Search Results for "homeopathy"

Mar 09 2015

Basic Science Should Inform Clinical Science

Last year David Gorski and I published an article in which we argue that it is a waste of resources and ultimately counterproductive to conduct clinical trials of a treatment that is so scientifically implausible it might as well be “magic.” Homeopathy, for example, fits squarely into this category. The alternative medicine (CAM) community did not respond favorably to our arguments.

A recent article by Sunita Vohra and Heather Boon directly critiques our article. Vohra and Boon are both involved in homeopathy research, so this is no surprise. In their brief article they essentially repeat the standard CAM talking points about scientific research, without really countering the position that David and I have described. In their article, in my opinion, they demonstrate the utter intellectual bankruptcy of the CAM position. They repeat points that have been deconstructed years ago, without ever addressing the counterpoints.

The core of the disagreement is about the relative role of various kinds of scientific research in evaluating medical therapies. The position of science-based medicine (SBM) is that rigorous efficacy trials are required to truly know if a treatment is safe and effective (that aspect of our position we share with standard evidence-based medicine or EBM). Further, this clinical evidence must be put into the context of all the rest of science, right down to basic laws of physics, summarized as an overall scientific judgement about the plausibility of the treatment. This basic science plausibility should also be used to guide the expenditure of our limited resources in conducting expensive and resource-draining clinical trials. At the same time, solid evidence from clinical trials can inform basic science by suggesting possible biological mechanisms.

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Feb 10 2015

Regulating Supplements

While I try to stick in these articles to science and critical thinking, and try to minimize any expression of my personal ideology or political opinion, I make no secret of the fact that I support fair and effective government regulation of all aspects of healthcare. This is partly because I feel the evidence strongly supports this position, but also I am a physician so it is my additional duty to advocate for the health of my patients and society.

The inadequate regulation of the supplement industry has recently been in the news and possibly (hopefully) this issue is coming to a head, perhaps sufficiently to garner the political will to revise current regulations.

First let me point out that I consider the pharmaceutical industry and the supplement industry to be essentially the same thing, the only real difference being the different rules for their regulation. They are different regulatory categories, but the companies making drugs and supplements have significant overlap. Further, the market forces are largely the same, the major difference being that for non-over-the-counter drugs a doctor’s prescription is needed.

I am often accused by defenders of supplements, homeopathy, and “natural” medicine of favoring the pharmaceutical industry, or at least giving them a pass. This is simply not true. I favor strong regulation of the pharmaceutical industry. I have specifically advocated reforms, such as registering clinical trials so drug companies cannot hide data. I favor recent reforms limiting conflicts of interest between physicians and pharmaceutical companies, and the full disclosure of any potential conflicts when they occur. I am against pharmaceutical industry practices, such as ghost authoring white papers to promote their products. There have been numerous multi-billion dollar settlements for pharmaceutical companies breaking the rules that govern the marketing of their products.

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Jan 01 2015

2014 Was a Bad Year for Homeopathy

I have been saying for several years that if there is a pseudoscientific medical treatment that is especially vulnerable to critical analysis it’s homeopathy. There’s a lot of nonsense in the world of medicine, but homeopathy takes the prize. First, it is complete and utter nonsense.

There is no need to equivocate. Homeopathy violates basic scientific knowledge in physics, chemistry and biology. It is transparent witchcraft that cannot possibly work by any known or even semi-plausible mechanism. Further, clinical studies unsurprisingly show that it does not work, for anything.

And yet the public does not generally understand what homeopathy actually is. The most common belief is that homeopathy is natural or herbal medicine. Rather, homeopathy is based upon several dubious notions. The first is that like cures like, and idea based on sympathetic magic and not science or any knowledge of the real world. Further, the actual starting ingredients are based upon a fanciful and often absurd interpretation of this dubious notion, leading to things like using duck liver to treat the flu.

None of this actually matters, however, because most homeopathic remedies are diluted beyond the point that there is any chance of a single molecule of starting ingredient remaining. All of this is supposed to work, however, because the potion is “activated” by shaking it.

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Nov 20 2014

How Much Water?

Water is the focus of a great deal of medical myths and snakeoil. This is perhaps due to water’s health halo – it is the very essence of purity, the elixir of life. I wonder if there is an evolved psychological connection to water. The idea of drinking dirty or contaminated water seems to be especially disgusting, while pure clean water is the most wholesome thing in the world.

Perhaps this is why there are so many “magic water” scams out there.  There is structured water, energized water, and ionized water. Homeopathy is essentially magic water with memory.

There is also a persistent belief that simply drinking more water has untold health benefits. You have probably heard that you should drink eight 8 oz glasses of water per day to stay healthy. This, however, is a myth, in that the 64 oz figure is not based on any evidence.

Your water requirements will vary, depending upon your body size, level of activity, humidity and ambient temperature. It will also depend on the type of food you eat. We get on average about 20% of our water intake from our food, but this will also vary depending on the type of food you eat.

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Oct 30 2014

Homeopathy for Ebola

New Zealand Green MP, Steffan Browning, stepped in it recently when he signed a petition asking the World Health Organization (WHO) to develop and distribute homeopathic remedies to end the Ebola epidemic. Unfortunately this is not an Onion article.

Browning later tried to do damage control by stating that his support of the petition was “unwise” and he blamed it partly on it being late at night when he signed it.

Asked whether he thought homeopathy could cure Ebola, Mr Browning said: “It’s not for me to go down that track at all. The World Health Organisation, world health authorities are doing that.”

This is a common political response. Ask a Republican eyeing national office what they think about global warming or evolution and you might get a similar answer. It is a disingenuous dodge to essentially say, “I’ll let the scientists decide.” when they have already decided. It’s simply a way to stake out a neutral position and not piss anyone off.

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Aug 21 2014

Researching Magic

David Gorski and I have just published a paper in Trends in Molecular Medicine titled: Clinical trials of integrative medicine: testing whether magic works?

While we have published literally thousands of online articles discussing these issues here, at Science-Based Medicine, and other venues, it’s great to get an article in the peer-reviewed literature, which hopefully will spark more of a discussion in academic circles.

The full article is available online at the link above, but here’s a quick summary of the main points:

The question is – should we devote limited research resources to investigating CAM (complementary and alternative medicine) methods? Those resources include not only money, but researcher time, available patients, and space for reporting and discussion at conferences and in the published literature. CAM is actually a false category, in my opinion, used really as a marketing strategy and not a meaningful designation. It makes it difficult to answer this question, because we first have to operationally define CAM. (As an aside, “integrative” medicine is essentially the same as CAM, just a different marketing term.)

The real question is – how far down the scale of plausibility should we go in allocating research resources? Should it matter?

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Aug 04 2014

Ebola Pseudoscience

It is natural for there to be a certain amount of fear and uncertainty surrounding the reported outbreak of a deadly virus. The recent ebola outbreak is the worst in history, with over 800 deaths reported out of over 1,400 infections (case fatality rate so far of 57%).

Crises like these tend to bring out the best and the worst in people. Health care workers are literally risking their lives to contain this outbreak. Meanwhile, charlatans are coming out of the woodwork to exploit the crisis to spread their nonsense.

Ebola was first discovered in 1976. The virus exists in central and western Africa, and outbreaks are usually small, involving isolated villages. The virus can exist in fruit bats, which is the usual reservoir that spreads to humans. Other animals can be the vector, however, including chimpanzees, gorillas, monkeys, forest antelope and porcupines. Once a human infection occurs, however, the virus can spread from person to person.

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Jun 02 2014

The Clinical Evidence for Homeopathy

Dana Ullman is a notorious apologist for homeopathy. He has a reputation, at least among skeptics, for cherry picking data and making dubious arguments – whatever it takes in order to defend his beloved homeopathy. He then tops it off by accusing skeptics of being closed-minded for not accepting his drivel.

An article of his recently popped up on the Skeptic subreddit (posted by rzeczpospolita) with the challenge, “Countless scientific studies showing that homeopathy works. Or are you “skeptics” too closed minded to accept this fact?”

The article is too long to deconstruct in one blog post, so I will focus on the key claim – that clinical evidence demonstrates that homeopathy works. His primary piece of evidence is this:

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May 19 2014

Drinkable Sunscreen

Recently the Daily Mail (some like to call it the “Daily Fail”) ran an article reporting, without any critical analysis, that a company is now offering drinkable sunscreen.

At first the claim seems extraordinary, but it is not impossible. It is theoretically possible to drink a substance that becomes deposited in the skin and absorbs or reflects UV radiation providing protection. However, upon reading the details it becomes immediately apparent that the product in question is pure snake oil.

The product is Harmonized Water by Osmosis Skin Care. In fact, UV protection is just one claim among many for the harmonized water line of products. The website claims:

  • Remarkable technology that imprints frequencies (as standing waves) onto water molecules.
  • Advances in the ability to “stack” thousands of frequencies onto one molecule.
  • Revolutionary formula allows us to reverse engineer the frequencies of substances found in nature and/or the human body.
  • Newly identified frequencies that have beneficial effects on the body.

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May 05 2014

David Katz on Evidence in Medicine

David Katz is a fellow physician at Yale, and he is also a strong proponent of so-called “integrative medicine.” He has written a recent commentary at the Huff Po, defending the integrative approach. He writes:

Integrative Medicine — a fusion of conventional and “alternative” treatments — provided patients access to a wider array of options. So, for instance, if medication was ineffective for anxiety or produced intolerable side effects, options such as meditation, biofeedback, or yoga might be explored. If analgesics or anti-inflammatories failed to alleviate joint pain or produced side effects, such options as acupuncture or massage could be explored.

His basic argument is this – when we lack strongly evidence-based options, we need to explore not-so-evidence-based options, for the good of our patients. Mainstream medicine is not that evidence-based either. And – mainstream medicine relies on money-driven research, which is biased against integrative approaches.

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