UPDATE

• If you regulate nonsense, it’s still nonsense
• What’s really in that dietary supplement?
• Thermography for breast cancer screening: big cost, no benefit
• NCCAM: Your tax dollars not working
• Med school “CAM” programs flunk test
• TV health news doesn’t make the grade

If you regulate nonsense, it’s still nonsense

As aptly stated by Edzard Ernst, M.D., the world’s first university-level professor of complementary and alternative medicine, if you regulate nonsense, its still nonsense. A brief trip through the websties of Florida-based “alternative” practitioners demonstrates Dr. Ernst’s point nicely. In a short time, and without much effort, we were able to uncover numerous absolutely false health claims from licensed Florida healthcare practitioners regulated through the Florida Department of Health. Here’s just a sampling:

Iridology for HIV

“Iridology is the scientific analysis of patterns and structures of the iris of the eye. . . .[The iridologist] will examine your eyes to diagnose your current and potential health conditions to forewarn of approaching difficulties or signs of disease. . . . [T]he iridologist can pinpoint what area of the body is inherently strong or weak. Toxic accumulation levels can be observed as well as nutritional and chemical imbalances.”

Source: “Iridology Consultations for the HIV infected in Miami, Florida,” The Center for Positive Connections Support and Resource Center, http://www.positiveconnections.org/iridology.htm (accessed 7/28/09).

Acupuncture face lift

“A practitioner specializing in Skin Rejuvenating Acupuncture is able to utilize the meridians that either end or begin at the face to stimulate and balance the energy and at the same time, treat the underlying factors that contribute to the aging process. This involves the insertion of hair-thin disposable needles just under the skin at specific areas on the face and body. The needles are inserted into the energy pathways or meridians to improve the flow of Qi (energy inherent in all living things). As the flow of energy improves, a greater amount of energy and blood are circulated to the face, oxygenating, firming and toning the skin to diminish fine lines and improve overall skin tone. . . . Skin Rejuvenating Acupuncture may take 5 to 10 years off the appearance of your skin. . . . It also firms and tones the skin to help reduce sagging along the jaw line and drooping eyelids.”

Source: Vita Health Medical Spa & Acupuncture, Broward County, FL, http://www.vitahealthmedspa.com/aesthetic-medicine/acupuncture-face-lift (accessed 8/18/09).

Homeopathy for just about everything

“Our alternative medicine center in Central Florida near Orlando focuses on the treatment of people with such difficulties as ADD,ADHD, Anxiety, Autism, Allergies, Asthma, Digestive Issues, PMS, Insomnia, Headaches, Recurrent Infections, and almost any other ailment. There are very few illnesses that do not respond to homeopathic medicine.”

Source: Homeopathic Associates of Central Florida, Orlando, FL, http://www.homeopath-orlando.com/index.html

Chiropractic for childhood asthma

“[C]hiropractic care represents a safe non-pharmacological health care approach, that may be associated with a decrease in asthma-related impairment, reduced respiratory effort, and a decrease incidence of asthma attacks. . . . The correction of vertebral subluxation . . . could reduce or eliminate the need for medication, and potentially ease the severity of the asthmatic condition.”

Source: The Family Center for Chiropractic, Palm Bay, FL, http://www.chirosal.com/templates20/article/1042.html (accessed August 18, 2009), quoting Richard Pistolese, International Chiropractic Pediatric Assoc.

Chiropractic care for baby

“Birth is generally a traumatic event for the baby. During the process, the body is ‘squeezed’ through a relatively small opening compared to the size of the baby. This can result in serious injury which is not readily apparent, especially to the untrained eye. Chiropractic doctors can assess the spine for injuries which frequently occur during the birthing process. Immediate correction of vertebral subluxations and other abnormalities are necessary to prevent developmental problems for the child later in life.”

Source: Bain Family Chiropractic, Tampa, FL, http://doctorbain.com/index.php?p=39807 (accessed 7/28/09).

Reflexology for correcting “imbalances”

“Like other pressure point therapies, Reflexology works with a reflex response. Stimulation to specific points activates the movement of energy to corresponding parts of the body to clear out congestion and restore normal functioning. . . . Reflexologists say that by promoting relaxation and stimulating circulation they may have a preventative effect, clearing minor blockages. If the sore points are followed like a road map, reflexology can be applied to assess these areas that are not functioning properly and at the same time try to correct the imbalance or alert the person to seek medical attention.”

Source: Margie’s Therapeutic Touch, Hollywood, FL, http://www.margiesmassage.com/reflexology.html (accessed 8/18/09).

Chiropractic and general health

“Chiropractic care is designed to restore the integrity of your nervous system so that everything works the way it’s supposed to. That’s why it’s vital to have your spine checked regularly for optimum health and well-being.”

Source: Parkside Health & Wellness Center, Parkland, FL, http://www.phandwc.com/printformat.asp?chiropractor=10072S (accessed 7/28/09).

Colon cleansing for removing “toxins”

“[T]he average person, that is one who is not overweight, may have some dried fecal matter in their colon! The toxins generated from accumulating such quantities of waste matter are responsible for many body imbalances and, in the end, disease. If you have any of these problems; constipation, leaky bowel syndrome, digestive distress, gas & bloating, skin disorders, irritable bowel syndrome, eating disorders, candida (yeast infections), allergies, muscle/joint pain, arthritis, hypertension, fibromyalgia, spastic colon, chronic breath odor, chronic fatigue, chronic body odor, headaches, toxic chemical exposures, acne, chronic skin problems, abdominal gas and bloating, lower back pain, sciatic pain, low resistance to colds and infections, low energy and vitality . . . then you may need to cleanse your body's elimination system.“

Source: Health Colon Care of South Florida, Boca Raton, FL http://healthcoloncare.com/about-ch.html (accessed 8/18/09).

What’s really in that dietary supplement?

A recent Associated Press news report highlighted dangers posed by the almost non-existent regulation of herbal supplements. Almost 40% of the U.S. adult population used some type of dietary supplement in 2007. Perhaps this is why poison control centers in this country handle tens of thousands of supplement-related health problems each year.

According to the report, one quarter of the supplements tested by an independent lab over the last 10 years had some kind of problem. In testing the lab found supplements which contained:

• contaminants such as lead and arsenic
• contents that did not match label claims
• ingredients that exceeded safe limits
• prescription drugs

“There’s at least 10 times more hoodia [the latest “natural” diet craze] sold in this country than is made in the world, so people are not getting hoodia,” Dr. Mehmet Oz was quoted as saying.

Unfortunately, the FDA, which regulates supplements, “has limited resources to analyze the composition of food products, including dietary supplements,” according to an FDA spokesperson asked to comment.

Did we say “regulate”? When the FDA finally adopted quality control rules 13 years after being given authority to do so by Congress, they came up short on both quality and control. The rules:

• do not tell supplement manufacturers what ingredient tests they must use
• do not set limits on toxins, such as lead
• do not change the way supplements are sold to consumers

Reference: Associated Press, “Contaminants lurk in many ‘natural’ products,” http://www.msnbc.com/id/31088175/ns/health-alternative_medicine/ (accessed July 26, 2009)

Thermography for breast cancer screeing: big cost, no benefit

A number of Florida “alternative” practitioners are touting thermography for breast cancer detection. A thermograph senses the body’s temperature and shows areas of differing heat emission by producing brightly colored patterns, each representing a specific temperature level. Interpretation of these patterns is marketed as an aid in diagnosing and evaluating many different conditions, among them arthritis, neck and back pain, dental problems, sinus problems, headaches, immune dysfunction, fibromyalgia, chronic fatigue, carpal tunnel syndrome, and digestive disorders. Thermography can cost hundreds of dollars and is almost certain not to be covered by insurance.

Proponents claim the different temperature levels reveal the location of inflammation and other physiological manifestations they say are indicative of disease. However, there is no evidence to support this conclusion and many health-related organizations agree that thermography is not an effective screening tool: the American Academy of Neurology, the American College of Radiology, the American Medical Association, the federal Agency for Health Care Policy and Research, and the federal Office of Health Technology Assessment. Based on the latter’s report, thermography was excluded from Medicare coverage. In 2000, the FDA warned a manufacturer of a thermographic device to remove claims from advertising which implied the device could be used to diagnose breast cancer.

The scientific consensus appears to be that all one can learn from the temperature differences pictured on a thermograph is that there are temperature differences, which does not aid in reaching a specific diagnosis.

As to breast cancer detection, proponents claim that thermography can detect blood flow patterns, inflammation and asymmetries, and that it offers the opportunity of earlier detection of breast disease than is possible through breast self examination, physician examination or mammography alone. These claims are not supported by the research. In addition, some thermography proponents exaggerate the risks and downplay the benefits of mammography.

The American College of Radiology’s position is that “thermography has not been demonstrated to have value as a screening, diagnostic, or adjunctive imaging tool.” The American Cancer Society exclusively recommends self-exams, clinical exams and mammography for early detection of breast cancer. For the Society’s recommendations specific to your age and risk factors, go to its website (see below). Of course, your primary care M.D. or D.O. or your OB/GYN are in the best position to recommend the most effective method of breast cancer screening for your situation. Chiropractors, acupuncturists and other “alternative” providers do not have the appropriate education or training to counsel patients about cancer screening. In fact, if you are told you need treatment for any disease or condition based on a thermograph be sure to get a second opinion from an M.D. or D.O. primary care physician or specialist.

References:

American Cancer Society, “Guidelines for the Early Detection of Cancer,” http://www.cancer.org/docroot/PED/content/PED_2_3X_ACS_Cancer_Detection_Guidelines_36.asp?sitearea=PED (accessed August 18, 2009).

Stephen Barrett, M.D., “A Critical Look at Thermography,” Chirobase, http://www.chirobase.org/06DD/thermography.html (accessed July 29, 2009).

American College of Radiology, “Digest of Council Actions, Breast Imaging Position Statements (excerpted text),” http://search.acr.org/search?q=thermography%20breast&btnG=Google+Search&sort=
date%3AD%3AL%3Ad1&output=xml_no_dtd&oe=UTF-8&ie=UTF-8&client=default_frontend&proxystylesheet=default_frontend&site=default_collection (accessed August 18, 2009).

Dept. of Health and Human Services, Food and Drug Administration, “Warning Letter” from Lillian Gill to Maurice J. Bales, March 14, 2000, http://search.acr.org/search?q=thermography%20breast&btnG=Google+Search&sort=
date%3AD%3AL%3Ad1&output=xml_no_dtd&oe=UTF-8&ie=UTF-8&client=default_frontend&proxystylesheet=default_frontend&site=default_collection (accessed August 18, 2009)

NCCAM: Your tax dollars not working

Ongoing studies are testing whether

• Pressing various spots on your head (acupressure) can help with weight loss.
• Brainwaves emitted from a special “master” help overcome cocaine addiction.
• Wearing magnets reduces pain in carpal tunnel syndrome.

And who is paying for these studies of highly implausible therapies? You are.

The National Center for Complementary and Alternative Medicine (NCCAM), a center of the National Institutes of Health (NIH), is funding the acupressure study with $2.1 million dollars. Dr. Charles Elder, who is heading the study, defended it by explaining that the pressure releases natural energy in a part of the body “responsible for transforming animal desire into higher thoughts.”

This couple of million is a small part of the $2.5 billion taxpayer dollars NCCAM has spent over the last decade testing unconventional therapies used in the U.S. to see which ones work. The results: no convincing evidence that a single “alternative” therapy is really beneficial. Perhaps this is because NCCAM works backwards from the rest of the NIH, where scientific evidence, or at least scientific plausibility, must be present before conducting a study. And as in medicine generally, the studies precede widespread use by the public.

Fortunately, prominent voices in the scientific community are beginning to take note of NCCAM’s deficiencies. Some comments:

• “You’d expect scientific thinking [at a federal science agency]. It’s become politically correct to investigate nonsense” R. Barker Bausell, research methods expert, University of Maryland.
• “Many of the studies . . . seem irrational and foolish [and] . . . are based on precepts and ideas that are contrary to what is known in terms of human physiology and disease.” Barrie Cassileth, Memorial Sloan-Kettering Cancer Center.
• “There’s been a deliberate policy of never saying something doesn’t work. It’s as though you can only speak in one direction.” Dr. Stephen Barrett, editor of Quackwatch.
• “This is not science, it’s ideology on the part of the advocates.” Dr. Joseph Jacobs, former head of the Office of Alternative Medicine, predecessor to NCCAM.
• “There is very little basic science behind these things.” Dr. Edward Campion, senior editor, New England Journal of Medicine.

Reference:

Associated Press, “$2.5 billion spent, no alternative cures found,” www.msnbc.msn.com/id/31111190909/ns/health-alternative_medicine/page/2/ (Accessed July 26, 2009).

Med school “CAM” programs flunk test

“Alternative therapies are popular, and information about them should be included in the curricula of health profession schools. During 2000 to 2003, the National Institutes of Health National Center for Complementary and Alternative Medicine awarded five-year education grants to 14 health professions schools in the United States and to the American Medical Students Association Foundation. The purpose of the grants was to integrate evidence-based information about complementary and alternative medicine (CAM) into the curriculum. The authors reviewed the educational material concerning four popular CAM therapies—herbal remedies, chiropractic, acupuncture, and homeopathy—posted on the integrative medicine Web sites of the grant recipients and compared it with the best evidence available. The curricula on the integrative medicine sites were strongly biased in favor of CAM, many of the references were to poor-quality clinical trials, and they were five to six years out of date. These 'evidence-based CAM' curricula, which are used all over the country, fail to meet the generally accepted standards of evidence-based medicine. By tolerating this situation, health professions schools are not meeting their educational and ethical obligations to learners, patients, or society. Because integrative medicine programs have failed to uphold educational standards, medical and nursing schools need to assume responsibility for their oversight.”

Reference:

Quoted from: Marcus DM, McCullough L. Abstract, “An Evaluation of the Evidence in ‘Evidence-Based’ Integrative Medicine Programs” Academic Medicine 2009; 84:1229-1234. (Emphasis added.)

TV health news doesn’t make the grade

HealthNewsReview.org, www.healthnewsreview.org, has decided to stop reviewing and grading TV health news reports. Why? Because they are generally so bad they are not worth the time and effort. How bad? In 3.5 years of reviewing stories from 60 news organizations (including TV, newspapers and magazines), the three main news networks (ABC, CBS, NBC) account for 68% of the stories scoring zero on a five-star scale. Only two network stories made five stars during that same time, a miniscule 2% of the of the 108 five-star stories.

HeathNewsReview.org is a well-respected non-profit organization which gives grades for health news reporting using five criteria. The site is published by Gary Schwitzer, journalism professor at the University of Minnesota, and is supported by the Foundation for Informed Decision-Making.

Mom was right -- turn off that TV!

Resource:

Schwitzer G, “It doesn’t make sense for us to review TV health news anymore,” HealthNewsReview.org, http://www.healthnewsreview.org/publishers_note34.php (Accessed September 2, 2009).