Natural Health Expo(sed)?

Driving around Hamilton the past few weeks I couldn’t help but notice the signs sprinkled around the city for the “Natural Health Expo” which is to take place here this week end. As I perused the website for this event yesterday I was disturbed by the large number of anti-scientific “treatments” that will be showcased. Like my co-blogger Grant who has already posted on this, I was troubled by the amount of misinformation that will be leveled directly at consumers.

As I was pondering how to answer the bewildering array of AltMed that will be promoted I checked my email and found a great little article just published in Chiropractic & Osteopathy (made available through the open access publisher BioMed Central).

The paper, “Why do ineffective treatments seem helpful? A brief review” written by Steve E Hartman, looks at how practitioners and patients can fool themselves into thinking that ineffective medical interventions actually work. An excellent example of Evidence Based Medicine 101, Steve covers the cognitive biases that hinder our ability to draw logical conclusions in the medical sphere such as the Post Hoc, Ergo Propter Hoc logical fallacy, confirmation bias and cognitive dissonance. Also covered are explanations of how it can seem that a treatment has been directly responsible for improvement in a patient’s condition when it may not  have been.

The paper touches on disease natural history, which simply refers to how a particular malady might be expected to progress without treatment. Self limiting diseases such as colds, headaches and fatigue can be expected to get better on their own . If a patient is taking a treatment at the time, the treatment (rather than their own immune system) might erroneously be given the credit.

This combined with the overlapping arenas of the placebo effect and regression to the mean can be a powerful confounding factor when treatments are not being considered in light of scientifically controlled settings. The placebo effect is referred to frequently in common culture but regression to the mean is a less well known entity for the layman. Steven does a good job of explaining the concept, essentially people experience a variety of different intensities in their symptoms. Also they will tend to seek medical help when the symptoms become severe, knowing that the severity of the symptoms will tend to cluster about a mean value it is likely that whether treatment is sought or not the patient’s condition will tend to get better.

Thus the patient will feel relief and attribute that relief to what ever modality they are using at the time. Practitioners are not immune to these effects either and will in their practice see time and again that patients are getting better after their pet therapy is applied. In which case they will feel justified in proclaiming it works in the absence of confirming studies (or even in the face of disconfirming evidence).

The one aspect that I felt was missing from the paper, although it may have been obliquely implied, is the role of prior plausibility in evaluating treatments. Many modalities that will be on offer at the Natural Health expo are not only unusual they fly in the face of currently understood science. Scientific plausibility is our compass, without it we can become lost in the wilderness of fanciful ideas without any method of discerning the way forward. This concept is what separates Science Based Medicine from simply Evidence Based Medicine. The former takes the plausibility of a treatment into account when deciding the threshold of evidence needed before it can be considered effective. The later only measures outcomes and so is less able to distinguish true effects from chance outcomes.

Consider the following scenario: I claim to be able to influence the outcomes of coin tosses by virtue of what I had for breakfast on a particular day. If I have eggs then tails with predominate, lettuce produces more heads. Now without considering the plausibility of the setup we could run a trial, perform statistical analysis and find that my predictions are correct. But given that there is no good reason to suspect that my diet can influence a coin toss the positive is more likely to be because of chance than because of a real effect. In this case then a higher standard of evidence would need to be achieved than if I had said I could alter the probabilities be sticking a piece of gum to one side.

All-in-all though this a very nice paper and my complaint is a small one, given the probable readership of the journal the inclusion of plausibility may even have alienated those that might otherwise have been receptive to the other points presented. I recommend reading it for yourself, it is a very easy and informative read.

Vitamins and Exercise

I think it’s safe to say that in recent years the push to “Become Healthier” has become much stronger than it was previously. Statistics like 1/4 of New Zealand adults are obese and New Zealand being the “3rd Fattest” country in the world are used to promote a lifestyle that is aimed at making us healthier. Many of us have taken this message to heart (pun intended) and attempted to shape up but sometimes it’s not clear exactly what is healthy. The primary action people are urged to take is exercise and it’s a good one. There are many recognised benefits to regular exercise including reducing risk of Type II diabetes and possibly even reversing the condition.

Another item that is also touted as a general health promoter is antioxidants. Here’s where things start to get tricky, in order to reap the benefits of excersise there has to be some way that the fact that you are exerting yourself is communicated to the cells of your body. A promising candidate for this signal is ROS, or Reactive Oxygen Species. In other words – Oxidants. This brings up an interesting question, if you are taking antioxidants and exercising in your attempt to be healthy – what happens? A study released early this year suggests that the antioxidants reduce the beneficial effects of excersise in the body.

Researchers looked at two markers of insulin sensitivity: Glucose infusion rates and plasma adiponectin levels (high Glucose infusion rate and high adiponectin levels correlates with high insulin sensitivity = no diabetes for you). They found that taking two antioxidants (Vitamins C and E) while engaging in exercise (not literally, friends don’t let friends jog and pill-pop) actually reduced the before and after exercise difference in these markers. This result strengthens the evidence that ROS are involved in signalling changes in cells and that taking antioxidants interferes with this process.

The drawback of this study is that the participant numbers were quite small. The intial group was made up of forty men, 20 that had athletic backgrounds and 20 that didn’t. These where then split into two goups either recieving supplements or not. So the end was 4 groups of ten, not exactly a significant cross-section of the population. Even so the results are compelling and should be investigated further.

I think the moral still holds, beware of taking too many suplements, you don’t always know what the side effects will be.

Gardasil Follow-up: The Evil Toxins

My last post on Gardasil has garnered quite a bit of interest so I thought I would follow it up with a look at some of the other claims about this vaccine that are also geared towards warning women away from it. The focus of this entry is, as the title implies, the ingredients of the vaccine and their alleged toxicity. Now I would first like to make clear that I am not trying to argue that these compounds are not at all toxic, that would be an untenable position almost anything is toxic at the right (or wrong) dose. This brings up the heart of the issue though, the dose is key here, the claims by detractors of the vaccine imply that the amounts of the chemicals in the vaccine are above the toxic threshold. I, along with the medical community so I feel I’m in good company, consider this to be an incorrect conclusion.

Matthias Rath – steal this chapter

A longer post than usual, luckily I didn’t have to write it. This post was written by Ben Goldacre of Bad Science blog fame, enjoy.

This is an extract from
BAD SCIENCE by Ben Goldacre
Published by Harper Perennial 2009.

You are free to copy it, paste it, bake it, reprint it, read it aloud, as long as you don’t change it – including this bit – so that people know that they can find more ideas for free at www.badscience.net

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The Doctor Will Sue You Now

This chapter did not appear in the original edition of this book, because for fifteen months leading up to September 2008 the vitamin-pill entrepreneur Matthias Rath was suing me personally, and the Guardian, for libel. This strategy brought only mixed success. For all that nutritionists may fantasise in public that any critic is somehow a pawn of big pharma, in private they would do well to remember that, like many my age who work in the public sector, I don’t own a flat. The Guardian generously paid for the lawyers, and in September 2008 Rath dropped his case, which had cost in excess of £500,000 to defend. Rath has paid £220,000 already, and the rest will hopefully follow.  Nobody will ever repay me for the endless meetings, the time off work, or the days spent poring over tables filled with endlessly cross-referenced court documents.

Herbal Medicines

It certainly seems that in recent years herbal style medicines have grown more popular and more widely available. I’m certainly not going to espouse the view that these medicines are a waste of time, that they do nothing or that they have no plausibility. However neither do I think that simply because they are seen as “natural” (whatever that means) that they are necessarily superior to drugs produced by pharmaceutical companies. The problem with herbal/natural remedies isn’t that there isn’t a plausible mechanism of action, (as in Homeopathy for instance) but that there is usually not enough good quality data to support their use for a particular indication. In addition, while drugs developed for the pharmaceutical industry must pass stringent safety and efficacy tests those that are labeled herbal supplements often get a free pass. So not only may there not be evidence that they work but no evidence that they are not harmful.

There also seems to be a disturbing corollary to promoting remedies despite lack of evidence and that is the continued use in the face of dis-confirming evidence. Recently good studies have been published refuting claims for benefits to taking either Ginkgo Biloba extract for cognitive function or Echinacea for colds. Though I expect this information to have zero impact on sales even if the results of the studies gain wide distribution.

Remedies that consist of preparations made from the raw plant also suffer from inherent variation between plants, both between individual plants and in the same individual over time. So even if there is an efficacious active ingredient the dose would not be controlled. If herbal remedies have an effect on the body then they are drugs, by definition, they should be treated as such. In other words they should be evaluated for safety and effectiveness, considered when taking other medications for potential interactions and dispensed by those who are trained to appreciate the risks/benefits and science based medicine.

Resources

http://www.theness.com/neurologicablog/?p=424

http://www.sciencebasedmedicine.org/?p=293

Are People Affected by Non-Ionising Radiation?

Modern living can have it’s drawbacks as well as it’s advantages, nobody died in plane crashes 500 years ago. Some of the disadvantages come as a direct result of our increase in scientific and technological knowledge, there would be no antibiotic resistant bacteria without antibiotics. Some people worry about ever more subtle forms of danger in the modern world, there are those who classify themselves as “Electrosensitive”. Electrosensitives consider the electromagnetic fields produced by electronic products such as computers, cell phones, T.V.s, well almost everything these days, to be harmful in general and to affect them in particular in a variety of ways. Symptoms may include but not be limited to: headache, fatigue, tinnitus, dizziness, memory deficits and irregular heart beat, in fact there are lists including over thirty symptoms ranging from asthma to epilepsy and Alzheimer’s.

Earlier this year researchers at the University of Regensburg conducted a study of self identified electrosensitive sufferers comparing their reactions to non-sufferers when exposed to a heat-emitting thermode and a cell phone. The sufferers experienced discomfort from both stimuli where as non-sufferers only experienced discomfort from the thermode. This was backed up by brain scans of the subjects which indicated that the pain experienced was real. Unfortunately the phone used in the experiment was fake, there were no electromagnetic fields being produced. The sufferers were not making up the pain they felt, it was real to them, but in the same way that a placebo treatment can (allegedly*) make people feel better it appears that the anticipation of pain by the sufferers lead them to feel it, in a sort of nocebo response to the sham phone.

It seems that while these electrosensitive people are not merely attention seeking, as the discomfort they feel is undoubtedly real, neither are they suffering from a disability brought on by exposure to fields that are generally considered harmless. What’s going on here? I have no idea but I’ll be interested to see how further research sheds light on this.

Resources

http://www.sciam.com/podcast/episode.cfm?id=cell-phones-sometimes-cause-real-pa-08-10-13

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WNP-4SB7TW1-4&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_version=1&_urlVersion=0&_userid=10&md5=993618adacb00f6dc3c58a70d580feb2

http://en.wikipedia.org/wiki/Electrical_sensitivity

http://www.electrosensitivity.org/

* It’s complicated, it could be that what we refer to as a placebo response doesn’t actually exist and is really a mislabelling of other factors that have nothing to do with response to treatment. Who knows.

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Frequency Specific Microcurrent Revisited

About two months ago I wrote a piece describing the practice of Frequency Specific Microcurrent therapy (FSM) and attempted to show why I thought the practice was at best the premature use of an unproven modality and at worst a new way of parting the afflicted from their cash. This post recently attracted a comment from a Chiropractor named Pamela Hall who wished to defend the technique. As the comment was lengthy and covered a number of interesting points I thought I would post my reply as a blog entry. First I would like to thank Pamela Hall, DC, for her comment and I hope that I can reply to her in as thoughtful and considerate a way as she has conducted herself. Her comment starts:

Research that meets the gold standard of large patient numbers, with controls costs millions of dollars. There is very little money available for treatment that won’t make the drug companies or some other big players in the medical-industrial complex a lot of money. This is why the research doesn’t get done on this scale. In fact in the 1930’s all electrical therapies, herbs, and homeopathy were banned. They were a threat to the profit of drug companies and the AMA.

Firstly there have been well designed studies on other modalities that “won’t make the drug companies … a lot of money” such as acupuncture, I don’t see why this one should be any different. Also you have presented a false dichotomy here, the choice is not between large definitive clinical trials and nothing at all, smaller pilot studies published in reputable journals will do. If you can provide that I will be greatly appreciative, the best I could find was a case study which vaguely mentioned “microcurrent” along with several other treatment options. Given the amount of time the treatment has been in use I don’t think this is unreasonable.

Those who are prejudiced against so called “alternative healing” fail to acknowledge that western medicine has used aspirin simply because it worked without knowing the reason why until rather recently. The common treatment for angina is nitroglycerin put under the tongue, and this treatment was taken from the realm of homeopathy.

I will gladly acknowledge that much of conventional medicine has come from herbal preparations, folk remedies and the like and that medicines may be used without knowledge of the method of action. However, that the active constituent of Willow bark, salicylic acid (the precursor to acetylsalicylic acid or Aspirin) was extracted and purified which enabled the creation of medicines of consistent dose and quality, is all because of science. Just because a treatment can be obtained from a particular tradition or practice (such as homeopathy) does not lend credence to any of the other methods common to that source, they all must be evaluated separately on their merits, or lack thereof as the case may be. Also, especially in the case of Aspirin, there is a plausible mechanism of action, where a metabolically active substance is introduced into the body and produces a biological effect.

You failed to mention the research done with the frequency for inflammation, using the same animal model as used to test most all of the anti-inflammatory drugs. FSM reduced inflammation by 64% in four minutes, and they never found a drug that reduced it more that 45%. Further more, all anti-inflammatory drugs have undesirable side effects some of which can be life threatening.

This is a fair point and I will accept it. I presume you are referring to this study, the reason I did not discuss it was essentially practical in nature, I could only find this one page abstract which was thin on details. There was nothing there I could dissect. Even If I could have found the full paper it is likely I would not have gone over it as I would have felt even less capable of interpreting it than the study I did present. You bring up another point though that I agree with, drugs do have side effects, as do almost all other types of treatments. As I pointed out in my original post the very fact that treatments have an effect on the body opens the possibility that that can have negative as well as positive effects. As far as I can determine the claim that FSM has no negative side effects can neither be proved or disproved, as you seem to confirm the data is simply not there.

You stated two frequencies are employed by Dr. McMakin, however, hundreds of frequencies are employed. There are always at least two frequencies applied at a time, one resonating with a specific tissue and one resonating with a specific condition.

This I think is simply a misunderstanding, I am aware that there are more than two frequencies that can be used, and I do allude to this fact in several places. My apologies for not being clear.

Microcurrent increases cellular energy by 500% and also increases protein synthesis. This is not what I would call a modest claim.

This may be true, here is the study (performed in 1982 and used as a reference for FSM everywhere), this study was on rat skin tissue in vitro and as such can not necessarily be extrapolated to treating the whole body or even significant parts of it for specific diseases. In addition I do not know how these increases affect other biological functioning or whether or not they are significant even in the context given. Indeed though there does seem to be a biological effect produced by the microcurrent and I refer you to my point above regarding potential harm. However my main point of disagreement with the treatment is the “Frequency Specific” part, in other words the claim that each disease has it’s own unique vibration that can be used to treat it, that is the real claim being made and that is the part that I find least convincing.

You state that Dr. Abrams was dismissed as a fraud in the 1920’s. You fail to mention that Dr. Abrams was investigated by Upton Sinclair, who according to Wikipedia, “was a Pulitzer Prize-winning prolific American author who wrote over 90 books in many genres and was widely considered to be one of the best investigators advocating socialist views. He achieved considerable popularity in the first half of the 20th century. He gained particular fame for his 1906 muckraking novel The Jungle, which dealt with conditions in the U.S. meat packing industry and caused a public uproar that partly contributed to the passage of the Pure Food and Drug Act and the Meat Inspection Act in 1906.”

Mr. Sinclair reported that “Albert Abrams was one of the most eminent practitioners in San Francisco, the head physician of large hospitals, recognized as the author of important discoveries.” Like many scientists who make major breakthroughs his ideas which involved a new paradigm in healing were met with disbelief and derision of his peers. Upton Sinclair was very skeptical when he first visited Abrams, and expected to be done in a couple of days. Instead he stayed and observed him for a couple of weeks, “and it might have been months or even years, if urgent duties had not called me home.” Sinclair considered Dr. Abrams to be a great scientist who had much to offer humankind.

No I did not, and would not have even had I been aware of his involvement. The opinions of a single author, even a “Pulitzer Prize-winning” one such as Mr. Sinclair would amount to anecdote. I read the biography of Mr. Sinclair and failed to note any mention of scientific training or any indication that he had any other expertise that might have been relevant, fame and popularity do not a reliable source make. Even if this had not been the case this point would have carried little weight as it is simply an appeal to authority and as such does not trump the decades of knowledge gained since his time. It is the consensus of scientific opinion that should be the more trust worthy authority here, the views of a single person, even a distinguished scientist (or author), are simply too prone to error and bias.

FSM is based on a new paradigm in healing. Dr. McMakin explains it well in simplified terms on a video clip now on her website: www.frequencyspecific.com. If you wish to have a better understanding of the scientific underpinnings of Frequency Specific Microcurrent, I suggest you read Energy Medicine: The Scientific Basis by James Oschman, Ph.D.

The trouble with new paradigms is that they must first prove themselves in the full sphere of scientific knowledge before they can be accepted. This means that they must either fit with the already established principles we have discovered in the realms of physics, chemistry and biology or provide a new underpinning that incorporates the known facts but explains them in a more complete and satisfying way that can be confirmed or falsified by experiment. When “Einsteinian” physics was discovered it did not overturn Newton, it added a new layer of complexity and richness to our understanding of the Universe.

Once again I would like to thank Pamela for her interest and for taking the time to comment without resorting to simple attacks. None of my points have been made in malice and if and offense is given it is with regret.

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Frequency Specific Microcurrent

This week in my local community paper I had cause to once again raise my brow in surprise at the low bar for inclusion in this publication. I refer to a story written by a journalism student promoting a therapy known as FSM or Frequency Specific Microcurrent (not Flying Spaghetti Monster). I say promoting rather than reporting on as it seemed that the student merely parroted what she had been told of the treatment with nary a skeptical thought. I was unsure when I read this article whether I was looking at a news report or an advertisement for yet another brand of alternative health device. Though I should temper this by pointing out that it seems to be becoming endemic to the field of journalism as a whole rather than be unique to this student of it.

As I could find little in the way of information about this therapy at my usual sources on these sorts of claims (Quackwatch and Skepdic, both excellent resources) I thought I would do some investigation of my own and share the results here. A brief search of PubMed found a decided lack of peer review studies either published by the technology’s alleged inventor Carolyn McMakin, nor on the effectiveness of the therapy itself. So I decided to start with the website of the inventor herself.

The “therapy” consists of applying microamp current to selected areas of the patient’s body, the current is tuned to two different frequencies that historically were supposed to correspond to the resonant frequency of the disease and the tissue of interest. It is unclear whether the current version makes this claim but two frequencies are still employed, apparently providing a unique synergy that is useful for treating only specific ailments. Practically the current is produced by a battery operated device that allows the practitioner to set both the frequency and the current on two independent channels. This current is then transferred to the patient via conductive graphite gloves worn by the practitioner as they lay hands on the patient. The claims for the device itself are modest apparently due to FDA restrictions that apply to the classification of devices it falls under. This classification is that of TENS devices which stands for Transcutaneous Electric Nerve Stimulation, this class of machine can provide relief from certain types of pain simply by virtue of electrical stimulation, no frequencies are explicitly invoked.

However, the frequencies used have much wider claims associated with them, one I found amusing was “There is one frequency combination that so far is 100% effective in a small number of cases to take away kidney stone pain.”, I perhaps naively think that a treatment is either 100% effective or is useful in a small number of cases, combining these two seems to be trying to get the best of both worlds. To clarify I don’t think there are necessarily treatments that are always 100% effective but I do have the opinion that a more useful statement would have been how effective the treatment is for the majority of patients. Other claims include the ability to treat asthma, liver dysfunction and irritable bowel syndrome as well as scar removal.

On the website’s FAQ a simplistic history of the use electromagnetic therapy devices from the early 20th century is given and spoken of in glowing terms stating that “There were thousands of physicians using this technology at this time. They had journals and associations and were treating patients and doing research and sharing the effects of frequencies in articles and books.” This may or may not be true but has no relevance as to the effectiveness of the treatment, I have no doubt there are thousands of practitioners prescribing Homeopathic preparations right now. Dr. Albert Abrams is also referenced as a pioneer of these techniques despite his unusual practices having been exposed as fraud in the 1920s. In 1994 Dr. McMakin started using these frequencies on her chiropractic patients and reports that they “appeared to do exactly what they were alleged to do”.

In 1995 Dr. McMakin developed the therapy using a device and a list of reputedly medically useful frequencies that she apparently inherited from a Canadian osteopath. Two years later Dr. McMakin began teaching FSM according to her website “to see if the effects of FSM were reproducible.” (curious, I thought that’s what studies and controlled trials were for). Despite the order in which the story is related this appears to be before papers were presented to either the American Back Society or Topics in Clinical Chiropractic, both chiropractic based. The teaching of the technique consists of a three day course in “the use of frequency protocols, the differential diagnosis of pain generators and neurologic conditions.”. Were this technique developed by the medical mainstream I hope it would have undergone slightly more rigorous investigation before being tested on patients or taught to other practitioners.

Moving on, there are several papers listed on the website in support of this therapy of mixed quality. The most convincing papers deal with the use of the therapy for Fibromyalgia, in particular this study on “Cytokine changes with microcurrent treatment of fibromyalgia associated with cervical spine trauma“. Now I am not medically trained and readily admit that I am not qualified to accurately interpret the results of this study, however there are several points that I as a layman found concerning. First was the inclusion of only a single control subject who also received treatment. Second there seemed to have been quite a high drop-out rate for the trial (approximately 30%) leaving only 32 subjects to acquire meaningful data from. Thirdly, the use of specific frequencies in the treatment is probably the most controversial part and yet those that were chosen for the study are simply asserted to be the most effective with no reference to how this was done or what data lead to this conclusion. Fourthly, and this is less a criticism of the study itself, is the topic under study. I am given to understand that Fibromyalgia is characterised by periods of flares and remission which may complicate the data. I realise however that this trial may be considered a pilot study and so can not be held to the same standards as a large rigorous placebo/non-treated group controlled trial.

In addition the almost ubiquitous claim in pseudo-scientific medicine and quackery is made that there are no dangers or side effects from the treatment itself. As has been pointed out in other places a modality that affects biological systems is unlikely to be all benefit. If there is an effect then it is almost guaranteed there is a side-effect. The consideration undertaken in the use of valid medical interventions is whether the benefits are worth the accompanying risks.

Due to the nature of the therapy it is unclear exactly what is being tested/providing relief, a shaky theory of dubious plausibility based on the unscientific premise that tissues and diseases have “Frequencies” that if applied externally can enhance or inhibit functioning and so cure medical conditions or transcutaneous electric nerve stimulation that at least one doctor considers to be an uncontroversial treatment for pain. What does seem to be clear is that there seems to be more emphasis on promotion of this therapy than on testing it’s efficacy and introducing to the wider medical community a truly useful technique.

Finally, it seems to me that the evidence is not convincing that there is an effect here that can only be explained by appeals to the recovery of lost knowledge from a golden age of medical treatments that was squashed by a jealous Medical Establishment.

Resources

http://www.frequencyspecific.com

http://www.quackwatch.org/04ConsumerEducation/News/rife.html

http://www.americanartifacts.com/smma/abrams/abrams.htm

http://en.wikipedia.org/wiki/Fibromyalgia

http://en.wikipedia.org/wiki/Transcutaneous_Electrical_Nerve_Stimulator

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What’s the Harm?

As I have pointed out countless times (ok, 4), we are a story telling species, one good anecdote is worth more to most people than a mountain of rigorous evidence and for good evolutionary reasons. This is just a fact of our psychology, it is not just difficult for us to weigh things rationally it is actually going against our basic nature. In recognition of this fact a website has been created to collect stories from around the world that show the real life harm that pseudo-science and other irrational claims can have on individuals. This website is the answer to the oft posed  rhetorical question “What’s the harm?”.

One of the more extreme cases on the site details the story of Sandra Nette, a Canadian woman whose regular visits to a chiropractor resulted in her becoming permanently paralysed. Sandra had been visiting her chiropractor for years to get “maintenance” adjustments that were to keep her healthy, after one such adjustment she began to feel dizzy and unwell. The Chiropractor suggested massage therapy offered at his office and allowed her to leave, she didn’t make it home. After pulling her car over and calling her husband she was taken to the hospital where it was determined that she had tears in both vertebral arteries in her neck which caused a stroke. One of the tears was 3 inches long. According to Sandra’s husband the first words out of the attending physician after reviewing the test results were “chiropractor, right?”.

Now this story in isolation proves nothing about the efficacy or lack thereof of chiropractic, nor does it prove relative safety or harmfulness. However, this is not the point. The point is that other venues have provided evidence of the implausibility and ineffectiveness of this practice and this story is meant to provide a human face to the issue and help people understand, in a way that is real to them and not abstract like a medical study, the possible harm that can be caused. When there is no benefit to a procedure any risk is too much.

Resources

http://WhatstheHarm.net

http://whatstheharm.net/chiropractic.html

http://www.sciencebasedmedicine.org/?p=152

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Mangosteen

Mangosteen: Fruit of the future. Claims for the health benefits of this fruit range from preventing your arteries from hardening to being an anti-depressant and anti-tumor agent. In fact the claims are a laundry list of everything you would want your food to do to keep you healthy including fighting dementia -ah the irony. Once again the claims are based on basic research, not clinical trials, that may or may not be applicable to real world in vivo consumption of the processed fruit. The rest of the evidence is anecdotal testimonials which we know are next to useless when looking at these kinds of heath benefits.

One of the leading promoter/sellers of Mangosteen juice was issued a warning letter by the US FDA to reign in it’s extravagant claims for the curative powers of their product as it was essentially being marketed as a drug. As such it would need to be tested and found to be safe and effective regarding these claims, neither is the case. The multi-level marketing company however has thousands of distributors who are more than willing to gush over the effectiveness of their product in treating all sorts of maladies, as well as more general health giving properties.

In the end Mangosteen is just one more in a long line of faddish foods and supplements for which the claims are plentiful but the evidence is scant. Thousands of test tube studies do not prove anything in the way of safety or efficacy. Many plants and fruits contain bio-active compounds that may provide the basis for future treatments but this does not mean that any particular preparation of these is clinically useful. Broccoli contains anti-cancer agents but I would hope that no-one in their right mind thinks the best way to fight tumors is with a plate full of greens. Similarly with Mangosteen I hope you think before you drink.

Resources

http://www.fda.gov/foi/warning_letters/archive/g6031d.htm FDA warning letter to XanGo

http://www.time.com/time/magazine/article/0,9171,1541294-1,00.html

http://www.mangosteen.com/Sciencenonscienceandnonsense.htm

http://www.xing.com/app/forum?op=showarticles;id=3611977;articleid=3613327

Spirulina

Is Blue-Green (algae) my colour? As I’m sure you soon will be I was surprised to find that the health claims for Spirulina have almost no medical backing. One of the claims I have heard for the supposed wonder single celled organism is that it improves the immune system. These claims are backed up by saying that the product is nutrient dense and the “perfect” food. However I have never seen it marketed as a food, it is a supplement. The amounts of nutrients that are available in the capsule or teaspoon of Spirulina that are the recommended dose can be obtained more easily (and cheaply) from eating a balanced meal.

As for “boosting” the immune system, this claim is common to many suplements and alternative practices and like their many other claims is vague and misleading to the point of meaninglessness. Presumably a “boosted” immune system prevents illness and/or speeds recovery but within medicine there is no such concept and it is quite possible that the increase in immune function that is cited could itself cause problems. The immune system is very complex (but not irreducibly so – Ha) and as such there are many more ways for it to go wrong than go right, any attempt to alter it’s function should be done with caution.

Those that attempt to market Spirulina by attempting to trade on it’s alleged medicinal value make a mistake common in the supplement and alternative medicine business, that of confusing fundamental research and clinical trials. There are always projects looking at the effect of compounds on tissue samples, a proportion can look very promising. However the human body is a network of intertwined and sometimes competing reactions and these studies are not always a good predictor of clinical usefulness.

On second thought I don’t think this shade brings out my eyes.

Resources

http://www.theness.com/blue-green-algae-nature%27s-perfect-scam/

http://www.quackwatch.org/01QuackeryRelatedTopics/algae.html

http://www.quackcast.com/ *There use to be a link here to something useful on the Quackcast site, but it’s moved and I can’t find it. But go and listen to everything anyway it’s good stuff.