MAY-JUNE 2016 NEWS

Best of the blogs, May – on Science-Based Medicine, Scott Gavura discussed the death of a toddler under care by a naturopath, and asked, "Is There a Naturopathic Standard of Care?" He also discussed scientific considerations in using dietary supplements. “A supplement worth taking is backed by good evidence, and is unlikely to cause harm. Most supplements fail this test – usually because they lack good evidence to show they work… there’s no easy way for a health professional or a consumer to independently verify that a product is of high quality.” David Gorski deplored attempts to license naturopathy: “what naturopaths mean by ‘the natural healing capacity’ is a mystical vitalism that is based in prescientific religious belief systems about life and disease.” He analyzed a study on tai chi for osteoarthritis: if it is “as effective as physical therapy in relieving pain and stiffness…it’s because of the exercise…Chi has nothing to do with it.” Mark Crislip discussed the differences between acupuncture and dry needling, and concluded that “for all practical purposes dry needling is yet another form of the acupunctures and likely just as ineffective.” Harriet Hall analyzed a study of Therapeutic Touch. “The results of a poor quality trial like this can be disregarded as meaningless.”

On Respectful Insolence, “Orac” critiqued the claims for wheatgrass made by Brian Clement.

Edzard Ernst reported on "11 Hard Questions About Chiropractic Physicians" and added four questions of his own. Another Post discussed a paper (Crothers et al., Chiropractic & Manual Ther. 24:16 (2016) Paper) showing that the chiropractic Graston Technique® works no better than placebo. A discussion of shiatsuconcluded that “There is no good evidence for effectiveness and some evidence of risk.”

May – Foster and others examined claims for Phiten titanium necklaces, which supposedly promote relaxation and emotional well-being (Skeptical Inquirer 40(3), 45-50 (2016) Paper). The claims are scientifically absurd, and a study by the authors found that blinded subjects wearing the necklace felt no different than those with placebo necklaces.

May – A review of acupuncture for functional dyspepsia (Zhou, Su, and Zhang, J. Altern. Complement. Med. 22, 380-389 (2016) Abstract) concluded that “Acupuncture appears to be efficacious in relieving FD symptoms and improving quality of life.” However, it also noted that “Half of the articles included in the analysis were low quality, and most of them were published in Chinese” [nearly all papers published in China report positive results].

May 2 – A Cochrane Collaboration review of acupuncture for polycystic ovarian syndrome found “insufficient evidence to support the use of acupuncture for treatment of ovulation disorders in women with PCOS” (Lim et al., Cochrane Database Syst. Rev., CD007689 (2016) Abstract). In his Blog, Ernst praised the review for the clarity of its conclusion, in contrast to many other reviews of methods having little evidence in support.

May 12 – An Article in Forbes by P. Lipson was entitled “Naturopaths: Fake Doctors in White Coats.” “Naturopathy is not medicine or science, but more akin to religion…[it includes] long-disproved quackery such as homeopathy, hydrotherapy, and electromagnetic therapy…naturopaths are not real doctors.”

May 10 – Essential oils are chemicals employed for some alleged health benefits, and are meant to be inhaled or applied to the skin. A Story reports on an increase in accidental poisoning of children, who sometimes try to drink the oils.

May 17 – In an article in Stat, C. Heijnen reported on lobbying efforts by naturopaths to get reimbursed by Medicare. “Naturopaths’ lobbying and public relations drives are funded in part by vitamin companies, which have a vested interest in seeing the profession expand…” Other commentary was provided by “Orac” on Respectful Insolence and by T. Gettys in Raw Story.

May 18 – The Federal Trade Commission has reached a Settlement with the LearningRx “brain training” programs over claims by the latter that the programs were “clinically proven to permanently improve serious health conditions like ADHD, autism, dementia…” and to improve school grades and job performance. The settlement requires future claims to be backed by human clinical testing.

May 20 – Alabama became the sixth state to ban kratom, a plant product used as a pain killer Story. While the FDA classifies it as a dietary supplement, the Drug Enforcement Administration considers it a “drug of concern” because of the potential for addiction.

May 21 – In Naturopathic Diaries, B. Hermes refuted naturopathic talking points made at their annual lobbying in Washington. Among the claims discussed are that naturopaths are educated similarly to medical students and are qualified to be primary care physicians.

Best of the blogs, June – on Science-Based Medicine, Harriet Hall was skeptical of whether the Primo vascular system exists and can provide an anatomical basis for meridians and acupuncture points. She then took on Ray Jardine's Blood Cleaner, which supposedly uses micro-currents to electrocute pathogens in the blood. “What’s wrong with this? Practically everything.” She concluded that the ROCA screening test for ovarian cancer is “not ready for prime time”: it looks promising, “but the evidence is preliminary.” Finally, she addressed the THRIVE program for weight loss, “a multilevel marketing scheme” including a mixture of dietary supplements. “There is no rationale for mixing all these ingredients, and no reason to think the effects are synergistic.” Steven Novella analyzed claims for the EMP Pad, which uses pulsed electromagnetic fields. He concluded that it “is a typical quack device…with science jargon” but no evidence in support. In another post, he examined the MEND protocol for Alzheimer’s disease. The approach “is highly dubious in that it extrapolates wildly from basic science to clinical application.” “Orac” also addressed this topic on Respectful Insolence. The “protocol appears to look at every marker Muses Labs can find that has been implicated in Alzheimer’s disease without actually bothering to figure out if these markers are actually etiologically linked to Alzheimer’s disease.” Cancer patient Jesse Luke discussed “the general harm caused to patients by the presence of integrative medicine in healthcare.” Grant Ritchey dealt with dental appliances to treat Tourette syndrome. He concludes that “the biological plausibility for such a device is very low.” Mark Crislip evaluated the "About Herbs" app offered by the Memorial Sloan Kettering Cancer Center. He terms it “an app to avoid,” since it presents information with little critical evaluation and explanation.

On Respectful Insolence, “Orac” criticized "naturopathic oncology," “With the vast majority of naturopathic treatments, the evidence of efficacy is sketchy at best, usually nonexistent, or at worst contradictory to any claims of efficacy.” He deplored the “false balance” in a STAT News article about alternative cancer physician Stanislaw Burzynski. He said, “…publishing an article like this potentially does other cancer patients damage by planting the idea that Burzynski might be on to something in their minds.” Another post was entitled "Quackery Expands in the Dana Farber Cancer Institute and Children's Hospital of Philadelphia". New programs will include pseudoscientific methods like reflexology and reiki. He noted, “…patients often want a lot of things, but we’re under no obligation to give it to them if it’s unproven and not science-based.” Finally, he analyzed a proposed “clinical trial” of foot bath "detoxification." He notes, “’detox’ foot pads and foot baths are among the very silliest treatments used in alternative medicine there are.” The purpose of the study is merely to act as a marketing tool for the baths.

Edzard Ernst critiqued the studies cited in a white paper by the Acupuncture Now Foundation. He also discussed turmeric. “What emerges from a critical reading of the evidence is that turmeric has potential in several different areas. Generally speaking, clinical trials are still thin on the ground, not of sufficient rigor and therefore not conclusive…There might be risks associated with ingesting turmeric at high doses over long periods of time.”

June – Klein and others reviewed “Integrative Approaches to Caring for Children with Autism” (Curr. Prob. Pediatr. Adolesc. Health Care 46, 195-201 (2016) Abstract). They concluded, “the most promising therapies recommend are applied behavior analysis, parent-implemented training, melatonin supplements to improve sleep, supplements to correct deficiencies, and music therapy…Given their risks, costs, and limited evidence of efficacy, chelation, secretin, and hyperbaric oxygen should be avoided.”

June – A review of mindfulness-based therapy for patients with breast cancer (Zhang et al., Complement. Ther. Med. 26, 1-10 (2016) Abstract) concluded that “MBT is a promising adjunctive therapy for patients with breast cancer. Due to some methodological flaws in the literature, further well-designed RCTs [randomized controlled trials] with large sample sizes are needed to confirm these preliminary estimates of effectiveness.”

June 1 – Rautiainen and others reported results from the Physician’s Health Study, examining health of more than 18,000 male physicians over 12 years (J. Nutr. 146, 1235-1240 (2016) Abstract). Although multivitamin use reported at baseline did not appear linked to the incidence of heart disease, those who had reported multivitamin use of more than 20 years at the start did appear to have a lower risk of cardiovascular events.

June 1 – An Article by D. Schardt asked, “Are Bio-Identical Hormones Safer and More Effective, as Suzanne Somers Claims?” “In reality, compounded products have similar or even greater risks than conventional hormone therapy.” Quoting women’s health researcher JoAnn Manson, ““Women interested in bio-identical hormones have many FDA-approved options to choose from and don’t need to go the custom-compounding route. There are many FDA-approved bio-identical hormones that come in pills, patches, gels, and sprays in a wide variety of doses.”

June 1 – Grant and others reviewed acupuncture for substance abuse disorders (Drug Alcohol Depend. 163, 1-15 (2016) Paper). They concluded “The results of this review do not support the use of acupuncture for substance use outcomes; we did not find consistent evidence in support of acupuncture for relapse and quantity of substance use, and the one result we found in favor of frequency of substance use was based on only one small trial.”

June 7 – A Cochrane review of tai chi for chronic obstructive pulmonary disease (COPD) concluded “Evidence of very low to moderate quality suggests better functional capacity and pulmonary function in post-programme data for Tai Chi versus usual care. When Tai Chi in addition to other interventions was compared with other interventions alone, Tai Chi did not show superiority and showed no additional effects on symptoms nor on physical and psychosocial function improvement in people with COPD” (Ngai, Jones, Tam, Cochrane Database Syst. Rev., CD009953 (2016) Abstract).

June 9 – D. Jones published a four-part series on the International Meta-Medicine Movement, “an elaborate philosophy of preventive health based on the discredited theories of Dr. Ryke Geerd Hamer,” a German physician (Part 1 Part 2 Part 3 Part 4).

June 21 – Franco and others reviewed plant-based therapies for menopausal symptoms (JAMA 315, 2554-2563 (2016) Paper). They concluded that “composite and specific phytoestrogen supplementations were associated with modest reductions in the frequency of hot flashes and vaginal dryness but no significant reduction in night sweats. However, because of general suboptimal quality and the heterogeneous nature of the current evidence, further rigorous studies are needed to determine the association of plant-based and natural therapies with menopausal health.”

June 24 – A Canadian couple received sentences for “failing to provide the necessaries of life for their 19-month-old son, who died from bacterial meningitis” News story. Instead of getting proper medical treatment for their child, the couple relied on naturopathic remedies.

June 28 – A Cochrane review evaluated "Acupuncture for the Prevention of Episodic Migraine” (Linde et al., Cochrane Database Syst. Rev, CD001218 (2016) Abstract). The authors concluded, “The available evidence suggests that adding acupuncture to symptomatic treatment of attacks reduces the frequency of headaches. Contrary to the previous findings, the updated evidence also suggests that there is an effect over sham, but this effect is small.”

June 30 – A Commentary by Walker, entitled “The New Chiropractic,” called on chiropractors to marginalize “the nonsensical elements of the profession” (Chiropr. Man. Therap. 24, 26 (2016)). “Insist that professional chiropractic organisations take a public stand against biologically implausible notions and theories, illogical ideas, dangerous practices and be prepared to report even likable but misguided individuals…chiropractors promoting anti-vaccination views need to be countered and also those in the profession who seek to medicalise infancy by ‘diagnosing’ infants with notional spinal manipulable lesions.”