In Good Health
(from Consumer Health Digest newsletter)

alternative "medicine"

Metaanalysis finds no benefit from reflexology. (Consumer Health Digest #09-46 November 19th, 2009)
Edzard Ernst, M.D., Ph.D. has located and evaluated 18 randomized controlled clinical trials involving reflexology. [Ernst E. Is reflexology an effective intervention? A systematic review of randomised controlled trials. Medical Journal of Australia 7;191:263-266, 2009] http://www.ncbi.nlm.nih.gov/pubmed/19740047.
. He concluded that 12 failed to show effectiveness, five suggested positive results, and one result was unclear, most of the studies were small and poorly designed, and the two largest studies had negative results. Overall, Ernst concluded:
**The trials failed to demonstrate that reflexology is clinically effective for any of the wide range of conditions for which it has been tested.
**Use of reflexology for diagnosis will generate false positive and false-negative results.
**If used instead of standard treatment for serious conditions, it could be life-threatening.
Reflexology is a pseudoscientific practice system of diagnosis and treatment based on the premise that each body part is "represented" on the hands and feet and that pressing on the hands and feet can have therapeutic effects throughout the body. Research will never validate it.

Serious new acupuncture infection risks described. (Consumer Health Digest #10-12, March 25th, 2010)
Microbiologists at the University of Hong Kong are concerned that the threat of infections associated with acupuncture may be much greater than previously thought. In a British Medical Journal editorial, the researchers warned that bacterial infections, hepatitis B and C viruses, and possibly even HIV may be transmitted through the use of contaminated equipment and lack of adequate skin disinfection. They expressed particular concern about mycobacteria that can grow rapidly where needles are inserted and lead to large pustules, abscesses, and ulcers after several weeks to months. Two outbreaks involving more than 70 patients were reported in 2006, and a case of methicillin resistant Staph aureus (MRSA)was reported last year. [Acupuncture transmitted infections. British Medical Journal 340:c1268, 2010] http://www.ncbi.nlm.nih.gov/pubmed/20233800.

Classic health survey report posted. (Consumer Health Digest #10-41, October 14th, 2010)
The full text of A Study of Health Practices and Opinions has been posted to the Consumer Health Sourcebook Web site. http://www.chsourcebook.com/articles/health_practices_and_opinions.pdf (15,72 Mb). The FDA-sponsored survey, published in 1972, investigated questionable and fallacious health beliefs and why people are susceptible to them. The covered areas include vitamin pills, other dietary supplements, weight-reduction practices, cancer-related practices, arthritis-related practices, laxatives, self-diagnosis, self-medication for common ailments, types of practitioners used, and general health-related attitudes and opinions. It is the largest survey of its type ever conducted.

Echinacea flunks another test. (Consumer Health Digest #10-51, December 23rd, 2010)
A randomized controlled clinical trial has found no evidence that taking echinacea will modify the symptoms or duration of the common cold. The trial involved more than 700 patients, ages 12 to 80, who received either no pills, placebo pills, echinacea pills without being told what they were, or echinacea pills that were identified as such. The study found no significant difference in outcome between echinacea and placebo treatment. [Barrett B. and others. Echinacea for treating the common cold. A randomized trial. Annals of Internal Medicine 153:769-777, 2010] http://www.ncbi.nlm.nih.gov/pubmed/21173411.

Review finds acupuncture ineffective for pain relief. (Consumer Health Digest #11-06 March 24th, 2011)
Reviewers who examined 57 systematic reviews of acupuncture for pain published since the year 2000 have reported:
**The majority of reviews were positive, but only four had excellent methodological quality.
**Positive findings have questionable significance because there is no plausible reason why acupuncture should reduce pain in some conditions while failing to work in many others.
**Recent well-designed clinical trials have found that real acupuncture was no better than sham acupuncture and any benefit in pain reduction resulted from nonspecific effects such as therapist conviction and/or patient expectation or enthusiasm.
**Ninety-five cases of severe adverse effects including five deaths were included.
**Pneumothorax and infections were the most frequently reported adverse effects.
The reviewers concluded: "Numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain. Serious adverse effects continue to be reported."
[Ernst E and others. Pain 152:755-764, 2011] In an accompanying editorial, Harriet Hall, M.D. identified additional harms (time and money wasted, effective treatment delayed, and unscientific thinking encouraged) and suggested that further studies of acupuncture for pain would have no practical value. [Hall HA. Acupuncture's claims punctured: Not proven effective for pain, not harmless. Pain 152:711-712, 2011]
.

Steve Jobs was a quackery victim. (Consumer Health Digest #11-33 October 6th, 2011)
Steve Jobs, the ultrasuccessful Apple Computer CEO who died this week of pancreatic cancer, delayed recommended surgery for nine months while treating himself with a diet. Although Jobs stated publicly that he was diagnosed with pancreatic cancer in 2004, a Fortune Magazine reporter learned that Jobs was actually diagnosed in 2003 with a rare form of pancreatic cancer that has a high cure rate if treated early. But instead of undergoing the operation, he relied on worthless dietary treatment. [Elkind P. The trouble with Steve Jobs. Fortune Magazine, March 8, 2008] http://money.cnn.com/2008/03/02/news/companies/elkind_jobs.fortune/index.htm
It may be impossible to determine whether the delay decreased his survival time and quality of life. But it is clear that whatever time and energy he used in pursuing "alternative" methods could have been spent doing something more useful.

Science-based "CAM" journal offers free access to recent issue. (Consumer Health Digest #12-11 March 29th, 2012)
The entire March 2012 issue http://onlinelibrary.wiley.com/doi/10.1111/fct.2012.17.issue-1/issuetoc of Focus on Alternative and Complementary Therapies (FACT) has been posted with free access. The lead editorial explains why biological plausibility should be critical in determining research priorities. It concluded: "In determining if we want to do efficient research, we should focus on those treatments that are already supported by biological plausibility. The danger of not adhering to this strategy is considerable; such as wasting time, money and experience on projects that have very little chance of success. This would not just be uneconomical but also unethical."

Toxic and illegal ingredients found in TCM products. (Consumer Health Digest #12-13 April 12, 2012)
Australian researchers have found that many traditional Chinese medicines contain ingredients that are toxic or are derived from endangered animals. Noting that few such ingredients were disclosed on the product labels, the study leader said "There is absolutely no honesty in labeling these products." The researchers used "next-generation" genetic sequencing to test samples of 15 powders, capsules, tablets, flakes, and herbal teas that had been seized by Australian authorities. The researchers also concluded that genetic sequencing is far more effective than standard chromatographic and DNA testing of specimens, particularly in mixtures when the source of the ingredients is unclear. [Callaway E. Screen uncovers hidden ingredients of Chinese medicine: Genetic audit reveals that some traditional remedies contain endangered animals and toxic plants. Nature News, April 12, 2012] http://www.nature.com/news/screen-uncovers-hidden-ingredients-of-chinese-medicine-1.10430#/b1

More ayurvedic herbal products found to contain lead. (Consumer Health Digest #12-30 August 30, 2012)
Public health officials have reported six cases of lead poisoning among foreign-born women who took ayurvedic herbal products imported from India. Since 2004, 22 such products have been found to contain potentially toxic amounts of lead. [Lead poisoning in pregnant women who used ayurvedic medications from India -- New York City, 2011-2012. MMWR 61:641-646, 2012] http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/ayurvedic_lead.pdf .
In 2003, a survey of ayurvedic herbal products manufactured in South Asia and sold in Boston-area stores found that 14 of 70 products (20%) contained concentrations of lead, mercury, and/or arsenic that-if the products were taken according to directions-would exceed published regulatory standards. The authors also noted that ayurvedic theory attributes important therapeutic roles to mercury and lead and that perhaps 35-40% of medicines in the Ayurvedic formulary contain at least one metal. [Saper RB and others. Heavy metal content of ayurvedic herbal medicine products. JAMA 292:2868-2873, 2004] http://www.ncbi.nlm.nih.gov/pubmed/15598918 .
In another study published in 2008, researchers who tested 193 ayurvedic products randomly selected from 25 Web sites found that one fifth of them contained heavy metals in amounts that exceeded standards for acceptable daily intake. [Saper RB and others. Lead, mercury, and arsenic in US- and Indian-manufactured ayurvedic medicines sold via the Internet. JAMA 300:915-923, 2008] Several studies done in other countries have had similar findings. http://www.ncbi.nlm.nih.gov/pubmed/18728265.

Health Magazine warns against 30 herbs. (Consumer Health Digest #13-11 March 14, 2013)
Health Magazine has published warnings about 30 herbal products that can cause serious reactions to people taking prescription drugs for heart problems. The list includes alfalfa, aloe vera, angelica, bilberry, black cohosh, butcher's broom, capsicum, echinacea, ephedra, fenugreek, fumitory, garlic, ginger, ginkgo, ginseng, gossypol, grapefruit juice, green tea, hawthorn, Irish moss, kelp, khella, licorice root, lily of the valley, night-blooming cereus, oleander, saw palmetto, St. John's wort, strophanthus, and yohimbe. [Heart trouble? 30 Herbal remedies to avoid. Health Magazine Web site, accessed April 14, 2013] link

British advertising regulators attacking reflexology claims. (Consumer Health Digest #13-17 April 25th, 2013)
The British Committee of Advertising Practice (CAP) Compliance has issued a guidance document on reflexology claims and is now checking Web sites for violations. In 2011, the Advertising Standards Authority upheld complaints about three websites that claimed or implied that reflexology could alleviate Parkinson's disease, arthritis, migraine, high blood pressure, fertility issues, cancer, lupus, hypertension, prostate problems, depression, glandular fever, ADHD, and many other conditions. Reflexologists claim that specific zones of the foot correspond to areas or organs of the body and that massaging these zones are effective against disease. The agencies have indicated that claims of this type should not be made without robust supporting evidence. (Such evidence will be impossible to get because the anatomical connections fancied by reflexologists do not exist.) Quackwatch has a detailed report on reflexology (link).

Acupuncture blasted. (Consumer Health Digest #13-21 May 30th, 2013)
David Colquhoun, Ph.D. and Steven Novella, M.D., have coauthored a hard-hitting article which concludes that that acupuncture is worthless for pain relief. [Colquhoun D, Novella S. Acupuncture is theatrical placebo. Anesthesia & Analgesia 116:1360-1363, 2013]. Their report concludes that "the benefits of acupuncture are likely nonexistent, or at best are too small and too transient to be of any clinical significance." The full text of the article can be downloaded from the journal Web site. However, a version on Colquhoun's blog contains links to dozens of supportive documents.

British regulators object to acupuncture claims. (Consumer Health Digest #13-23 June 13th, 2013)
The British Advertising Standards Authority has upheld complaints against two acupuncture leaflets issued by the Royal London Hospital for Integrated Medicine. One leaflet claimed that acupuncture was effective against menstrual disturbances, other gynecological disorders, prostatitis, urinary disorders, infertility, stress, anxiety, depression, addictions, migraines, tinnitus, dizziness, sleep disturbances, immune system imbalances, allergies, herpes zoster (shingles), gastrointestinal conditions, musculoskeletal problems (including joint pain and back pain), sinusitis, asthma, and high blood pressure. The other leaflet made efficacy claims for various musculoskeletal conditions. The RLHIM conceded that about half the claims could not be substantiated but submitted 43 reports that supposedly supported the rest. But the ASA concluded that the evidence was insufficient to support the advertised claims.


Acupuncture complications analyzed.
(Consumer Health Digest #13-23 June 13th, 2013)
Chinese researchers have published a systematic review of adverse events associated with acupuncture reported between 2000 and 2011. The investigators found 117 reports of 308 adverse events from 25 countries and regions. The main complications were bacterial infection caused by skin contact at acupoint sites. Internal injuries such as puncture of the lung were also reported. [Xu S and others. Adverse events of acupuncture: A systematic review of case reports. Evidence-Based Complementary and Alternative Medicine, Volume 2013, Article ID 581203] The full text of the article is accessible online.


Herbal product investigation finds scandalous results.
(Consumer Health Digest #13-44 November 21st, 2013)
Researchers who used DNA barcoding—a type of genetic "fingerprinting"—to test herbal products have reported widespread discrepancies between the ingredients listed on the label and those found in the products. The study encompassed 44 products representing 12 companies and 30 different species of herbs. The researchers concluded:
Most of the herbal products tested were of poor quality, including considerable product substitution, contamination and use of fillers.
Only 2 of the 12 companies had products without any substitution, contamination or fillers.
59% of the products tested contained DNA barcodes from plant species not listed on the labels.
Product substitution occurred in 30 out of the 44 products tested.
Although the researchers were able to authenticate 48% of the products, one-third of these also contained contaminants and/or fillers not listed on the label.
Some of the contaminants pose serious health risks to consumers.
The researchers recommended that the herbal industry should embrace DNA barcoding for authenticating herbal products. [Newmaster SG and others. DNA barcoding detects contamination and substitution in North American herbal products. BMC Medicine 11:222, 2013] Even if quality control is improved, however, the widespread problems of ineffectiveness and inferiority to prescribed drugs will remain. [Barrett S. The herbal minefield. Quackwatch, Nov 23, 2013].


Pharmacists urged to shun "integrative medicine"
(Consumer Health Digest #14-20 June 1, 2014)
Scott Gavura, BScPhm, MBA, RPh, has written a blog lamenting the development of "integrative" pharmacies that offer homeopathic products and dietary supplements and herbs claimed to "boost the immune system," "detoxify the body," or "cleanse" you of Candida. [Gavura S. Beware the integrative pharmacy. Science-Based Medicine Blog, May 22, 2014] He notes:
Integrative medicine purports to take a "best of both worlds" approach' mixing science-based treatments with a variety of unconventional treatments. The fundamental challenge with integrative medicine is that "integrative" products and services don't have scientific evidence to support them: if they did, they'd simply be called "medicine." Instead of evidence, promoters of integrative medicine rely on other standards - many are grounded in belief systems, such as the idea of "vitalism." While ideas like vitalism are long-discarded from science-based medicine, they live on in the philosophies of practices like homeopathy, naturopathy, and chiropractic. And the retail part of the pharmacy profession sees an opportunity.
I'm seeing the retail component of the profession deciding between one of two paths: One path will involve retail pharmacists, supported by pharmacy regulators, taking greater responsibility for their own profession and professional standards. . . . On this path, professional ethics trump retail pressures, and the practice of retail pharmacy changes to a new equilibrium, where products and services offered are focused on optimizing health, based on the best scientific evidence. . . .
The alternative path for pharmacy is . . . . the "anything for a buck" model, otherwise known as the "integrative" pharmacy. In this model, the retail practice of pharmacy becomes a loss-leader to get customers into stores, and there is a growing disconnect between the practice of dispensing and selling prescription drugs, and the rest of a pharmacy's offerings. The pharmacy is a retailer first, and abandons any scientific standards or justification for products and services offered. Customers may be pleased, but they won't be well-served. Pharmacists and pharmacies may profit in the short-term, but this self-sabotage will effectively and ultimately ostracize the retail pharmacy from science-based medicine.
Personally, I see only one path that is tenable. First, the profession needs to stop embarrassing itself, and get the most egregious quackery, like homeopathy, out of the pharmacy. Second, it needs to stop confusing and misleading customers into the sloppy (and potentially dangerous) thinking that underlies "integrative" care. Finally, it needs to recommit to putting the patient at the center of its practice. . . . As a pharmacist I want retail pharmacy to thrive - but in a framework that is grounded in the best science and the best medical care. "Integrative" pharmacy isn't that path.


Old chiropractic business manual uncovered
(Consumer Health Digest #14-39 - October 26, 2014)
Software engineer Dan Kegel has discovered a 61-page manual from the Chiropractic Business Institute that appears to have circulated in the 1950s. The manual states:
In addition to technique, there are four other factors of vital importance. You must also be a master salesman, an astute psychologist, a brilliant individualist, and an able business man.
All doctors are naturally familiar with Diagnosis, but its interpretation means only the diagnosing of disease. Yet there is a second diagnosis of equal and vital importance. It deals primarily with analyzing a patient from a business standpoint, to determine his worth to the doctor.
Many of the sales pitches are geared toward (a) persuading patients to continue to have weekly care long after their symptoms have resolved, (b) undermining trust in medical doctors, and (c) promoting chiropractic for preventing as well as treating the gamut of health problems. The themes are still common in currently available chiropractic practice-building courses.


Free "Science Based Medicine" course available
(Consumer Health Digest #15-47 - November 29, 2015)
The James Randi Educational Foundation has produced a superb 10-part video lecture series in which Harriet Hall, M.D., contrasts science-based medicine with so-called "complementary and alternative" methods. The topics include: What is CAM?; acupuncture; chiropractic; energy medicine; homeopathy; miscellaneous "alternatives"; naturopathy and herbal medicines; pitfalls in research; science based medicine vs. evidence-based medicine; science-based medicine in the media and politics. The lectures range from 32 to 45 minutes. A companion course guide is also available.

Anti-quackery podcast posted
 (Consumer Health Digest #16-10 March 20, 2016)
Drs. Stephen Barrett and Harriet Hall are featured in a 1-hour podcast that focuses on claims and facts related to "alternative medicine."

Acupuncture judged ineffective against back pain
(Consumer Health Digest #16-13 April 10, 2016)
The National Institute for Health and Care Excellence (NICE) has concluded that acupuncture is no better than a placebo in treating low back pain and sciatica. Its draft guidance report also said that enough studies had been done to conclude that further research is unlikely to alter this conclusions. NICE's 2009 guideline had recommended considering up to 10 sessions of acupuncture needling over a period of up to 12 weeks. [Davis N. Acupuncture for low back pain no longer recommended for NHS patients. The Guardian, March 24, 2016]

Parents convicted of killing child (Consumer Health Digest #16-17 - May 8, 2016)
A Canadian jury has convicted David and Collet Stephan of a criminal charge of "failing to provide the necessaries of life" to their 18-month son, Ezekiel, who died of bacterial meningitis while they treated him for 2½ weeks with hot peppers, garlic, onions, and horseradish and a product from a naturopath said to be aimed at boosting his immune system. [Alberta parents convicted in toddler's meningitis death. CBC News, April 26, 2016] The College of Naturopathic Doctors of Alberta has opened an investigation in response to a complaint signed by 43 physicians. [Naturopath in toddler's meningitis death trial to be investigated by industry body. CBC News, April 27, 2016]

Couple convicted of killing their child get sentenced (Consumer Health Digest #16-24 - June 26, 2016)
Canadians David and Collet Stephan, who were convicted of a criminal charge of "failing to provide the necessaries of life" to their 19-month son, Ezekiel, have been sentenced. [Bell D. David Stephan gets jail time, Collet Stephan gets house arrest in son's meningitis death CBC News, June 24, 2016]
- David was ordered to serve four months in prison.
- Collet was ordered to serve three months on house arrest and to post an unedited copy of the sentencing hearing to all Web and social media sites with which she is personally
affiliated.
- Both were ordered to complete 240 hours of community service.
- The couple's three other children must see a medical doctor at least once a year and a public health nurse every three months.
Press reports indicate that Ezekiel died of bacterial meningitis while they treated him for 2½ weeks with hot peppers, garlic, onions, and horseradish and a product from a naturopath said to be aimed at boosting his immune system. [Alberta parents convicted in toddler's meningitis death. CBC News, April 26, 2016] Before the sentencing hearing, Collet urged her Facebook supporters to send handwritten letters to her lawyer "regarding Dave and myself's parenting character, concern for our children losing us and how this verdict will affect your parental rights." David is vice-president of Truehope Nutritional Support, a company that markets "natural remedies."

Acupuncture claims shredded (Consumer Health Digest #16-29 - July 31, 2016)
Friends of Science in Medicine, an Australian anti-quackery group with more than 1,100 members, has issued a devastating report calling for an end to acupuncture as a medical practice. [Is there any place for acupuncture in 21st century medicine? Friends of Science in Medicine, July 25, 2016] After summarizing acupuncture history, theories, research, and rationalizations for failed studies, the authors conclude:
- Acupuncture has been studied for decades, and the evidence that it can provide clinical benefits continues to be weak and inconsistent. There is no longer any justification for more studies. There is already enough evidence to confidently conclude that acupuncture doesn't work. It is merely a theatrical placebo based on pre-scientific myths.
- All health care providers who accept that they should base their treatments on scientific evidence whenever credible evidence is available, but who still include acupuncture as part of their health interventions, should seriously revise their practice.
- There is no place for acupuncture in medicine.
For many years, proponents have cited as supporting evidence a World Health Organization (WHO) report that listed over 90 conditions for which acupuncture was supposedly effective. In 2014, however, this report was withdrawn in response to substantial evidence contradicting the WHO's advice, including Cochrane Collaboration reviews that shredded the majority of claims.

Stem cell clinics proliferating (Consumer Health Digest #16-29 - July 31, 2016)
A survey has found that hundreds commercial clinics are advertising stem cell therapy to consumers. [Plummer Q. 570 clinics in the US are offering expensive, unproven and unregulated stem cell therapies and that's very dangerous. Tech Times, July 5, 2016] Stem cells are primitive cells that can become specialized cells such as skin, fat, and muscle. They can help to repair tissue and to generate new tissue cells to replace old red blood cells, torn muscles, old skin, and other tissue in the body. They may have the potential to replace tissues damaged by disease, but research is at best preliminary and safety is a major concern. Gabe Mirkin, M.D. lists these reasons to be wary of commercial clinics:
- When stem cells are removed from your own body and re-injected into you, there is no way to tell if anything has been changed.
- Stem cells taken from you do not appear to be as capable of making new tissues as stem cells that are embryonic cells taken from the umbilical cord of a newborn baby.
- Stem cells from a baby's umbilical cord are far more likely to have abnormalities that would keep them from growing lasting new tissue.
- Stem cells can trigger an immune response in which your body treats the new cells as it does invading bacteria and kills them.
- The stem cells from most of these clinics usually have none of the therapeutic advantages that research labs use to make their stem cells more effective. For example, research
labs are making stem cells better by manipulating and transplanting DNA genetic material.
- No government agency is checking these unapproved and unregulated stem cell clinics for effectiveness or safety.
- The procedures used in most of the clinics have not been approved for the general population.
- Celebrity endorsements and patient testimonials are meaningless.
- The prices charged are often outrageous and unlikely to be covered by insurance. [Be wary of stem cell clinics. Gabe Mirkin's Weekly e-Zine, July 10, 2016]

HIV transmitted to acupuncture patients (Consumer Health Digest #17-08 - February 19, 2017)
At least five patients at Zhejiang Provincial Hospital of Traditional Chinese Medicine have been infected with HIV as a result of receiving acupuncture with needles that had not been properly sterilized. The South China Morning Post also reported that a technician and five hospital officials had been fired as a result. [Mai J. At least five infected with HIV after dirty needles used at Chinese hospital. South China Morning Post, Feb 9, 2017]

FDA attacks sale of marijuana derivative as cancer cures (Consumer Health Digest #17-41 - November 5, 2017)
The FDA has ordered four companies - Greenroads Health, Natural Alchemist, That's Natural! Marketing and Consulting, and Stanley Brothers Social Enterprises LLC - to stop selling cannabidiol (CBD) products with unproven claims that they are effective against cancer. The products include oil drops, capsules, syrups, teas, and topical lotions and creams. Some were also marketed as an alternative or additional treatment for Alzheimer's and other serious diseases. CBD is a component of the marijuana plant that is not FDA approved in any drug product for any indication. [FDA warns companies marketing unproven products, derived from marijuana, that claim to treat or cure cancer. FDA news release, Nov 1, 2017]

Spain proposes "alternative medicine" ban in health centers (Consumer Health Digest #18-46 - November 18, 2018)
Science and health ministers of Spain have announced a proposal to: (a) remove "alternative medicine" such as acupuncture and homeopathy from health centers where all treatment must be given by recognized professionals, and (b) develop alliances with deans, chancellors or Spanish regional authorities to end the awarding of diplomas by Spanish universities linked to these practices. Health and science advocates pressured the health ministry to act following several high-profile deaths, including that of 21-year-old Mario Rodriguez, who died after stopping his hospital treatment for leukemia based on the advice of a supposed naturopath who claimed to be able to cure cancer with vitamins. [Spain plans to ban alternative medicine in health centres. The Guardian. Nov 14, 2018].

WHO blasted for legitimizing non-evidence-based Chinese medicine (Consumer Health Digest #19-14 April 8, 2019)
The editors of Scientific American have harshly criticized the World Health Organization for including in the 11th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD) disorders described in ancient Chinese medicine (ICD-11). [Editors. The World Health Organization gives the nod to Traditional Chinese Medicine. Bad Idea. Scientific American. April 2019] Their key points include:
- Including traditional Chinese medicine in the ICD is an egregious lapse in evidence-based thinking and practice. Data supporting the effectiveness of most traditional remedies are scant, at best.
- In China, traditional medicines are unregulated, and they frequently make people sick rather than curing them.
- Analyses of Chinese remedies have revealed hidden ingredients including banned Western drugs, toxic chemicals, and DNA from endangered species.
- The proliferation of traditional medicines contributes to destruction of ecosystems and increases the illegal trade of wildlife.
- Until they undergo rigorous testing for purity, efficacy, dosage and safety, the WHO should remove traditional medicines from its list. These remedies should be given the same scrutiny as other treatments before being included in standard care practices.

Impact of unaffordable medical treatment estimated (Consumer Health Digest 19-47 - November 30, 2019)
Based on a survey of 1,099 U.S. adults conducted in September 2019, Gallup and West Health have estimated that 34 million American adults (more than 13%) know someone who died after not getting treatment and 58 million adults report being unable to pay for needed drugs in the previous year. The percentage of adults who reported not having had enough money in the previous 12 months to "pay for needed medicine or drugs that a doctor prescribed" has increased significantly, from 18.9% in January 2019 to 22.9% in September. Only 7% reported that the Trump administration has accomplished "a great deal" on the issue of drug prices, while 66% said the administration has accomplished "Not very much" or "None at all." [Witters D. Millions in U.S. lost someone who couldn't afford treatment. Gallup, Nov 12, 2019]

Warning issued against unregulated traditional Chinese medicine (Consumer Health Digest 19-47 - November 30, 2019)
The European Academies' Science Advisory Council (EASAC) and the Federation of European Academies of Medicine (FEAM) have issued a joint statement calling the recent proposed addition of a chapter on traditional Chinese medicine to the World Health Organization's International Classification of Diseases coding tool (ICD-11) a "major problem." Calling for the requirement of rigorous evidence of quality, efficacy, and safety, the statement warns:
EASAC and FEAM add our voices to those who have expressed concern about this ICD-11 reclassification to include diagnostic approaches that are not yet, and may never be, adequately validated according to established scientific and regulatory criteria. There is risk in misleading patients and doctors and in increasing pressures for reimbursement by public health systems at a time of limited resources. [Traditional Chinese Medicine: A Statement by EAASAC and FEAM. Nov 2019]

European manifesto against pseudo-therapies published (Consumer Health Digest 20-05 February 2, 2020)
The Association to Protect the Sick from Pseudoscientific Therapies (APETP in Spanish), a civil society association formed by victims of pseudoscientific therapies along with scientists, doctors, nurses, physiotherapists, computer scientists, lawyers, and other professionals has published the European Manifesto Against Pseudo-Therapies. Scientific and medical personnel who add their names as signatories of the manifesto declare that:
Scientific knowledge is incompatible with what pseudo-therapies postulate, as in the case of homeopathy.
European laws that protect homeopathy are not acceptable in a scientific and technological society that respects the right of the patients not to be deceived.
Homeopathy is the best known pseudo-therapy, but it is not the only one nor the most dangerous one. Others, such as acupuncture, reiki, German New Medicine, iridology, biomagnetism, orthomolecular therapy and many more, are gaining ground and causing victims.
Measures must be taken to stop pseudo-therapies, since they are harmful and result in thousands of people being adversely affected.
Europe needs to work towards creating legislation that will help stop this problem.
Collaborators with APETP include the Skeptic Circle, the ARP Society for the Advancement of Critical Thinking, the Association of Pharmacists in Favor of Scientific Evidence, and Red UNE. The APSPT Web site is in Spanish but can be read in English with Google Translate.

Nobel laureates who promoted irrationality profiled (Consumer Health Digest #20-21 - May 31, 2020)
Psychology scholars have provided thumbnail sketches of Nobel laureates in the sciences who have promoted "assertions that are (a) highly implausible in light of scientific knowledge; (b) roundly rejected by essentially all scientific experts; and (c) based mostly or exclusively on anecdotal or uncorroborated evidence." [Basterfield C. and others. The Nobel disease: when intelligence fails to protect against irrationality. Skeptical Inquirer. 44(3):32-37, 2020] The laureates include:
- Linus Pauling, who made extraordinary claims for megadoses of vitamin C and other nutrients
- Brian Josephson, who has hyped transcendental meditation and advocated "water memory," a mechanism claimed to underlie homeopathy 
- Nikolaas Tinbergen, who promoted discredited "holding therapy" to cure autism
- Kary Mullis, who denied that HIV causes AIDS
- Louis J. Ignarro, who was hired as a consultant to Herbalife and and promoted Niteworks, a powdery mix of amino acids and antioxidants that he claimed would protect against heart disease by boosting the body's nitric oxide production
- Luc Montaigner, who has claimed that autism can be caused by vaccines and successfully treated using antibiotics
These examples illustrate how brilliant people are not immune to irrational thinking and intellectual overreach.

Belief in “complementary and alternative medicine” and low health literacy linked to health misinformation susceptibility (Consumer Health Digest #21-14 - April 11, 2021)
A team of experts in psychology, cardiology, pediatrics, and internal medicine considered two research questions:
- Are some people generally more susceptible to online health misinformation than others, regardless of the particular health topic at hand?
- What type of person is susceptible to online health misinformation? That is, what are some important psychosocial predictors of misinformation susceptibility?
They invited U.S. residents ages 40 to 80 via email to participate in an online survey designed to measure respondents’: (a) perceived accuracy of posts related to statins, “alternative cancer treatments,” and vaccinations the researchers found on social media, (b) educational level, (c) health literacy, (d) predisposition to seek health care for minor problems [medical maximizers] or avoid medical intervention unless it is necessary [medical minimizers], (e) attitudes toward “complementary and alternative medicine,” (f) trust in the healthcare system, (g) belief in science, and (h) tendency toward reflective reasoning. The survey also asked respondents about standard demographics, their health experiences relevant to health topics addressed in social media posts, whether they are a parent or guardian, if they have child age 10–18, whether their child was vaccinated, and their use of social media platforms. [Scherer LD and others. Who is susceptible to online health misinformation? A test of four psychosocial hypotheses. Health Psychology, March 1, 2021] Based on data from 923 respondents, the researchers concluded:
- People who believe misinformation about vaccines are likely to also believe misinformation about statins and cancer treatment, and vice versa.
- The more hours per day respondents spent on social media, the more likely they were to perceive misinformation as accurate and influential.
- Individuals who were higher in literacy or education were less likely to believe misinformation was true or would influence their decisions.
- individuals with positive attitudes toward complementary and alternative medicine and those who distrusted the health care system were more likely to believe all three types of misinformation were true and would influence their decisions.

Urine therapy scrutinized (Consumer Health Digest #22-41 - October 30, 2022)
Two scientists have rejected the persistent, ancient idea that drinking, bathing in, or otherwise applying urine can bring good health or heal certain ailments. Urine consists of 95% water, 2% urea, .1% creatinine, and more than 3,000 other compounds that may include toxic environmental chemicals best removed from the body. While urea-based skin lotions and nail softeners are on the market, the concentration of urea in urine is too weak to have any therapeutic value. Contrary to popular myth, urine is not sterile; it usually contains low levels of bacteria whereas high levels of bacteria are associated with urinary tract infections. [Moro C, Phelps C. Is urine sterile? Do urine ‘therapies’ work? Experts debunk common pee myths. The Conversation, Oct 20, 2022]

Stem cell report available (Consumer Health Digest #23-48 - November 26, 2023)
 The International Society for Stem Cell Research is providing About Stem Cells, developed by stem cell researchers worldwide to provide trustworthy advice to help people make informed decisions about stem cell procedures. The society’s website has sections on types of stem cell treatments, stem cell treatment terminology, nine things to know about stem cell treatments, and unproven stem-cell treatments.

Doctor sentenced to prison for killing wife with “alternative” treatments. (Consumer Health Digest #23-52 - December 23, 2023)
Dr. Jeffrey Harris, 59, has been sentenced to an indeterminate term of 5–15 years in state prison, the maximum penalty, following his trial conviction for recklessly killing his wife, Tammy, by treating her improperly. In October, a New York State Supreme Court jury found Harris guilty of second-degree manslaughter for giving her “alternative” treatments, including poisonous levels of selenium, and preventing her from seeking treatment for lupus. [D.A. Bragg announces sentencing of Jeffrey Harris for recklessly killing his wife, Tammy Harris. New York County District Attorney press release, Dec 15, 2023]
Evidence in the case indicates that in 2016, Tammy began to experience aches and pains. She was diagnosed with an auto-immune disease by her primary-care physician, who suspected she had lupus. Despite this diagnosis, Harris refused to believe her doctors, took Tammy’s treatment into his own hands and began prescribing antibiotics, antifungals, pain medication, and many herbal supplements.
Tammy’s health began to rapidly decline. She lost a significant amount of weight, became severely jaundiced, and was eventually bedridden. When they went to a hospital in August 2017, Dr. Harris argued with Tammy’s doctors, instructed her to spit out the medications they prescribed, and continued to provide her with his preferred supplements without her doctor’s knowledge. Over the next four months, Tammy would decline at home, briefly improve with hospitalization, and decline again when Harris removed her from the hospital against medical advice. In January 2018, Dr. Harris flew Tammy, who at this point weighed less than 80 pounds, to New York City to visit an “alternative medical center” in Midtown Manhattan run by a doctor that Dr. Harris admired. Testing done at that center came back negative for mercury poisoning but showed more than ten times the reference range of selenium in her blood. She died of selenium poisoning in February 2018. Tammy’s obituary in The Lewiston Tribune, noted that she had graduated from Washington State University with a bachelor of science degree in nursing and a master’s degree as a psychiatric nurse practitioner. [Palermo A. Former area doctor charged in wife’s death. The Lewiston Tribune, Nov 28, 2021]

Science communicator scrutinizes microbiome-related hype. (Consumer Health Digest #23-52 - December 23, 2023)
McGill University science communicator Jonathan Jarry, M.Sc., has examined popular factoids regarding the microbiome, the vast community of microorganisms (including bacteria) that grow on and inside our bodies. [Jarry J. The microbiome and its myth-making machine. Office for Science and Society, Aug 11, 2023] He concluded:
The number of microorganisms making up the human microbiome is sometimes claimed to be ten times larger than the number of human cells. However, the best estimate we have is that they are roughly equivalent in number.
There is strong evidence that taking probiotics can prevent the diarrhea that is associated with a course of antibiotics, but we do not yet know enough to recommend specific strains, dosages, or duration for these probiotics.
Many diseases have been associated with changes in the microbiome, but at this point, we cannot say these changes cause the diseases as there are too many variables at play.

Scientific evidence on chiropractic, osteopathy, and massage summarized. (Consumer Health Digest #24-40 - October 10, 2024)
Thomas J. Wheeler, Ph.D., a retired associate professor at the University of Louisville School of Medicine, has updated his summary of scientific evidence concerning chiropractic, osteopathy, and massage. The material was originally developed as the second in a series of handouts for an elective course given to medical students. An updated version was previously published in 2014. [Wheeler TJ. A scientific look at alternative medicine: Chiropractic, osteopathy, and massage. KyCAHF, 2024] The document is also downloadable as a 49-page PDF. Readers seeking more comprehensive information on chiropractic shortcomings can find it on Chirobase.org.

New video shows 19th-century quackery. (Consumer Health Digest #24-44 - November 3, 2024)
A new 12-minute video describes “false or unproven claims of cures using strange ingredients or bizarre materials, often with dire consequences for the end user.” The products included arsenic-laden soaps/cosmetics, radium toothpastes/cosmetics, asthma cigarettes, Dr. Williams’ Pink Pills for Pale People, Pond’s Tampons soaked in opium, cocaine cocktails such as Mariani wine, Clark Stanley’s Snake Oil, and high-heeled orthopedic shoes. [Retro Group. History of medical quackery vintage practices selling false hope. YouTube, Oct 22, 2024].

Harms of “alternative medicine” summarized. (Consumer Health Digest #24-45 - November 10, 2024)
Dr. Edzard Ernst, an emeritus professor at the University of Exeter, has described several categories of harm caused by so-called alternative medicine (SCAM). [Ernst E. The harm of so-called alternative medicine. Skeptical Inquirer, 48(6):56-57] They include:
• direct harm by SCAM therapies such as chiropractic spinal manipulation, acupuncture, and herbal medicine
• harm such as missing a serious diagnosis or giving false positive diagnoses caused by SCAM diagnostic techniques that haven’t been validated
• harm caused by SCAM practitioners recommending subpar treatments, offering poor advice, diagnosing conditions that don’t exist, or exaggerating the importance of everyday health impairments
• harm caused by the industry by leading consumers to misspend their money and by endangering species through the exploitation of natural resources
• harm caused by unreliable research that undermines trust in science
• harm caused by fallacious notions, such as “nature knows best,” that undermine rational thought
Ernst concluded:
As the benefits of SCAM are often only marginal or entirely absent, even relatively minor risks count heavily. It follows that the risk-benefit balance of much of SCAM fails to be positive. In turn, this means that consumers should think twice before they use or recommend SCAM.
Epidemiologist and healthcare informaticist Katie Suleta, DHSc, concluded in her review of Ernst’s latest book. Bizarre Medical Ideas…and the Strange Men Who Invented Them:
Ernst’s book demonstrates what can happen—and why it’s dangerous—when anyone, but especially physicians, become so enamored with their own cunning, intelligence, and ideas that they forget to ask the question “Is it even feasible?” [Suleta K. Inventor tales in alternative medicine. Skeptical Inquirer, 48(6):60-61]

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acronyms : FDA: Food and Drug Administration, http://www.fda.gov
FTC: Federal Trade Commission http://www.ftc.gov/
AMA: American Medical Association https://www.ama-assn.org/

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Good health to everyone (except for the charlatans that make money on other people's health).

page created: August 24th, 2011 and last updated: November 14th, 2024