Archive for the 'Science and Medicine' Category

Jun 29 2015

Drinking the “Integrative” Kool-Aid at the Atlantic

A recent article at the Atlantic by Jennie Rothenberg Gritzi demonstrates just how thoroughly the alternative medicine movement (I will refer to this as CAM) has been able to influence the cultural conversation over the practice of medicine.  This is great evidence of how successful a persistent marketing campaign can be.

Gritzi relates early on in the article that she was predisposed to CAM from a young age, which might explain her journalistic failures in this piece.  She writes:

After visiting the NIH center and talking to leading integrative physicians, I can say pretty definitively that integrative health is not just another name for alternative medicine.

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Jun 23 2015

Human Breast Milk – The New “Superfood”

This is yet another example of why making decisions based upon ideology, or what feels right, instead of logic and evidence is a terrible idea. There is currently a market for adult consumers of human breast milk, which is being sold as a “superfood” that can treat numerous conditions and optimize athletic performance. These claims are, of course, nonsense. The practice is also risky. A new report in the Journal of the Royal Society of Medicine details the problems.

A market for human breast milk (HBM) exists as a means of providing HBM for infants whose mother cannot produce. A recent survey finds that most HBM exchange happens offline, but facilitated through online sites. There is also a lot of overlap between donors and recipients, with women being donors at one time and recipients at others. This infrastructure exists to provide HBM for infants, and there is good evidence that HBM is the optimal food for infants.

A parallel market is emerging, however, for HBM intended for adult consumers based upon the idea that HBM is a natural superfood. Both of these concepts, however, are problematic. I have discussed many times how the term “natural” is used as a marketing ploy, but has no real meaning and is not rationally regulated. Whether or not a substance occurs in nature is irrelevant to its toxic or health effects, but it is meant to feel good. The idea of “natural” has a health halo, but does not mean anything specific, and is therefore ideal for marketing.

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Jun 19 2015

Are We Seeing the End of Homeopathy?

Several years ago, during a lecture on Science-Based Medicine, I noted that if there were one medical pseudoscience that was vulnerable to extinction it was homeopathy. Homeopathy is perhaps the most obviously absurd medical pseudoscience. It is also widely studied, and has been clearly shown to not work. Further, there is a huge gap in the public understanding of what homeopathy is; it therefore seems plausible that the popularity of homeopathy can take a huge hit just by telling the public what it actually is.

Further, homeopathy is in a precarious regulatory position. Homeopathic products are presented and regulated as drugs, but clearly they are not, and they are also not supplements, herbal drugs, nutrition-based, or natural products. They are simply fraudulent drugs riding a wave of ignorance.

In the last few years homeopathy has had a rough time. While the industry is still growing, there are signs of clear trouble on the horizon. Let’s review:

Some Background

Homeopathy is a 200 year old pre-scientific system of medicine based upon magical thinking. It is mostly based on two notions, the first of which is that like cures like. In other words, a substance that causes a symptom can cure that symptom in extremely low doses. There is no scientific basis for this, despite the desperate attempts by homeopaths to invoke vaccine-like analogies, or their new favorite, hormesis.

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Jun 18 2015

Autism Pseudoscience in the NY Post

The NY Post recently published an article The miracle that cured my son’s autism was in our kitchen. It is a horrible piece of science journalism published in the “Living” section of the paper by a writer, Mackenzie Dawson, who writes about reality TV and how to organize your closet when she is not mangling science. The piece stumbles from trope to trope as it follows a tired formula.

First open up with a heart-warming anecdote of a child “cured” by a plucky parent who would just not give up. Let a bunch of cranks explain how it all works, and sneak in one paragraph of token skepticism that you then immediately contradict. Then finish off with flourish of how amazing your star anecdote is doing. Dawson gives us an added bonus, a cherry-picked study to create the illusion she did some actual journalism.

The story is an old one – dietary restrictions to treat autism. Dawson writes:

“I remember thinking, ‘Oh my God. What are we going to do?’ ” Levin recalls. “Everyone knew autism was a lifelong disorder and couldn’t be cured.”

Except that in Ben’s case, it could be. And it was.

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Jun 05 2015

Allergy and Other Health Scams

Allergies are a real problem, and for some people are life-threatening. Allergies also appear to be on the rise in developing countries, and scientists are not sure why.

Meanwhile, charlatans are exploiting fears of allergies and making bogus allergy diagnoses based upon bogus tests. Sense about Science recently published an excellent guide for the consumer to help make sense of what is real and what is fake when it comes to allergies. It is getting increasingly difficult for the consumer, as regulations increasingly fail to maintain a single science-based standard of care in medicine.

Narrative-Based Medicine vs Science-Based Medicine

Fake allergy diagnoses is just one manifestation of what might be called “narrative-based medicine.” I am seeing this phenomenon increasingly, both in my office as patients tell me their tales of their diagnostic misadventures, and as part of my science-based medicine (SBM) activism. The problem is that it takes a genuine dedication to, and thorough understanding of, science-based medicine in order to avoid falling into the trap of confirming your own compelling narrative. There is no sharp demarcation line, but there are examples at the extremes.

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May 15 2015

The Meddling Prince

Context is important. If a celebrity promotes a good cause, such as Michael J. Fox raising awareness about Parkinson’s disease, then that is considered altruism and charity. If, however, they promote something with which you disagree, then they are exploiting their celebrity.

I find this analogous to many legal and political claims. In the legal context, if you can’t win on the merits, then argue the law. In politics, if you oppose a law then you can challenge it based on state’s rights or as a constitutional purist. I am not opposed to these concepts – I just want to point out that often such arguments are used selectively when it is really the substance that is unwanted.

I am not decrying the use of celebrity itself. Celebrities have a right to advocate for whatever they want, and their celebrity will lend power to their advocacy. I do think that in general the public should not give weight to celebrity itself. They should be, in fact, more skeptical if celebrity is being used to support a claim. I also respect celebrities who use their power for good, and I am free to publicly criticize those who use it for “evil.” Indulge me while I engage in the latter.

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May 07 2015

Fight Over WiFi In Public Schools

A Los Angeles middle school has turned WiFi off in a classroom to accommodate a teacher, Anura Lawson, who believes she has electromagnetic sensitivity. Now Lawson is petitioning to have WiFi turned off in every classroom in California. That’s what you get for catering to pseudoscience – more pseudoscience.

Electromagnetic (EM) sensitivity is a controversial disorder; well, controversial in that the scientific community has investigated it and concluded that it does not exist, but some individuals still believe they have it. Like many spurious disorders, the symptoms are mostly non-specific. Lawson claims she experienced, “dizziness, migraines, and heart palpitations,” while her daughter claims that her “brain was running slower.”

Such non-specific symptoms can be the result of anything stressing out the system: poor sleep, lack of physical activity, an unrecognized chronic illness, anxiety or depression. They may also be purely psychological. There are no specific symptoms or objective signs to indicate that there is any pathology present. Once treatable pathology has been ruled out, it’s best to focus on treating symptoms and improving quality of life.

However, there are many fake or dubious diagnoses out there to place a label on patients with such non-specific symptoms. These labels have changed over the generations, but apparently have always existed. Today there are several popular fad diagnoses for non-specific symptoms, including candida hypersensitivity, multiple chemical sensitivity, chronic Lyme disease, adrenal fatigue and EM sensitivity.

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May 04 2015

Homeopathic Rant

Every now and then we get a public peek into the mind of a crank or pseudoscientist. This is not to say that they don’t utter complete nonsense often, but usually in public they try to put a sanitized and rational face on their quackery. An unfiltered rant can be refreshing and illuminating.

Recently a homeopath, Mary English, wrote such a public rant against Simon Singh, who is a science communicator and promoter of rationality. What has English so riled is the fact that Singh is threatening to sue the National Health Service (NHS) for wasting taxpayer money by funding homeopathy.

Singh is an open critic of so-called alternative medicine. He has written about homeopathy before, explaining why it is complete unscientific lunacy. He famously was sued by the British Chiropractic Association for daring to say that they embrace “bogus” therapies (because they do).  He works for a charity, the Good Thinking Society, which has challenged the UK powers-that-be to reconsider their support of homeopathy:

In February 2015, The Good Thinking Society, working with Bindmans LLP, wrote to Liverpool CCG (Clinical Commissioning Group) in order to highlight and challenge the CCG’s decision to approve spending on homeopathic treatments – a decision we believe to be unlawful, and contrary to the best interest of local patients. In April 2015, Liverpool CCG conceded our challenge and agreed to make a fresh decision on the issue.

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Apr 27 2015

Defending Children – See, That Wasn’t So Hard

Last year two similar cases in Canada came to public attention – both involved young girls with terminal blood cancer, but ones that are very treatable. Their cancers would almost certainly result in death if they go untreated, and yet they would have about an 85% chance of survival with standard treatment. Both girls were also members of the First Nations, natives with a history of not being treated well by the Canadian government.

In both cases the family wanted to seek “traditional” treatment instead of completing chemotherapy. However, the “traditional” treatment they were seeking was holistic garbage peddled by a charlatan (who is white, and not a native) in Florida, Brian Clement. Clement is not a doctor, but claims to treat cancer with the usual assortment of popular quackery today. Recently the state of Florida accused him of practicing medicine without a license, but they then dropped the case for unknown reasons. I guess Florida just doesn’t have the political will to protect the public from harmful nonsense.

Clement’s false hope has already claimed the life of one of the girls, 11 year-old Makayla Sault died of her leukemia in January. Her mother was literally lured away from continuing chemotherapy by the promises of Clement.

What is most interesting is that the Canadian courts had an opportunity to intervene and to protect these children. They failed with regard to Sault and it is now too late for her. The second girl, whose name is not public, also was allowed to forgo chemotherapy to pursue traditional Floridian quackery. In November 2014 Ontario court Judge Gethin Edward ruled that the family has the right to deny their daughter standard medical treatment. This was done to respect the rights of the First Nations. I argued at the time, while I understand this is a sensitive issue, the rights of a young girl to live trumps everything else in such cases, and I felt this was a profound failure on the part of Judge Edward.

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Apr 21 2015

Recent Death from Diet Supplement

Eloise Aimee Parry, 21, died on April 12 after taking 8 diet pills she bought online. The pills contained 2,4-dinitrophenol (DNP), which is essentially an illegal weight loss aid. The case illustrates the failure of current regulations to protect the public from potentially dangerous drugs. There are many factors that contribute to this failure.

First, some background on DNP

DNP is a powerful uncoupler of oxidative phosphorylation – it allows protons to leak across the mitochondrial membrane, bypassing ATP synthesis. Mitochondria are the energy factories of cells; they make energy using oxygen in a process called oxidative phosphorylation, essentially adding a phosphate atom to ADP to make ATP. ATP are the batteries of cells, they store energy in their phosphate bonds and then can release that energy to drive the reactions necessary for cell functions.

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