – Jarry analyzed the claims for ThetaHealing®. “Take-home message: ThetaHealing® is a philosophy according to which a healer and a patient tap into a type of brainwave to allow divine energy to heal them. Its founder was successfully sued for fraud over a degree she was offering in ThetaHealing® and she has said she thinks her healing method can regrow limbs and organs. The only study of ThetaHealing® published in the scientific literature did not show that experienced ThetaHealers® increased their theta activity, but actually that this activity went down.”

August 5 – Haller and others reviewed “Complementary therapies for clinical depression” (BMJ Open. 2019 Aug 5;9(8):e028527 Paper). “In patients with mild to moderate major depression, moderate quality evidence suggested the efficacy of St. John’s wort towards placebo and its comparative effectiveness towards standard antidepressants for the treatment for depression severity and response rates, while St. John’s wort caused significant less adverse events. In patients with recurrent major depression, moderate quality evidence showed that mindfulness-based cognitive therapy was superior to standard antidepressant drug treatment for the prevention of depression relapse. Other CAM evidence was considered as having low or very low quality.”

August 8 – A trial with more than 2000 participants found no benefit of vitamin D supplementation for prevention of type 2 diabetes (Pittas et al. N Engl J Med. 2019 Aug 8;381(6):520-30 Abstract). Harriet Hall discussed the findings on Science-Base Medicine in her post “Vitamin D and Diabetes: Another Case Where Supplementation Sounded Like a Good Idea But Wasn’t.”

August 11 – Power posted “Chiropractic: Quackery Hiding in Plain Sight.” Includes 18 minute video.

August 12 – A Press release was entitled “FDA warns consumers about the dangerous and potentially life threatening side effects of Miracle Mineral Solution.” The product “has not been approved by the FDA for any use, but these products continue to be promoted on social media as a remedy for treating autism, cancer, HIV/AIDS, hepatitis and flu, among other conditions. However, the solution, when mixed, develops into a dangerous bleach which has caused serious and potentially life-threatening side effects.” Steven Novella discussed the events on Science-Based Medicine. “This is not the first such warning from the FDA. The first one was in 2010. The warning is essentially the same as the 2019 version, and it is amazing that almost a decade later this blatant and dangerous snake oil is still around…What more evidence do we need that the FDA does not have the proper authority and tools to protect the public from this kind of dangerous snake-oil?”

August 18 – Stephen Barrett revised his post “Curiosities of the Homeopathic Pharmacy” on HomeoWatch. It is an essay from 1890. “Even though medical science was in its infancy in 1890, enough was known to be certain that ‘high dilution’ homeopathic remedies made by repeatedly diluting an original substance to a point where no molecules of the original substance remained could not work.” Absurd homeopathic remedies are described, including ones based on sunlight and moonlight.

August 23 – Kylstra published “Who Cares What Celebrities Think About Vaccines?” “Very rarely do the misguided beliefs of famous people deserve headlines.”

August 23 – Schwarcz wrote “The Right Chemistry: The science and pseudoscience of essential oils.” Essential oils are used as scents and flavorings, and are employed in aromatherapy, “There’s no question that a massage with an essential oil or soaking in a scented bath may have a pleasant, relaxing effect, but it is not going to ‘align your DNA,’ ‘repair your energy field’ or ‘keep your nerves in balance’.”

August 25 – A story by Shapiro was entitled “Seven Reasons Why Alkaline Water Is Basically a Waste of Money.”