Naturopathy has been a recurrent topic on this blog. The reasons should be obvious. Although homeopathy is the one woo to rule them all in the U.K. and much of Europe, here in the U.S. homeopathy is not nearly as big a deal. Arguably, some flavor of naturopathy is the second most prevalent "alternative medical system" here, after chiropractic of course, and perhaps duking it out with traditional Chinese medicine, although naturopathy does embrace TCM as part of the armamentarium of dubious medical systems that it uses. In any case, some sixteen states and five Canadian provinces license naturopaths in some form, and in some states naturopaths are fighting for--and in some cases winning--the power to prescribe certain real pharmaceutical medications and order real medical tests. For instance, in California, naturopaths can order laboratory tests and X-rays, which reminds me of a conversation I had with a mammographer from California at TAM last summer. He told me a tale of the dilemma he had when naturopaths and other "alt-med" practitioners ordered tests at his facilities. Specifically, the dilemma came about because he doubted that the naturopath knew what to do with the results. Meanwhile, in Oregon, naturopaths can prescribe certain types of pharmaceutical drugs (as opposed to the usual supplements, herbs, or homeopathic remedies they normally prescribe). Meanwhile, moves are under way to expand the prescribing privileges of naturopaths in Canada.
Unfortunately, naturopathy is a hodge-podge of mostly unscientific treatment modalities based on vitalism and other prescientific notions of disease. As a result, typical naturopaths are more than happy in essence to "pick one from column A and one from column B" when it comes to pseudoscience, mixing and matching treatments including traditional Chinese medicine, homeopathy, herbalism, Ayurvedic medicine, applied kinesiology, anthroposophical medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine. Despite their affinity for non-science-based medical systems, naturopaths crave the imprimatur of science. As a result, they desperately try to represent what they do as being science-based, and they've even set up research institutes, much like the departments, divisions, and institutes devoted to "complementary and alternative medicine" (CAM) that have cropped up on the campuses of legitimate medical schools and academic medical centers like so many weeds poking through the cracks in the edifice of science-based medicine. Naturopaths also really, really don't like it when they encounter criticism that their "discipline" is not science-based. Indeed, the president of the American Association of Naturopathic Physicians, Carl Hangee-Bauer, ND, LAc (he's an acupuncturist, too!), wrote a revealing post on the official AANP blog entitled Science and Naturopathic Medicine.
Science. You keep using that word, Mr. Hangee-Bauer. I do not think it means what you think it means.
The President of the AANP takes umbrage
Apparently criticisms of naturopathy as unscientific have started to penetrate even the reality distortion field of the AANP, because Carl Hangee-Bauer has noticed them, and he's not happy. Oh, no, he's not happy at all. First, he begins by enumerating his bona fides as a science-loving geek, in order to prove to readers just how dedicated he is to science. These bona fides include a love of marine biology and a mention of how much he originally wanted to become a marine biologist. (Hey, I was a huge fan of The Undersea World of Jacques Cousteau when I was a kid, too, you know. I was even totally bummed out when Philippe Cousteau died.) Hangee-Bauer then discusses how he "took every course in biology, chemistry, physics, etc." that he could in school and in college majored in biology, with dual minors in physics and chemistry. Then, somehow, while he was in the U.S. Army, he developed an interest in medicine as a Medical Service Corps officer, and that led him to naturopathy. Personally, this story leads me to ask: What happened to Hangee-Bauer? How could someone who was so interested in science go so far off the rails? Whatever happened, Hangee-Bauer's narrative leads up to this lament about nasty bloggers like us:
I tell you this to let you know that I am no stranger to science. I still find it fascinating and appreciate the many ways it helps us understand the workings of nature and the world, helping us separate what appears to be the truth of things from reality. Studying naturopathic medicine, and especially acupuncture, presented me with many challenges, and I learned along the way that our medicine, as well as all other systems of medicine, are really a combination of science and art. When we work with our patients, we draw from both in order to stimulate the vis and provide well-rounded care to our patients.
Thus it has become an increasing concern to me when I read articles and blogs on the Internet blasting naturopathic medicine for being "unscientific." These frequently polemic articles, while professing to come from scientific logic, to my eye are biased misrepresentations of the truth. They often lambast our profession and philosophy as unscientific, yet I have yet to see any one of them provide a critical analysis of research done by naturopathic physicians and researchers. It is sad that science can be used in these political ways.
It's very hard for me not to point out that in Hangee-Bauer's case science has apparently not been particularly successful in helping him to separate "what appears to be the truth of things from reality." He is, after all, an acupuncturist and naturopath. It's also apparent from the website of Hangee-Bauer's practice, which treats all manner of ailments, as listed here on this page. Out of curiosity, I started clicking around on the conditions for which Hangee-Bauer provided links. For example, naturopaths frequently claim to be able to treat allergies (whether you have them or not!); so I gravitated to the page on allergies first. After a description about how "allopathic" medicine treats allergies by blocking histamine, having the patient avoid the allergen, and desensitization, we then see this passage:
Let's look briefly at an example of TCM treatment for allergies. John presented with acute allergy symptoms of one-month's duration which included sneezing, runny nose with lots of watery phlegm, extreme fatigue and occasional loose stools. After taking his history and doing an examination, his acupuncturist assessed his condition according to TCM as Wei Qi Deficiency resulting from a weakness of the Lung and Spleen. In addition to general recommendations for his condition, John was given Minor Blue Dragon formula which has decongestant properties for those with copious clear phlegm, as well as Astra 8, an herbal formula designed to tonify the Lung and Spleen Qi. He was also told to minimize or avoid dairy products and excessively sweet or spicy foods. As John's condition improved, he and his acupuncturist developed a plan to strengthen his immune system in preparation for next year's allergy season. This plan included replacing coffee with green tea, which is rich in catechins which exert anti-allergy effects, as well as taking quercetin, a bioflavonoid which has been shown to stabilize mast cells thus slowing the release of histamine and other chemicals related to allergic symptoms.
One wonders what "science" supports the vitalistic prescientific notion that allergies are due to "Wei Qi Deficiency" or detonification of "Lung and Spleen Qi" requiring "tonifying" (whatever that is). In all fairness, however, I will give Hangee-Bauer credit for one thing: on the same page, he actually states that applied kinesiology "may be of no value in testing for an allergy." Imagine my relief, except that he should have said "is of no value whatsoever" for diagnosing allergies. That relief is also tempered by Hangee-Bauer's suggesting that "strengthening the immune system" in an allergy would be a good thing in preparation for next year's allergy season. Given that allergies are due to an excessive histamine response to a particular kind of antigen, "strengthening the immune system" might well make it worse. Of course, "strengthening the immune system" is a meaningless phrase, as we've pointed out many times before, but apparently, for all his love of science, Hangee-Bauer hasn't figured that out.
But let's move on. Elsewhere on the web page, Hangee-Bauer's practice recommends breast thermography as an adjunct to mammography. I was shocked. No, I wasn't shocked that he recommended thermography, as thermography is very popular among the "alternative medicine" set. Rather I was shocked and relieved that Hangee-Bauer apparently still recommends mammography. Even so, his website parrots scientifically unsupported claims common among CAM practitioners that thermography can find cancer ten years before breast cancer is identified by other methods (claims of the sort that I wrote about recently and over a year ago), and that it should be done at least once a year to screen for breast cancer. Amusingly, there was then this claim:
Finally, licensed acupuncturists can use thermography to detect slight temperature variations which reflect disturbances in the flow of Qi and blood, which can result in pain and dysfunction. Concrete evidence that acupuncture therapy actually restores blood flow and normalizes disrupted temperature patterns has been proven by thermographic studies.
I would so love to see the scientific studies demonstrating that thermography can detect disturbances in the flow of qi and how acupuncture restores it and blood flow. Surely there must be such studies; Hangee-Bauer, after all, claims that he is all about science and just bristles with outrage at the commentary of bloggers who correctly castigate much of naturopathy for being unscientific. What he does is based on science, isn't it? So show it! What is the science demonstrating that thermography can detect disturbances in the flow of qi?
These are but a couple of examples that stood out of unproven treatments modalities and scientifically--shall we say?--"debatable" statements that I found on Carl Hangee-Bauer's web page. I encourage SBM readers to check out other examples, such as the pages on tips for lung health (complete with recommendations for regular acupuncture sessions to "increase your resistance to both viruses and allergens"), treating springtime allergies, naturopathic "detoxification" (it's always about those evil "toxins," isn't it?), and, of course, treatment of heavy metal poisoning. You know, whenever I see the term "heavy metal poisoning," I can't help but think of Ozzy Osbourne being the way he is as a result of 40 years of heavy metal poisoning. Oh, wait. It was the alcohol and illicit drugs. And perhaps the heavy metal poisoning.
But I digress.
Perhaps the most bizarre bit of ostensibly "science-based" recommendations to be found on Hangee-Bauer's website is something called biotherapeutic drainage. I must admit, I had never heard of biotherapeutic drainage before. It turns out that if you Google the term "biotherapeutic drainage," you'll find that naturopaths appear to love this particular treatment modality. But what is it? Erika Horowitz, one of Bangee-Bauer's naturopath partners, describes it thusly:
Detoxification is a big part of naturopathic theory and practice.
I can't help but interrupt right here and say: No kidding! Too bad these "toxins" are as fantastical as the "science" that naturopaths invoke to support "detoxification." Naturopaths (and pretty much all woo-meisters) seem completely unable to identify exactly what these "toxins are. I tend to view them as the equivalent of miasma or "evil humors" or even black bile. Horowitz then continues:
Helping the body eliminate toxins safely and effectively can play an important role in improving health and preventing disease. One of the most useful detoxification therapies I use in my practice is the use of UNDA numbers, which are unique combinations of liquid homeopathic formulas founded on the theories of Chinese medicine, homeopathy, and anthroposophy.
Wow. Apparently one woo isn't enough; so Horowitz combines three. It's hard for me not to imitate a commercial and say something like, "Biotherapeutic drainage. It's three, three, three woos in one!" Oh, wait. I just did. In any case, I had never heard of UNDA numbers before, which means I'm definitely learning something while writing this post. Unfortunately what I'm learning is that, even though I've been at this several years now, I still haven't learned all the forms of unscientific medicine and treatments that exist out there. I can still be surprised, and UNDA surprised me. Apparently, it's this:
UNDA numbers consist of homeopathically prepared low-dose combinations of plants and minerals. The plants possess specific characteristics as to how they affect an organ or organ system; some may have a stimulating effect, whereas others will calm or sedate an organ's functions. The minerals in the compounds affect how the cells carry out chemical reactions that are necessary to efficiently begin the detoxification process. So the plants guide the remedy to the appropriate organ system (be it digestive, cardiovascular, or respiratory) and the minerals help change the cells' biochemical function. These remedies help the body detoxify by helping cells work more efficiently and eliminate waste effectively, and by improving how our organs of elimination work.
UNDA numbers treat both acute ailments and chronic disease, addressing symptoms but more importantly concentrating on the reason that the body is manifesting the symptoms in the first place. The remedies are nontoxic, won't interfere with other allopathic or holistic medications, and have a gentle yet deep-acting effect.
If they're homeopathic, then I can't really argue with two out of the three claims made for UNDA numbers. They certainly must be nontoxic and I'm sure they don't interfere with other medications. Speaking of homeopathy...
One huge reason (among many) that naturopathy can't be scientific
After this detour to Hangee-Bauer's website, where we can find ample evidence suggesting that, when the rubber hits the road (or the patients hit the exam rooms) his dedication to science-based medicine is not nearly as strong as he proclaims in his message to the AANP, let's move on to the single most glaring reason why naturopathy can't be scientific. It begins when Hangee-Bauer lionizes Joseph Pizzorno, a prominent naturopath on the faculty at Bastyr University, arguably the most influential school of naturopathic medicine in North America, as having spent the past 25 years trying to use science to increase the credibility of naturopathy. Now I'll give Pizzorno credit. For example, he did recognize as quackery Hulda Clark's "parasite"-zapping "syncrometer," which is a lot better than a lot of proponents of "natural medicine" have ever done.
On the other hand...
Pizzorno is currently the President Emeritus of Bastyr University, having been its founding President. Presumably he is still involved in Bastyr University, but until 2000 he was the one running its day-to-day operations right from the very beginning. Hangee-Bauer lauds Pizzorno as being a visionary in terms of trying to make naturopathy science-based, but there's one problem with that view. Pizzorno's school embraces homeopathy uncritically. It is, after all, a school of naturopathy, and there is are few forms of woo that naturopathy doesn't embrace uncritically. Indeed, Bastyr not only embraces homeopathy, but requires its students to study it. Indeed, as I pointed out about a month ago, homeopathy is so intimately tied with naturopathy that the two are inseparable. Bastyr teaches homeopathy. The AANP defends and promotes homeopathy. And the naturopathy licensing exam (the NPLEX) even requires homeopathy. Indeed, I would love to see what questions the NPLEX includes regarding homeopathy. My guess is that the multiple choice questions would be a hoot; that is, if I didn't know they were completely serious. Unfortunately, as Kimball Atwood points out, no one other than naturopaths really knows what's on the examination. Indeed, Dr. Atwood observed that naturopaths seem to take great pains not to let scientifically-minded physicians see a copy of an actual NPLEX examination.
Be that as it may, homeopathy is but one example of how strongly naturopathy embraces pseudoscience. Be it myofascial analysis, vega testing, traditional Chinese medicine, Ayurveda, germ theory denialism, or even distant healing, there is no nonsense that naturopathy excludes as being too unscientific for it. Yet none of this stops Hangee-Bauer from bragging about how next year at the AANP Convention, it'll be all about the science:
On August 16, 2011, the Tuesday before the start of the 2011 AANP Convention, the AANP will be sponsoring a scientific summit. While only in the early stages of planning, it promises to be a gathering for the different players in the naturopathic profession to connect and define how the AANP mission, naturopathic research, and evidence-informed health policy can join and result in healthier patients, a more effective health-care system, and a flourishing naturopathic profession. Core discussion points will include articulating policy and practice issues driving our research agenda, where the profession is now and what future possibilities exist, and defining the core research questions relating to safety, effectiveness, and costs.
You might recall that last year's AANP Convention was a quackfest indeed, as documented by Dr. Kimball Atwood, both in the context of lamenting the appearance of Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine (NCCAM) as a speaker. Some examples of pseudoscience at last year's AANP Convention included (of course) homeopathy, "medical intuitive" scans, emunctorology, "detoxification," functional medicine, water-only fasting, and many others. If you click around the Naturopathic Physicians Research Institute (NPRI) website a bit (which Hangee-Bauer referenced in his post), you'll find "research" about chelation therapy for autism and cardiovascular diseases (which is an utterly useless and potentially dangerous intervention) and homeopathy in pediatric care. I do have to thank Hangee-Bauer, however. I'll keep my eye out for when the AANP announces its speaker list and agenda for its scientific conference on August 16 and the AANP Convention to follow immediately. I'm sure it'll provide at least one good blog post in a few months.
In the meantime, if I may be so bold, I will make one small suggestion. If Hangee-Bauer is truly serious about making naturopathy science-based, there's one thing he could do right away to prove it. It would be a simple, powerful, and unequivocal indication of the strength and sincerity of his intent. It's all Hangee-Bauer has to do as a first step, albeit tiny, to demonstrate that he is not simply mouthing the words in praise of science and proclaiming how much he loves science and wants naturopathy to be based on science. All he has to do is to state that homeopathy is quackery, that it should no longer be considered part of naturopathy, and that he is going to put the weight of the AANP behind removing homeopathy as a required component of training in naturopathy and the examinations used to certify naturopaths. Extra points would be given for correctly stating why homeopathy is nothing but water and how there is no evidence supporting the law of similars as a general principle. If Hangee-Bauer does that, I might start to take his pontificating about the wonders of science and the scientific rigor of naturopathy somewhat seriously. If he can't do it, then I know it's a load of hot air.
After Hangee-Bauer deals adopts a science-based approach to homeopathy, then we can talk about purging distance healing, anthroposophy, applied kinesiology, and many of the other bits of pure pseudoscience embraced by naturopaths. However, like infants naturopaths have to creep before they can crawl and crawl before they can walk. Eliminating homeopathy would be that first attempt at creeping. Anyone want to lay any odds on whether or not they'll take that first creep forward?
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Perhaps utilisation of the Kadir-Buxton method would help legitimise Naturopathy?
http://www.kadir-buxton.com
All of this just represents the distilling of everything we "used to believe" about medicine, before we applied actual science to it - bleedings, humours, evil spirits, and whatever else people did to try to treat the ill, because they had no idea how the body actually worked or why.
These people might as well have jumped right from the Middle Ages, for all of the scientific evidence they have to support what they do (which is mil).
Although there is a ton of superstition and ritual in naturopathy, I think that it has non-optimal modalities that have identifiable technical bases, usually problems that simply are not adequately addressed by current medicine.
I'll say this again, however empirical herbalism and alternative nutrition may be, the naturopaths often seem to be succeeding with patients previously failed by "regular medicine", especially on issues involving digestion and nutrition. Further, when I go look up scientific literature, I can identify active components in their nutritional and herbal treatments that have published physiological bases, if not a current patent or trademark.
One problem I see here, is outright dismissal from purported "scientific" medicine by people that should have looked harder at both the literature and older medical practices. I've seen therapeutic failures in modern medicine that leave me wondering if you can trust a doctor under 75.
Sometimes it almost sounds like they'll be lynching Newton next.
You know, I get sick and tired of people saying that "wellness & nutrition" aren't a part of modern medical science. Every single time I've been to the doctor, we've had a discussion about nutrition, exercise, and general health - it is considered very important on the preventative side of the house.
I don't know who you've been speaking to, but doctors are not just "pill-pushers" and actually do care about preventing diseases and illness as well.
The naturopaths' threshold of clinical significance or even presumption, as well as digestive health and nutrition drills are quite different.
Most MDs simply don't know at all, or reject out of hand things that ARE working for, at least, their therapeutic or diagnostic failures.
Four years of allergy shots, one per week, in the arm... instead, I have missed out on the thrilling discovery that placing needles over my entire body in one session would have had the same effect. I am saddened by my lack of understanding of alternative medicine. :(
"The naturopaths' threshold of clinical significance or even presumption, as well as digestive health and nutrition drills are quite different."
True. The threshold at which naturopaths' bullshit-o-meters is triggered is much, much higher than in medicine.
Please excuse me now. I must go tonify.
What sort of malpractice insurance do naturopaths carry? For example, what's going to happen when they misinterpret a mammogram result or make a mistake in prescribing real meds? Is the person harmed just SOL?
And why on Earth would the plants "guide" the medicinally active chemicals to the appropriate parts of the patient's body? It makes no sense evolutionarily, and no mechanism is suggested for how a piece of a dead plant can have that much volition and control.
If he's actually feeling scientific, there would be some good places for research. First, tests as to whether this happens. I assume they'll find it doesn't, but if I'm wrong, the next thing would be to try to elucidate the mechanism and its limitations.
As in, they don't have such a threshold and couldn't do anything with it even if they did, since they don't bother to pay attention to such niggling little details as science or facts?
And why on Earth would the plants "guide" the medicinally active chemicals to the appropriate parts of the patient's body?
Actually, I can think of a reason that the plant might want to "guide" chemicals to the appropriate place in an animal's body: Most "medicinal" plants are actually poisonous plants. The plants produce taxanes or digitalis or vinca alkaloids or opioids not out of altruism, but because they are trying to kill any animals that try to eat them and thus survive. So a plant that could get its chemical to the right part of the animal's body for maximal effect might have an evolutionary advantage. That having been said, I want details on mechanism. I can imagine a plant making, say, a secondary chemical that irritated the meninges making it easier for a neurotoxin to get through the blood brain barrier, but I don't know of any examples and am not sure about the practicality of it all.
@ Dianne:
That's not the plant doing any guidance, that's the active ingredient having an affinity for particular parts of the body. Which means any such effect would work equally well with the purified active ingredient, and there's less than no reason to use the impure herb instead.
Beamup: I agree in general, although I can imagine a synergy between two plant products producing a better effect than the presumed active ingredient alone. For example, a lot of people state that marijuana gives them better relief from nausea than marinol. This could be placebo effect or maybe smoking delivers the drug quicker and more efficaciously. But another possibility might be a second psychoactive ingredient that, perhaps along with THC, really does relieve nausea better.
Of course, this also applies to risks: a plant that makes one toxin might make another. And while the first relieves your pain or shrinks your cancer, the second might be destroying your liver or your heart. Not to mention the whole issue of dose control: it's simply not possible to give a proper therapeutic dose of most medications via a plant which may produce different amounts of the relevant chemical depending on where and when it grew, etc.
So, while a specific claim such as "marijuana works better than marinol" might be worth investigating to see if there is a second useful chemical to be extracted, the idea that using plants rather than purified chemicals is overall better is just wrong.
About those "nasty bloggers" and my fellow/sister SB commenters:
Because I don't live in cloud cuckoo land, I continuously ask myself, "What if I'm wrong?" ( Isn't *that* question integral?) Isn't that what we're really all about? Isn't that the basis of statistical analysis? Now in contradistinction to our woo-meisters, I rarely experience the warm-fuzzies of certainty - especially when I counsel people about their lives or advise relatives about their money - I find it horrendously distasteful to be cavalier. Actually, it's a real b#tch, but somebody has to do it.
Maybe we *are* the problem: we go around kicking holes in comforting so-called theories that make people *feel* good and chase off uncertainty. I suppose we could all concoct inspirational, self-congratulatory fictions to ward off displeasure. I don't think so. We may be nasty but so's reality.
And it was very likely not an in depth conversation at all unless it was based on personal experience of your particular doctor.
Your doctor is no more an expert in nutrition, exercise, and general health than a personal trainer is.
Handing someone a picture of the food guide pyramid (in lieu of the 4 food groups), telling them to eat less fast food and exercise more is more of lip service than a commitment to prevention and lifestyle.
It sounds nice but that statement just doesn't reflect what doctors, as a group, do in actual practice.
As always, when quackery advocates say "Physicians don't pay attention to diet and nutrition!", they really mean "Physicians don't support my non-evidence-based woo!".
@14
I'll second that.
Those warm fuzzy myths keep people from taking real life-saving or life-improving treatment, especially if the treatments are scary, like surgery.
I'll stick with the mean-spirited, nasty, no fun realities, thanks.
(Although this has a lot to do with why I don't get invited to parties any more.)
Coming from someone who doesn't even know what a 45 lb plate looks like your interpretation doesn't mean much.
@1 Sharon, that's hilarious. "...stuns and resets the brain of the patient"
Perhaps utilisation of the Kadir-Buxton method would help legitimise Naturopathy?
No, but it sounds suspiciously like earlier generations' childrearing practices. Thwack!
@7 and 10 Simple, uninformed dismissals again.
@16 advocates...mean..."Physicians don't support my non-evidence-based woo!".
Physicians need to either do better than the NDs on nutrition and digestive issues, or replace mossback RDs with NDs or better informed RDs, if they don't want to get their collective asses kicked economically. I've even seen erudite biochemistry discussions on the internet by a DC on advanced biotech issues that rival, or draw upon Japanese glycan technology for immune stimulation, years ago, where the American biotech industry is just barely beginning to start their first FDA trials for a glycan now.
As for as whether the pre-MD has a 3.6 (or 4.0) from a better school vs the pre-ND has a 3.2 from somewhere, most people don't care. They want RESULTS now, especially after striking out a few times, and the ND are scoring the most points on nutrition and digestive issues, citing old and new literature, getting results. This doesn't mean that homeopathy, kinesiology, reflexology etc are science based, it means that the NDs with nutrition and digestive related treatments have something useful to sell that patients aren't getting at Homeboy Medical from Dr Dolittle, FACP, GSK, PFE, MRK.
prn:
You're arguing with something that people aren't claiming. It's not that the naturopath may have had a lower GPA, it's that they have less training, and much of the "training" they have is useless or counterproductive. You could recruit a bunch of people with 4.0 GPAs and teach them homeopathy, and the homeopathic "remedies" would still be useless water.
On a different note: Reality isn't as nasty as the fantasyland the naturopaths lure people into, because reality contains cures, and useful treatments, for things that the woo peddlers can't do anything for.
@ Scott Cunningham: Here's the secret- you can as nasty and realistic as you like if, and only if, you can manage to be utterly charming at the same time. Smile. People will invite you to many parties.
prn,
I'm willing to believe that, but need evidence. Do you have a source and some statistics on the quality or results for naturopaths and how they compare to the results for physicians?
prn,
If NDs are so kickass at science when it comes to nutrition, then why do they support bogus treatments like homeopathy, reiki, etc?
Are you seriously arguing that that's acceptable? If I were in your position, I'd be pissed that NDs have to learn so much useless crap.
Anybody who accepts homeopathy is so utterly divorced from anything vaguely resembling reality that they can be given no credence on any other scientific or medical question. Full stop.
Only a fool would trust any medical advice a naturopath has to provide.
Given that augustine has yet to prove he knows more about nutrition than the physicians he continually lambasts, it would be nice if he would just shut up. Also given that in the world of woo you have everybody from the Raw food extremes to the other end where the only thing you need is saturated fat and cod liver oil I really doubt there are any good experts out there.
I would like to point out that if you want to consult someone about nutrition and diet, a registered dietitian will focus on that. All the focus on diet, and none of the built in quackery. Unlike NPs, Registered Dietitians are actually regulated and required to get an accredited degree along with "1200 hours of practical, supervised experience through an accredited program." Then they are allowed to take the registration exam.
@20 Thanks, Vicki. 3.2 v 3.6 was an attempt at a shorthand version of "the gap", the point is still ND results following MD failures.
@22 Thanks, MOB. This is largely my own observation and conclusion after many interviews with various patients and several dozen MDs. A better launch point might be the insurance companies files in states with licensed NDs and parity treatment.
However, even mainstream medical literature is starting to sit up and take note that even the worst digestive disorders, like sprues (selected severe enteropathies like celiac), remain greatly underdiagnosed for years, or never diagnosed at all. Ditto, thyroid diagnostics and treatment have started to budge a very little bit toward ND land (endocrinology changed to lower TSH several times, T3 may be added more often).
@23 I am not even going to argue that their science has to be better, simply that customers have found them more useful after striking out repeatedly with the MDs. As for the extra rituals, I really don't know how much is psychology or what kind.
I'm suggesting the MDs are in an even worse position, because they learn even less useful nutrition. I'm pissed because I am tired of the MDs being led around by their collective noses while the country has suffered greatly from gross malnutrition like on transfats, PUFA, essential fatty acids, vitamin D, natural folates, carbs, mineral profiles and other replacement type nutrition treatments that may be life and death nutrition.
I would prefer to have MDs that could surpass the ND on breath and depth of medical nutrition. The few that I've met are called other names, here.
@26 Ross, a registered dietitian will focus...on diet, and none of the built in quackery.
I've had one geriatric RD experience not so long ago. The RD was biased, ignorant and unethical. Fit many stereotypes that I've read. I was prepared with medical and science references. I even had clinical data. She did not contradict me in conversation, and then she went off and fabricated a report to suit her management.
I hate to prejudge a profession on a single experience, but it sounded like others' experience with ADA backwardness. I don't plan any future RD use. I've looked at some of the common undergraduate nutrition textbooks and I spotted misstatements where some old, dangerous biases come from. I think the graduate level nutrition texts are in somewhat better shape, more overconservative rather than actual false statements. However, I'll read the therapeutic nutrition papers in the literature for myself and collect my own data, thank you.
prn: "(People) want RESULTS now, especially after striking out a few times, and the ND are scoring the most points on nutrition and digestive issues, citing old and new literature, getting results...I'm suggesting the MDs are in an even worse position, because they learn even less useful nutrition...I've had one geriatric RD experience not so long ago. The RD was biased, ignorant and unethical."
Gosh, I hate to be all dismissive again, but do you have any evidence at all to back up your diatribes? What are these "RESULTS" you claim for naturopaths? What revolutionary paradigms do you believe NDs have introduced to the field of nutrition?
Maybe you should read John Ioannidis first.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/
Dunning & Kruger might be a good idea too.
Wow, now naturopathys offer breast screening services and have "specialist" in gynecology, in addition to their treatments for "boosting your immune system"...whatever that means.
Remove toxins from your digestive system with a twelve day toxins removal program? I guess it is a new wrinkle on high colonics (enemas) for removing "toxins"...that is just done from the other end of the digestive system. There are easier ways to screw up your electrolytes and metabolic processes by overdosing on OTC potassium supplements...in the comfort of your own home
They are doing breast studies with technology that is presently being tested and has not replaced mammography as a screening for breast cancer. Do naturopathy colleges offer courses to become certified in naturopathy radiation technology? Is it a naturopathy radiologist that is interpreting the tests?
How about the naturopathy gynecologist "specialist's" training in some basics such as microbiology, organic chemistry, immunology and the other sciences taught in pre-med and medical school? And, their residencies in hospitals that qualify them for certification in obstetrics/gynecology. Do they and their naturopathy trained technologists have any credentials in infection control...maybe they do, but use homeopathic disinfectants rather than those nasty chemicals to sterilize equipment.
"Immune Boosters" What a joke. Even "traditional medicine" trained physicians and nurses are constantly updating their knowledge about vaccines, immunology and infectious diseases by attendance at seminars, teleconferencing with the CDC and attendance at grand round conferences.
These quacksters have no research that has ever been replicated by scientific research and yet they seek acceptance by the established/traditional medical community. To that end, their conference in August will be dealing with re-packaging their garbage with sciency lexicon. I'm reminded of the Alaskan Diva's remarks about "lipstick on a pig...."
UNDA means "wave" in its Latin roots.
Wave of woo,
a trace of Q,
quantum wave,
pinch of physics,
all the rave
for the mystics.
@29 The NDs aren't revolutionary in the discovery and invention sense. They are simply making more effective use of the totality of the science and medical literature, often with medical procedures supposedly obsoleted by the marketing of newer products with high margins.
The graduate nutrition texts are actually making progress, just that they are over cautious from a patient point of view, and slow. 31st century vindication holds little appeal to today's patient.
A number of the patients I've interviewed (interrogated?) mentioned their prior MDs' lack of success, and the NDs' digestive / nutritional recommendations with subsequent health improvements, with the suggestion of their employer.
One of the problems with marketing products based new placebo controlled tests has been that new products are often automatically considered "superior" just because they are new. Commodity, generic products always are vulnerable to deprecation by slick marketers pushing high margin dreck. So ND may often not be so revolutionary as ("regular") medicine has had forms of devolution.
revolutionary paradigms? transfats [elimination], PUFA [reduction], essential fatty acids, vitamin D, natural folates, carbs[reduction], mineral profiles and other replacement type nutrition treatments were advocated by "alternative medicine" much sooner, often more aggressively, than current generation MDs and RDs. Earlier at eliminating nitrites, too, Dangerous Bacon.
UNDA means "wave" in its Latin roots, like "onde" in French.
Onde de woo,
a trace of Q,
quantum wave,
pinch of physics,
all the rave
for the mystics.
@31 lilady "boosting your immune system"...whatever that means.
Means exactly that. For many people, like cancer patients, the immune system's continued functioning is a life and death battle between chemo and cancer, and a patient can benefit greatly from immune stimulation.
Glycans have been long demonstrated since the 1960s and 1980s in asia and Europe to boost immune function. Vitamin D is making a comeback, as well as digestive-immune links that were long known but out of favor. Measuring some immune paramters is now something you can do at home, drawing the blood part anyway.
That's quite a disingenuous comparison. I've yet to see a diet change that "alternative medicine" hasn't advocated. Yeah, if you take a shotgun approach then something's bound to hit, but it all comes to that old adage "Even a stopped clock is right twice a day."
Do you have any reason to believe that the nutrition advice an average ND gives is better that that of an average MD?
So we have to avoid Glycans if we have allergies? Good to know.
prn
Try as you might you can not debate with people who will not listen. Just like at post #37.
@31 cont'd "Immune Boosters" What a joke. Even "traditional medicine" trained physicians and nurses are constantly updating their knowledge about vaccines, immunology and infectious diseases by attendance at seminars, teleconferencing with the CDC and attendance at grand round conferences.
The [big name] doctors I've met are definitely behind on applying several immune boosters like glycans, vitamin D, and H2-type antihistamines that enhance dendritic cell presentation of antigens for metastatic cancer.
Of course for $2, one cent and 6 cents per day, respectively, they don't fund many boats and black tie dinners.
But what does "boosting the immune system" mean? Increasing lymphocyte production? Triggering class switching of B-cells? Activating macrophages? Are you boosting the adaptive arm? The innate arm? The cell-mediated arm? The humeral arm?
Taking about the immune system like it's some monolithic entity just betrays ignorance of basic immunology.
Yawn - Long on claims and short on evidence again
@36 diet..."alternative medicine" hasn't advocated. Scientifically oriented "alternative" can be hard work if you are collecting references and evaluating lab results as an individual. But good results are worth it.
the nutrition advice an average ND gives is better that that of an average MD?
Easy, ND wins by default, MDs aren't even really in the water.
@37 So we have to avoid Glycans if we have allergies? Good to know.
My limited experience is that all allergies in a high histamine producing person went away with the H2 antihistamine, multiple antioxidants, and direct histamine neutralization while the glycans etc restored WBC to high pre-op levels even on long term chemo.
@41 Dismissive scientific illiteracy again. Actually I've been over this before with multiple mainstream journal links on the H2 antihistamine. Vitamin D is a happening thing now for the last 10 years for anyone that has a pulse. Ditto glycans.
prn: "revolutionary paradigms? transfats [elimination], PUFA [reduction], essential fatty acids, vitamin D, natural folates, carbs[reduction], mineral profiles and other replacement type nutrition treatments were advocated by "alternative medicine" much sooner, often more aggressively, than current generation MDs and RDs. Earlier at eliminating nitrites, too, Dangerous Bacon."
A nice laundry list of stuff, even if a lot of it is rather incomprehensible ("replacement type nutrition treatments"? "mineral profiles?). What I still don't see from you is evidence that naturopaths pioneered in adopting significant evidence-based changes in these or other areas that demonstrably (getting back to that ol' evidence-based thing again) improved clinical outcomes for their patients as compared to physicians.
"A number of the patients I've interviewed (interrogated?) mentioned their prior MDs' lack of success, and the NDs' digestive / nutritional recommendations with subsequent health improvements...The [big name] doctors I've met are definitely behind..."
More anecdotal vagueness. Sorry, this is not at all helpful.
"31st century vindication holds little appeal to today's patient."
Oh good, the "Science will prove me right someday!" argument.
Apparently we will also have to wait until the 31st century to get some evidence out of prn. :(
@43 - You haven't posted one link in this thread or cited one paper. Until you do, you are offering nothing but Gish Gallup and gratuitous insults.
Eh, to be fair, prn's offered some laughs as well. Like when he gave H2 antihistamines as an example of an immune booster? That was worth a chuckle.
And all prn's talk of glycans? Seriously, could prn be any more vague? Glycans are a huge class of molecule, with a really diverse number of functions, and that's not even getting into glycoproteins. Honestly I'd be surprised if prn knew what a gylcan was without looking it up.
What I still don't see from you is evidence that naturopaths pioneered in adopting significant evidence-based changes in these or other areas that demonstrably (getting back to that ol' evidence-based thing again) improved clinical outcomes for their patients as compared to physicians.
I am not claiming naturopaths pioneered most of this stuff, rather they are the early adopters for the past 10-30 years. Most of this stuff was developed even earlier by scientists, MD-PhDs, and science capable MDs, some clinically. Ordinary evidence levels certainly have changed over the years. The neat part of modern technology is that lab tests enable capable individuals to directly assess whether they are in the groove. Sorry, I can't write a book.
"A number of the patients I've interviewed (interrogated?) mentioned their prior MDs' lack of success, and the NDs' digestive / nutritional recommendations with subsequent health improvements
Yes, my point of view.
...The [big name] doctors I've met are definitely behind..." More anecdotal vagueness. Sorry, this is not at all helpful.
I've noticed a lot of doctors floating around this blog. I would be interested to hear any say, "I do" or even their acquaintences do. Let's say even infrequent recommendations to pts of, say, 6 - 10,000+ iu vitamin D3/day (Ca, P, 25OH-D3 monitored of course), 3+ grams/day of Krestin (Japanese type Coriolus extract, 40+% polysaccharide glycan) and 800-1600 mg/day of cimetidine for any form of stage III-IV adenocarcinoma, and their application criteria from the journals.
"31st century vindication holds little appeal to today's patient."
Oh good, the "Science will prove me right someday!" argument....Apparently we will also have to wait until the 31st century to get some evidence out of prn. :(
You have a reading comprehension error. The patients who understand the existing evidence implications can't wait on unmotivated MD or government until the 31st century to finish gathering data, if ever.
@prn Glycans? Tell us all about research conducted to "boost the immune system"...I was only able to locate scientific research being conducted on congenital disorders of glycosylvation,O-glycen profile and quantification to identify genetic disorders that result in mental retardation, other developmental disabilities and seizures. I also located scientific research about glycen testing markers to identify cancers.
I'm interested in your statement about "measuring immune parameters is now something you can do at home, drawing the blood part only." Gee, I'm only aware of at home testing meters for glucose and Coumadin levels. What meter are you using at home? Tell us the name of the laboratory which measures "immune parameters".
Your statement "The (big name) doctors I've met are definitely behind.....", piqued my interest (I must be working from a different "big name" doctor's list). Please provide the names of the "big name" doctors, so I can revise my list.
What a crock!!!
Arrgghh. I can't ignore prn any more.
9 out of 10 horoscope readers cited the total failure of Western astronomers to tell them what dress to wear to the party as a reason for consulting astrologers and the Zodiac.
The NDs are good a telling people easy-to-believe reassuring nonsense and emotional platitudes. If that's what the patient wants, the patient wants absurd things.
Two things:
1 - You're saying NDs use "the totality of the literature" because they also use ancient superstition, previously falsified ideas and dubious unproven stuff? Fabulous. By that logic small children are the best zoologists - they know about real animals, plus dragons, unicorns and closet monsters.
2 - You imply profitibility is why drugs are promoted over CAM by non-NDs. Nice side-step away from whether there's evidence the treatments work. Two can play the "dismiss the other as greedy" game. There are two woo stores in my neighbourhood. How do you say "huge gouging prices" and "requiring endless return visits?" Oh right. That's how.
When I have pneumonia, should I spend $56 on a bottle of antibiotics or $140 a week forever for reiki?
Prn, the NDs excell in emotional appeal, not in evidence, and not in any kind of actual good conduct.
@45 Militant Agnostic, I guess you weren't reading too closely when I saw you previously. I covered cimetidine, the H2 antihistamine, at some length between your posts in December.
Elizabeth Edwards and Kim Tinkham... breast cancer
me @ 72, 75, 78, 81 you:@ 19, 118, 154, 168
So NDs will happily embrace things like homeopathy, acupuncture, reiki and so on, but when it comes to nutrition they suddenly become insightful scientists capable of carefully separating the wheat from the chaff, combining the medical literature with clinical experience into a coherent whole, and adopting the same nutritional treatments as mainstream medicine but decades earlier?
@48 @prn Glycans? Tell us all about research conducted to "boost the immune system"...I was only able to locate...I also located scientific research about glycen testing markers to identify cancers.
Me (prn)@47: "3+ grams/day of Krestin (Japanese type Coriolus extract, 40+% polysaccharide glycan)"
What part of the "glycan" details didn't you read ? Google (Krestin Japanese Coriolus) tells you all about it.
I'm interested in your statement about "measuring immune parameters is now something you can do at home, drawing the blood part only
It's called a CBC with white blood cell counts and things like Neutrophils, Lymphocytes, Eosinophils. Lab drops by to collect in the morning, emails results mid afternoon.
Your statement "The (big name) doctors I've met are definitely behind.....", piqued my interest (I must be working from a different "big name" doctor's list).
Irrelevant stalking on my personal list. Again, I cited the treatment elements that have literature, but you probably won't find any such experienced doctors here at RI, either.
prn: "I am not claiming naturopaths pioneered most of this stuff, rather they are the early adopters for the past 10-30 years.
Again, it's an empty claim when you don't supply evidence to back it up.
"The neat part of modern technology is that lab tests enable capable individuals to directly assess whether they are in the groove."
Yes, how "neat" it is that one can find labs willing to take one's money to conduct dubious and poorly regulated tests, yielding results questionable for accuracy and relevancy, which then can be used to justify expensive, useless and potentially hazardous treatments (see for instance chelation therapy for autism).
"Sorry, I can't write a book."
Nor reference one. Or any articles, curricula or other evidence to demonstrate how naturopaths are on the cutting edge.
What the evidence does show (see Orac's article), is that naturopaths are on the cutting edge of medicine as it existed in the 19th century or earlier. Homeopathy, "toxin cleansing", traditional herbal use - all things without demonstrated effectiveness, and/or superseded long ago by modalities that do work.
Enough with responding to this silliness, at least until you have something to say that's more than a repetition of your personal prejudices and undocumented anecdotes.
@49, 51 No, Matthew and Scott, I am not claiming NDs as great scientists. Simply that they have biologically based protocols on nutrition and digestion that can work when used with a little diligence. Protocols that also have literature of various age and levels of evidence. A big deal if one can't any useful results from whatever MD land near you.
I am not interested in many of the ND mystical offerings, either.
Wow! "Dr." Hangee-Bauer has given me a new all-time favorite "alt-med" Jabberwocky-like quote:
OK, homeopathy is medicine for people who don't understand big numbers, I get that. But claiming that combinations of homeopathic remedies (originated in 1796) are "founded on the theories of Chinese medicine" seems a bit bizarre, unless he's positing that Traditional Chinese Medicine also had/has a belief in the effectiveness of nothing (a sort of therapeutic nihilism?).
However, what finally convinced me that this had to be either word salad or a deliberate Poe, was the addition of "anthroposophy" ("human wisdom"). All of medicine - the real and the "alternative" - is "anthroposophy", unless someone is claiming that their particular woo brand came from extraterrestrials.
Additionally, "prn" and his/her parroting about "boosting the immune system" has been a real scream. Yes, there is a lot of research being done on improving the immune response to cancer (I'm working on a piece of that, myself), but that's doesn't mean that "boosting the immune system" will help allergies.
As has been (repeatedly) pointed out, "allergies" are the result of an over-responsive immune system, so "boosting the immune system" would make the problem worse. As for "boosting the immune system" in cancer, that would be a terribly over-simplified (and incorrect) description of what is being attempted. A better (if still grossly over-simplified) description would be that researchers are trying to "awaken" the immune system and get it to "notice" the cancer.
Attacking cancer by "boosting the immune system" overall has been tried - the general outcome is that the immune system then kills the cancer and the "patient" (usually experimental animals).
It's a "yin and yang" thing - something "prn" with his/her fascination with "alternative" and "non-Western" medicine should appreciate. The immune system - when everything is working properly - is in a delicate balance between too little response and too much. Too much of a "good thing" (immune response) can kill as surely as too little.
Finally, it is entirely irrelevant that schools of naturopathy put their students through four years of education in classes that often have names similar to those taught in medical school. A student educated for four years in errant nonsense (all homeopathy, much of naturopathy), mis-information (much of the rest of naturopathy) and magical thinking (see above) is still no more able to treat real illness than the average entry-level car-wash employee.
In fact, the car-wash employee might be a better choice for medical care, since they wouldn't be burdened with all the nonsense, mis-information and magical thinking.
If you think - as they teach in naturopathy school - that Nature has the "cures" for every human illness (or "dis-ease"), then you don't know much about Nature.
Prometheus
@46 Eh, to be fair, prn's offered some laughs as well. Like when he gave H2 antihistamines as an example of an immune booster? That was worth a chuckle.
Your Redundant Ignorance?
Cimetidine is the H2 antihistamine allowing antigen presentation by the dendritic cells.
Kubota (2002) Cimetidine modulates the antigen presenting capacity of dendritic cells from colorectal cancer patients
[Cimetidine in stage II/III adenocarcinomas w/o leucovorin]
The CA19-9 - CSLEX based assessment to targeted [cimetidine] therapy represents over 20 years of investigation overseas by a number of medical research groups.
S Matsumoto (2002)Cimetidine increases survival of colorectal cancer patients with high levels of sialyl Lewis-X and sialyl Lewis-A epitope expression on tumour cells
"Example: An old biomarker, CA19-9, correlates highly with improved survival in various solid carcinomas adding a generic drug that is a VEGF inhibitor, EGF signaling inhibitor, unmasks dendritic cells, and stimulates granulocytic attack. It's not FDA approved, never will be under the current structure.
Figs A (CSLEX) and D (CA19-9) for colorectal cancer. The 5FU portion (ca 1989) of the following paper is superceded by other oral 5FU chemo, but p=0.0001 might be interesting:
http://www.nature.com/bjc/journal/v86/n2/fig_tab/6600048f3.html#figure-…
Subsequent research indicates high CA19-9 biomarker (cheap marker) results combined with high CSLEX biomarker results may be a quantitative treatment indicator in, at least, stage III CRCs.
Vs not-so-impressive mabs for VEGF and EGFR inhibition with expensive testing for a lower population percentage AND expensive treatment for mostly poor results with significant side effects. The pharmas appear to be belatedly copying the VEGF and EGF application of the unacknowledged, cheap predecessor, poorly.
-----
[Cimetidine in stage IV adenocarcinoma with leucovorin]
There is some limited stage IV cancer data for cimetidine that is very promising for colorectal(Gan To Kagaku Ryoho. 2003 Oct;30(11):1794-7. Effect of cimetidine with chemotherapy on stage IV colorectal cancer) and ovarian cancer (MOLECULAR MEDICINE REPORTS 1:119-122, 2008 Prognostic implications of cimetidine on advanced serous ovarian carcinoma related to cyclooxygenase-2 expression). Since cimetidine is both a VEGF inbibitor and interferes with EGFR signaling as well as allowing dendritic cells to unleash a large scale granulocyte attack, one might consider the possiblity that cimetidine is an unsung hero, unadvertised, equal or better than Avastin and Erbitux combined, without the huge side effects. Lack of cost and side effects mean cimetidine, could theoretically, be used very long term.
@ prn Your test for "immune parameters"...a rather exotic name for for a CBC is informative. Uh, I think you mean a CBC/differential/RBC morphology test. I'm interested in "the blood drawing at home part". Is it with a finger stick or with a venous draw? I still haven't gotten the name of the lab that uses blood to test for "immune parameters" with either a finger stick or venous draw blood specimen. I also would be interested in the WBC diffential report and the RBC morphology report that is returned to the patient and/or naturopath physician and the treatment provided with abnormal elevated WBCs, the abnormal shift in the WBC differential test and abnormal RBC morphology test results.
We are also waiting for the "big name" doctors list.
Honestly, you are starting to sound like a stalker. The doctors and lab are irrelevant for you.
The WBC are normal range. Abnormal only in the sense of being significantly nonzero while on chemo.
This is the format of the hematology section of the report:
"HEMATOLOGY RESULT NORMAL VALUE
Hemoglobin 12.0 - 16.0 gms%
Hematocrit 34.2 37 - 47 vol%
White Blood Cell 5-10 x 10^3
Red Blood Cell 4.0 - 5.5
Lymphocytes 20 - 40 %
Eosinophils 1 - 3 %
Platelet Count 150-400x10^3/cumm
M C V 83.89 - 100.66 fl
M C H 27.21 - 33.27 pg
M C H C 31.85 - 33.87
E S R 0 - 20 mm/hr
prn,
Why do you hate me?
@prn:
The thing is, if they choose which nutritional modalities to use in the same manner that the choose which other modalities to use, they should end up essentially choosing them at random, and end up with a few nutritional modalities which work and a bunch which don't. If, on the other hand, they choose nutritional modalities which work at a greater rate than chance would account for, then they must use a different method for choosing their nutritional modalities than for choosing their other modalities.
I don't think that lilady wanted the results of your blood test in particular, but rather examples of blood test data of those who NDs recommended "immune boosting" diets vs those who weren't recommended such data.
As for the lab(s), there are some labs that tend to be used by quacks because they return results favorable to quacks, like DDI, so I don't think that asking for the lab is an irrelevant request.
Prometheus, check again. I am mentioning having an immune system left, to survive chemotherapy. Your interpretation of this entire discussion is badly garbled.
I mentioned the separate suppression of the histamine related allergies by direct neutralization of histamine, the H2 antihistamine, and antioxidants. This cocktail had no obvious interference with glycan stimulated WBC, over the two months treatment with PSK. WBC rose to pre-op levels, all while on long term chemo after adding the glycan, PSK.
Civil and intelligent discourse is getting extremely difficult here.
I'd also be interested in seeing how NDs recommend "immune boosting" on the basis of a CBC (which appears to be the blood test prn is referring to, given the reference ranges provided).
The CBC provides minimal and crude information on immune function (if your white blood count is very low, it's probably not in the best of shape). What's the ND answer to having, say a WBC of 1.2? Homeopathic tonics? Toxin cleansing? Colloidal silver ingestion? Wallet slimming?
There's gotta be a sophisticated paradigm there somewhere.
It is a regular commercial lab, they literally wouldn't even have a clue about naturopathy. The blood tests are similar to others reported in blogs and technical papers, a little more detail, more frequently done to guide formulation and dosing.
I am not using a naturopath, they don't exist here per se. I have talked earlier to ND, DO, MD and patients at length at other times and locations, mostly about non-cancer items. I read various literature, and made efforts to technically decipher some of the biological alternative medicine protocols.
I have a high board scoring MD that does the nutritional work. I also had a few hours reviewing components and protocols with a medical professor at a large regional university, specializing in therapeutic nutrition for cancer patients.
So please don't think think I am "naturopathic", I am not. Otherwise you're making still another mistake. What I see is how you folks deride nutrition in regimes you apparently have absolutely no idea what the physiological result is going to be.
Underwoo 2, rise of the Glycans ?
"What's the ND answer to having, say a WBC of 1.2?"
Never get down to 4.5. Oops, that was the surgeon's answer. Some NDs apparently advocate "non-toxic", including PSK and cimetidine, but not 5FU compounds at all.
We on the other hand, using various immunogenic mushroom extract combinations managed to hit 9 in 1-2 months, after more than 6 months straight of daily 5FU chemo. However that "more immunogenic" combo was a little too rough on RBC, so PSK is now 90% of the current solution.
Did anyone see the PBS special last week on drugs obtained from venom?
I wonder what naturopaths would think about giving heart attack patients some snake venom?
@63 A biotech company in the US is starting their own patented glycan trials, now. Wooing Wall Street.
Seriously, this dumping the "woo" label nonsense on glycans would mark anyone as scientifically illiterate on international research of the last 40-50 years.
Prometheus - "anthroposophy" in this context is probably the theories and teachings of Rudolph Steiner, the guy who is behind the philosophy of the Waldorf schools.
errant nonsense
I have a mental image of Lewis Carroll's White Knight, though "arrant nonsense" is also good.
> the guy who is behind the philosophy of the Waldorf schools.
Don't forget Biodynamic agriculture. Among other nonsense.
Steiner was a fairy-stroker with some really odd ideas that should probably have died with him. If only this planet were a bit more of a rational place...
Now, to the original point. The official AANP site was on blogger.com? Very official. Oh, and I say "was" because it's not there any more.
"Sorry, the blog at naturopathicphysicians.blogspot.com has been removed. This address is not available for new blogs."
> the guy who is behind the philosophy of the Waldorf schools.
Don't forget Biodynamic agriculture. Among other nonsense.
Steiner was a fairy-stroker with some really odd ideas that should probably have died with him. If only this planet were a bit more of a rational place...
Now, to the original point. The official AANP site was on blogger.com? Very official. Oh, and I say "was" because it's not there any more.
"Sorry, the blog at naturopathicphysicians.blogspot.com has been removed. This address is not available for new blogs."
prn: "A biotech company in the US is starting their own patented glycan trials, now. Wooing Wall Street."
Makes sense. Supplements are a multibillion dollar industry and "Glycans" have been a buzzword for awhile now. Just look at Mannatech, the multilevel marketing giant that's a sold a lot of "glyconutrients", magical stuff that's been touted as treatment for various diseases, though coming up short on that pesky evidence thing (and drawing the attention of the Texas attorney general, whose lawsuit against the company for deceptive health claims resulted in a $6 million settlement against the firm (sales associates had claimed Mannatech's products could cure or prevent such diseases as cancer, autism and Down syndrome)).
Here's a classic tale of naturopathic practice and multilevel marketing. (the subject of this article also has done an interesting form of blood testing).
Huh. So in the end, prn thinks the WBC is the gold standard of immune function measurement? That's... anticlimactic, to be honest. I was hoping for something wackier. But no, prn is just a vanilla example of the Dunning-Kruger effect.
72. Dear anti-science illiterates, I am talking about approved or in-progress FDA phase II glycan trials with all the PhD-MD trimmings. "combination...doubled the historical overall response rate" (ESMO)
73. Hey [i]nsi[pid], if you have a better value lab, let's hear it. Some of us actually pay bills with real money. It is not like I have RHHBY-PFE-GSK paying for a 256 slice CT every month or two. Also I did get some monitoring advice for setup, directly from a pharmaceutical company's medical director for oncology...
You idiots should go ask Orac how hard it is to necrose an invasive metastasis with a non-toxic neoadjuvant in a few weeks before surgery, or to raise a hemo toxic patient's WBC back up to the 9s while still on chemo.
The surgeon right out of surgery, before the path report, was grim. Being able to rely on my own eyes, I followed the published literature, like JCO, BMJ, etc, on more advanced medicine from outside the broke(n) US.
Of course, if I were Orac, I wouldn't want to admit knowing you.
A bit of a hint, prn. Trials being done don't mean that the thing works. They mean that it MIGHT work, and the trial is necessary to find out. In particular, phase 2 is generally the FIRST attempt to test whether it actually has an effect.
Touting such trials as evidence that glycans are legitimate and not woo gives a very strong impression of scientific illiteracy.
As a pre-health advisor, I belong to the National Association of Advisors for the Health Professions (NAAHP). I am sad to report that their December 2010 issue of the "The Advisor" (Volume 30, No. 4)was devoted entirely to naturopathic medicine. I simply won't advise my students to go into NM. I am deeply disappointed that there was not a single skeptical voice in the entire issue. It is disturbing. I am reconsidering my membership with the organization.
The point is that "officially" vetted science is being privately funded and done, in conjunction with Merck KGA in this case. A minor IIa report is out, promising result "double...", more phase II work in the pipeline. Hardly the stuff of woo.
I'll go further. With the previous published results of other medically approved glycans, mostly Asian mushroom extracts and European work, this area is not nearly as unknown as you think. Just less known in the US, largely due to normal FDA communications interference. There is already lot of clinical and preclinical work that demonstrates the chemistry, biological effect and mechanisms.
Further, the clinical effects can be surprisingly obvious, when used according to instructions. A normal, established on chemo, clear downward trend of WBC, RBC, platelets with many data points, suddenly reverses itself. Yes, I know, not proof of many things, like long term survival, but the proximate change in toxicity related morbidity is hard to miss.
In this case, MORE chemo could be used, without ANY stomatitis or limiting hematological toxicity due to vanishing WBC, RBC or platelets. Consistent with other reports. One experience is certainly not a significant or publication quality result. However, on an individual clinical basis, coupled with existent literature, certainly reason to continue.
Absolutely the stuff of woo. Woo on the path to someday becoming more, true. But as of today, most emphatically still woo.
I ask prn for refernces and he refers to a 3 month old thread instead of putting in links in the crrent thread. It then calls everyone scientific illiterates while complaining about tone.
Prn, I'm disappointed that you never answered nsib's questions @ 40, which raised a number of points that interested me. All I get from your subsequent posts is that "boosting the immune system" = increasing the white count.
It should also be mentioned that ingesting certain mushrooms can elevate the white blood cell count and be "rough" on RBCs (i.e. hemolyzing them), and this is a toxic effect that accompanies mushroom poisoning; it is not considered "immune boosting". Whether or not this applies to prn's case, we have no way of knowing. But increased WBC count does not necessarily equate to enhanced immune function.
What this or the wonders of glycans have to do with naturopathy remains in question; prn is apparently not seeing a naturopath and still hasn't given us any evidence that naturopaths are jumping to use valuable new therapies ahead of mainstream physicians.
I wish prn a positive health outcome, regardless of whether credit gets assigned to the woo or to the actions of an evil reductionist Western surgeon and other physicians.
Bu ne ya glukanlardır harikalar naturopathy ile yapmak zorunda soru kalır; prn olup naturopath bir görmüyorsanız görünüÅe göre hala hekimlerin genel sahiptir tedaviler öncesinde yeni bir Åey deÄil deÄerli kullanmak atlama olduÄunu naturopaths oldular verilen delil bize herhangi bir.
It occurs to me that my previous post bears some clarification. Saying that there's some interesting possibilities which might be borne out is not woo; it would be quite reasonable.
Enthusiastic, uncritical, and vigorous endorsement of their use, without any apparent understanding of the actual state of the evidence, is what qualifies as woo.
@78 Apparently we have a different perception on the usage of "woo" as related to +unproven. I would say woo is, at least, highly unlikely, unprovable, disprovable or disproven propositions. I would not include "highly promising with some data but as yet unproven" to some arbitrarily high confidence level, as being in the woo category.
@79 I thought you claimed ignorance of the previous discussion and links, so I obliged you with a convenient starting point, still the same intro. "scientific illiterates" was about too much negative disconnect on glycans, me trying to discuss PSK/Krestin, an official Japanese cancer drug, vs having Mannatech marketing dropped in my face.
@80 A lot of immune related material is presumptive from the literature, or indicative, if this happens, consider.... Immune testing is limited and expensive. Because of the daily chemo, CBC are frequent, WBC is the primary data point available ca biweekly, along with ESR and, less frequently albumin. Vitamin D was drastically low, with bone pain, even with supplementation. I am not considering expensive, perhaps low yield testing like NK Cells, ImmuKnow or stool testing.
Digestive health and function is considered a crucial immune component several ways, maldigestion can produce horrific autoimmune effects. Several decades ago, 2/3 of the immune system was considered to be in the gut. Definitely some nutrition related drills there.
@81 The more immunogenic version, Chinese PSP, contains more protein attached to the polysaccharide than Japanese PSK, and had lower degree of polysaccharide extraction too. The PSP was escalated to a higher dose also. I strongly doubt that the oxidizing mushroom poison mechanism was in play - an extract (inherently low dose), wrong species, and one of those "other" antioxidants I mentioned, R,S-lipoic acid is present in a daily amount several times what the CDC principal investigator for lipoic acid routinely used to salvage severe mushroom poisoning cases for over 20 years.
Some years ago, I casually interviewed a 5 yr naturopath, specializing in oncology cases for about 1.5 hours after a health conference in the US. He confirmed a lot of his procedures to me. At different times, many seem willing to talk to me at length, pharma reps, MDs, deans on various subbjects.
The partcular brand of an American "PSK" clone was recommended by a staff ND for a buyers club with an oncology section. Normally I am an aggressive commodities type buyer, not a "brands buyer," but in this case, after comparing specs from different sources (higher polysaccharide concentration is considered a major efficacy factor, and taken on an empty stomach) and some brief WBC/RBC/platelet trials, I'm buying the branded version until I can do better. arggggg. I'm eyeing the biotech company too.
I don't consider surgeons evil, just hard of hearing or head. :) I know they are still more likely to stomp the last cancer cell than chemo is.
@82 My Turkish is nonexistent, I never made it across the Green Line. So I need some help on translation.
Long answer. Spam filter got me, 15 min ago.
Regarding diet and exercise - how much do doctors need to know? It's not rocket science - eat a lot of fruits and vegetables. Try to keep them unprocessed for the most part. Don't eat that much meat. Don't drink that much pop. Really, really specific attention to diet is only needed if an individual has a specific condition (in which case most doctors would probably refer their patient to a specialist) or if someone is trying to do something unusual (ranging from the nutty - live forever by only eating cranberries - to the simply problematic - vegetarianism). Eating a proper diet means not overeating, and getting enough nutrients to avoid deficiencies. There's really not much support for anything else. For exercise, just get some every day. If you're trying to do something specific, then see a personal trainer. If you hurt yourself, see a doctor who will probably refer you to a specialist.
It's not rocket science. For most people, the problem is simply one of overeating and underexercising. It's only when you get into crazy stuff or disease that you really need a doctor's attention. Claiming doctors are nutritionally incompetent because they can't tell you exactly what magic pill to eat to prevent all cancers a) ignores science and b) ignores the role of a primary care physician.
@WLU:
Right on, but be prepared for a bunch of trolls to accuse you of being patronizing. I made a similar comment here a few months ago, and all of a sudden a whole lot of bridges became unattended.
Sometimes you've gotta pay the troll toll, Bruce.
I personally believe that a large percentage of the population who are healthy and large numbers of people who have some serious medical conditions, are prone to advertising that they see on the internet. Why in the world would a healthy person seek potions, wacky treatments and the advice of practitioners of quack medicine, when they have no medical problems.
In the case of people who have some serious medical conditions, when they blow past sites on the internet that provide researched scientific articles, they invariable hit the commercial sites that "push" alternative treatments and nonsense supplements. I suppose some healthy and some not-so-healthy people spend more time researching the ratings on a washing machine before they make a purchase, than they do researching the "claims" for alternative medicine and treatments and "supplements" before they have their pockets picked by the charlatans.
The ONLY benefit I see for homeopathy medication and "supplements" is that they won't do you any harm..they are plain water...if you use them in addition to treatments prescribed by a "traditional" physician...NOT in lieu of the treatments prescribed.
Naturopathy substances probably do contain some chemicals which can have a deleterious effect on body systems stasis and any "traditional" medicine prescribed by a real physician.
I would be worried about what the naturopathy supplements are contaminated with. There have been many, many lab analyses of the contamination in the big drums of chemicals and minerals imported from China and other countries used in supplements and vitamins. (See the FDA website for contamination with heavy metals, pesticides and other toxic materials). Even some reliable major vitamin/supplement manufacturers, in spite of their laboratory facilities and testing for purity, have been assessed fines by the FDA.
PRN, don't be so sensitive and knock off the paranoia. We asked you for citations for prescribing glycan for "immune system boosting"; you haven't provided them. We asked you for the names of the "big name" doctors; you haven't provided them. When I asked you some general questions about what blood tests are used and what labs process the blood and what the significance of certain blood component values regarding treatment with glycen, you get all huffy and provided what you say is your own blood test result.
If you are going to post here about CAM medicine, be prepared to provide some citations.
Bruce - no doubt.
I think this is the part I have been scratching my head over. prn says above that mentioning the food pyramid and exercise is "lip service." But jeez, I gotta think that for 95% of the people, that's actually the most important first step that needs to be done. Beyond that, as Bruce says, you have the people who need special diets, and I would add into that the people who say, "I already do that, what more can I do?"
But 95% of a "good diet" is indeed really that simple. Shoot, I would argue that 90% of a good diet is as simple as "the 4 food groups" in conjunction with "moderate portions." Actually, 80% of a good diet is probably "moderate portions."
This is the real scam of sCAM - to convince people that nourishing the body is something complicated. Just look at all the supplements they think we need. And if doctors don't go into extensive detail about all the supplements that you need to take, and have the audacity to suggest that you should start by eating smaller portions, with lots of fruits and veggies and maybe some fish, limiting meat and eliminating junk food, while getting enough exercise to get your heart rate up to 130 for 1/2 hr maybe three times a week, then they are just "paying lip service."
That's not lip service nor condescending. It's 95% of the battle, and what most people going to the doctor are not achieving.
Why worry about the details when people aren't living up the basics?
Actually, it was WLU that provided the sensible comments, I simply agreed with him or her.
Credit where credit is due, and all that.
Prn, very high doses of vitamin D (i.e. blindly going for >>2000IU/d and blood levels of >>40ng/ml) ARE quackery.
Gosh, even the most optimistic data is suggestive of increased mortality at higher intakes and I am saying this as an advocate of vitamin D based on its risk/benefit ratio. (the optimum of the J-shaped mortality curve is around ~30ng/ml, with most promising RCTs using 1000-3000IU)
I think, at some point in the future, the authors of this blog will reflect on its criticism of alternative medicine and perhaps find that, yes, we were wrong. Why do I feel this way? My undergraduate degree was in marketing and I've worked in advertising over many years. In our studies, we reviewed old ads to see how the profession has changed over time for one reason or another. I have seen ads -- BY DOCTORS SPONSORED BY THE MEDICAL PROFESSION -- from the 50s and 60s that say smoking is not at all harmful to a person's health. Fast forward to the 21st century. I'll let you all reflect on that. Good night and good luck.
@Laurie,
The fact that doctors have been wrong before does not make alternative medicine right. It is certainly possible that certain pieces of what is now called alternative medicine is correct; only evidence will prove that. If you have evidence on which ideas in the grab-bag of alternative medicine are safe and effective, I'd love to hear it.
What does sponored by he medical profession mean - somehow it think Laurie has no evidence of that part of its claim.
In other words "I cannot back up what I just said so I will cut and run."
I believe you are referring to the ads from the 1950's put out by the tobacco industry that attempted to counter the increasing evidence that smoking was harmful to health. These ads claimed that "leading researchers and doctors" disputed these findings. Of course, they didn't name any such doctors. I haven't found any ads "sponsored by the medical profession" - it was all done by tobacco companies. And as well, these were ads, which are not the first place to go for the truth.
Funny thing, the evidence that smoking is harmful was the result of scientific medical research.
I have reflected on all that, and conclude that you have got things completely backwards.
Funny, I see that Angela (Dr. Oz defiantly embraces The Dark Side) is now posting the same thing as Laurie!
Angela:
Laurie:
Actually, those were actors and models paid by the tobacco companies (and sometimes tobacco companies found sympathetic doctors). Click on the "Robert Jackler" link about the advertising. Also listen to the podcast, you can hear how upset Dr. Jackler is about the lies and harm perpetuated by the tobacco companies.
You majored in marketing (it was advertising for Angela), you should have known better. The tobacco companies were reacting to the real science that showed in the 1950s that smoking was harmful: Cigarettes and the US Public Health Service in the 1950s:
@Laurie:
No wonder you're confused. You can't even keep your own name straight!
See comment 219 if you don't get my drift.
That was augustine, not prn.
@98 Thanks, Matthew.
@91 The vitamin D3 question is unsettled, some researchers are saying the claimed "J" is due to vitamin A contaminated data, from large doses of modern cod liver oil in several studies. The bulk of the data suggest total intakes for better health, including the sun exposure, will go over 4000 iu for most people. Some cancer patients are experiencing requirements well over 10,000 iu per day.
Canadian research(ers) showed that total intake under 1000 iu per day is dangerous to many.
@88 mushroom extracts (p.144)polysaccharides act mainly as immunestimulants with little or no adverse drug reactions. ...several ... stimulate apoptosis in cancer cells
My careful replies to 78-82 remain in limbo.
@prn
Canada gets a lot less sunlight than most of the US, so I would wonder about the applicability of Canadian data (if the research was localized to Canada). If the science is unsettled, they you shouldn't be promoting higher consumption of vitamin D until it is because of the law of unintended consequences. Doc Spock casually mentioning babies should sleep on their stomachs probably killed thousands, maybe hundreds of thousands of children because of SIDS.
The sun as a source of vitamin D might be a better idea than supplements since the body can regulate its own stores.
prn's link gets me an error message.
Today anyway, the AANP's blog "Physician's Who Listen" (see http://naturopathicphysicians.blogspot.com/ ) is labeled
"removed"
but their new site (see http://physicianswholisten.blogspot.com/ ) has the Hangee-Bauer post cited in this RI post.
Also, the AANP sponsored Colorado 2011 ND licensure bill died yesterday in committee.
-r.c.
I have a second substantial post MIA for over 24 hrs now. I don't know the problem.
@100 I don't think I've said anything here outside acceptable vitamin D ranges and practices. To the extent IOM has two, largely inconsistent "VD nutrition recommendation" tracks, a default oral intake rate e.g 200iu, wait, 400iu, er no, hang on, 600iu daily, and separately, intake rates driven by blood level measurements, I support D3 intakes that reflect real lab measurments, rather than dangerously low guesses. An order of magnitude difference is apparently still not uncommon. Burned twice, thrice shy?
The crude evidence is that tens or hundreds of thousands of new patients suffer chronic and fatal morbidity due to vitamin D deficiencies, each year.
I can't speak for where the dermatologists are now. However, there are many people who are either not going to get adequate sunlight, or that they have diminished absorbed production for one of several reasons.
@101 Link still works for me.
Maybe prn could summarize what that link shows (still can't access the site). When I do a Google search on the highlighted text in prn's post, I see alt med and supplement dealer sites, plus a link to a 2004 obscure journal article that refers to various in vitro (test tube) studies, but doesn't reference human trials.
It would be interesting to see an actual paper discussing clinical studies of mushroom use to beneficially stimulate immune activity in patients on chemotherapy (and explaining how "little or no adverse drug reactions" can be reconciled with prn's statement about whatever mushroom therapy he/she was on having detrimental effects on red blood cells.
Even if multiple-link comments are being held up for moderation, it's possible to break the links and list the articles one feels are relevant, thus avoiding automatic comment moderation.
Doing so without gratuitous references to those with differing opinions as "scientific illiterates", "idiots" and "stalkers" would be appreciated, prn.
Dangerous Bacon - prn's link is to a pdf. Sometimes I have had problems opening pdf's after updating a browser. Try right clicking and "save link as".
I am pretty sure prn has would benefit from doing the save link as thing with John Ioannidis' Paper on Why Most Published Research Findings Are False
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/
the pdf is at
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/pdf/pmed.0020124.pdf
Cancer Research UK is a UK cancer foundation with academic origins, not a spam site. The reference is an extensive monograph published in 2002 and includes human trial data.
I linked "CHAPTER 7 THE ROLE OF POLYSACCHARIDES DERIVED FROM MEDICINAL MUSHROOMS IN CANCER," pages 142-177
My long post that Orac's filter swallowed, the first one mentioned @84, addressed the mushroom extract. Basically polysaccharides (PS) are low toxicity. Larger protein portions increase immunogenic potential. Japanese style PSK is mosty polysaccharride, with a small peptide portion, higher PS content. Chinese PSP has more protein and lower PS content, so more misc. mushroom for a certain PS content.
I pointed out that mushroom poisoning are from oxidative poisons of relatively few species, in the whole mushroom. Extracts remove most mushroom material, concentrating the low toxicity PS, and the total dosage of extract is also relatively small to a meal serving of mushrooms.
I also pointed out that even severe mushroom poisoning cases were stopped promptly with an antioxidant treatment used by CDC's principal investigator of several decades for R,S lipoic acid. We use several times that amount of lipoic acid for various purposes as since recommended by the same PhD from a high ranked graduate program of the 60s(Ill. if you will), professor-turned MD and principal investigator.
Yes, when repeatedly provoked, brushed off, insulted, ganged and short weighted on factual issues reflecting others unseeing bias or ignorance, I briefly reverted to a "less Respectful Insolence" form often favored here, even by ORAC. This helped place some issues and answers in a stark daylight, rather than allowed to be adversarily poo-poohed again, en masse.
As for people repeatedly asking for any personal or medical related information that I am uncomfortable with, "No" means no. Calling me "paranoid" on multiple such personal items insults my experience, and intelligence.
Got filtered (#3) on 1 link. Guess some netizens are more equal than others.
Got filtered (#3) on 1 link. Guess some netizens are more equal than others.
I've had comments held for moderation here, apparently on the basis of including only one link.
I guess I'm not equal either. :(
So...you're upset because the IOM is refusing to issue firm guidelines while they are waiting for evidence to accumulate? Or that they're changing their recommendations in the face of changing evidence? Nailing down an "optimal" vitamin D intake will take time, and I'm not upset they're late getting to it since that means they've been focusing on acute deficiencies. Frankly, rickets versus maybe someone dying prematurely sometime, somewhere, from a multifactorial disease? I'd rather they focus on rickets.
I would put emphasis on the "crude" part. There's evidence that vitamin supplementation can cause harm in the form of premature mortality. Those deficiencies aren't proven yet, it's a bit early to attribute hundreds of thousands of deaths to vitamin D deficiencies (that don't produce visible signs of actual deficiency).
Purenoiz: "Given that augustine has yet to prove he knows more about nutrition than the physicians he continually lambasts, it would be nice if he would just shut up."
Some hope, to be honest... his brand of home-schooling left out that wonderful 'sound-bite' from Wittgenstein ("Whereof one cannot speak, thereof one should remain silent"). Pity, since there is obviously no thing 'whereof he can speak'!
Ross: "I would like to point out that if you want to consult someone about nutrition and diet, a registered dietitian will focus on that. All the focus on diet, and none of the built in quackery."
Absolutely. And what a medical practitioner does not know about nutrition can be found out from a dietician... this is why we have dieticians. A medical practitioner can always make a referral!
lilady: "If you are going to post here about CAM medicine, be prepared to provide some citations."
But they can't. CAM practitioners can't provide such things because they know that their 'studies' don't pass muster.
David N Andrews@112:
I think I post more technical links per blog that I participate in, than most here.
Absolutely. And what a medical practitioner does not know about nutrition can be found out from a dietician... this is why we have dieticians. A medical practitioner can always make a referral!
Dieticians' ideas of therapeutic nutrition, as a group like ADA, are downright primitive in a number of categories, in my recent experience.
They simply are unfamiliar with many science papers that can be reasonably analyzed with SBM and Bayesian inference, then translated to concrete applications on an immediate trial basis. Likewise, I tried to upgrade hospital nutrition through a physicians' group that claimed to be bringing therapeutic nutrition to bear in the hospital - no luck there either. The closest I got was on one item, for wound healing, "Oh, we'll be introducing that [8 months from now]" And then beat all their recovery predictions cold, since they finally agreed to a "don't ask, don't tell" approach to imported nutrition.
lilady: "If you are going to post here about CAM medicine, be prepared to provide some citations."
This jibe was posted before a long response, I call Missing In Action (MIA)#1, now prn @84, was finally rescued from the filter. See also @100, @106, @107.
---------
Orac, if I could get my MIA#2 ( the reply that mentions graduate nutrition texts vs undergraduate nutrition texts) posted here, at this location, rather than messing up the numbering again, I would sure appreciate it.
I am getting cutoff and lightweighted by the filter on legitimate responses with technical content.
Still "MIA" is any documentation of prn's claim that naturopaths are applying new, effective and safe therapies to their practices ahead of physicians.
If there's actual convincing clinical research showing that giving patients mushrooms is an effective and safe way of "boosting immune function" in chemo patients, I've yet to see that either.
DB@115
Still having trouble with that link thingy? I gave the UK Cancer website that links the entire monograph @107 and the specific chapter with a verbatim immunity quote @100, above.
Usually Naturopathic medicine is considered safe, especially the homeo part. As for new, well, less so. A lot of the naturopathic materials would have been recognizable to your/their gandparents' physicians.
I don't think I need to re-document things generally or trivially agreed by nontrolls.
prn,
Now that I've read your two longer replies that were caught in the filter, I think I see where you're coming from. However, the way you switch from discussing studies to discussing your own treatment with no transition whatsoever makes it very difficult to have a dialog with you.
When I was asking about what "immune boosting" meant, I was not talking about measuring immune system markers in a clinical practice setting. I know those tests can be expensive and have a longer turn-around time. Instead, I was asking about what "immune boosting" means from fundamental perspective, about what physiological phenomena it refers to.
I looked through that link you posted, and two examples from that review paper were increased WBC and increased killer-T/suppressor-T ratio. Now, both of those can be considered immune boosting, yeah, but it's through two very different pathways and with two very different effects. That's my beef with the term "immune boosting." It has too many possible meanings, and they're all only tangentially related. Saying that a substance is "immune boosting" gives no useful information, while saying that it boosts WBC or the killer-T/suppressor-T ratio at least gives you an idea of what it does.
"Immune boosting" should indicate some reproducible, medically significant enhancement of the immune system that enables one to more readily fight off infection (leaving aside questions about toxicity and susceptibility to autoimmune illness). I haven't seen any human clinical studies posted indicating that there are any mushrooms or mushroom extracts on the market proven to do this. If there are any buried in prn's link that's unaccessable*, maybe someone else could list it.
As for documentation that naturopaths are beating out docs in offering cutting edge therapy, prn gives us:
"Some years ago, I casually interviewed a 5 yr naturopath, specializing in oncology cases for about 1.5 hours after a health conference in the US. He confirmed a lot of his procedures to me...The partcular brand of an American "PSK" clone was recommended by a staff ND for a buyers club with an oncology section."
This is again just prn offering unconfirmable anecdotes - not evidence.
Obviously, prn is carrying a big load of bitterness towards medical practitioners whom he/she feels have let him/her down. But failing to provide more than anecdotes (while calling those who ask for evidence "trolls", "stalkers" and the like) does not obscure the fact that documentation for prn's claims remains lacking.
*I must be unequal, unworthy, or something. :(
@ Dangerous Bacon: I am familiar with rumour about the "incredible, magical power of mushrooms"**- most especially reishi, maitaki, krestin (PSK)- on the immune system amongst the woo-faithful. A few sample websites: mushroomscience.com, immunesystemremedies.com.
**or is it the "incredible power of magic mushrooms"? Your guess is as good as mine.
Denice:
incredible power of "magic mushrooms"?
Sounds more like a weekend psylocybin party.
----------
DB:
"interview...a 5 yr naturopath, specializing in oncology cases" was contextual background that I was investigating the naturopaths, not a technology claim.
"...an American "PSK" clone was recommended by a staff ND for a buyers club" was more of sourcing example that the Japanese style product appeared hematologically superior overall to the Chinese, and a gripe about relative cost, ca 4x PSP. MD v ND would your inference about a complementary usage in the US, where PSK was #1 in sales for regular, offically approved cancer medicines in Japan for many years. Stereos and automaking were not the only areas Japanese products got ahead in the 1980s.
As far as glycan technology, American doctors that tow the ASCO/NCCS line are just SOL on offering glycans until the yeast based PGG technology presumably gets FDA approval. The patients that can't figure it out for themselves are really SOL.
----------
The glycans, from various sources, are an area of legitimate biotech research. The Japanese have long been ahead in commercialized mushroom research into glycan products. The chinese have had a longer presence through TCM. A biotech group from MIT called AlphaBeta entered the area ca a dozen years ago, using a yeast techology, but apparently went bust on the marketing. I am not sure who originally organized the financing to recapture the patent portfolio.
The glycans seem to have two impressive uses in Asian oncology: first, to stimulate an immunological attack on tumor cells and the second, to rescue patients' hematological parameters on chemo.
I can't speak to the first. The second, well, based mostly on CBCs and general well being, I'm impressed. Actually more for the platelet performance than the WBC and RBC. On conitinous chemo, there's no space for the normal genetically engineered treatment to boost platelets, and who wants multiple platelet transfusions?
All these things are described in the Asian medical literature.
If one in three dies of cancer, scoffing at the glycan technologies might be worse than playing Russian roulette. It's fight that every technological avenue has to be considered. That the US oncology market doesn't employ a technology says more about US regulatory mechanism and its economics.
nsib@117
Discussions on "immune system," speak of organ or sites involved, or combinations of molecular entities (cytokines, etc) stimulated.
Various papers describe macrophages picking the (proteo)glycans in the gut and the specific glycans yielding elevations of different cytokines. Ultimately, some of the overall survival curves from Japanese RCT piqued my interest. Lots less damage, or actual improvement in quality of life, for dramatically improved incremental time or RR.
Basically, if you look closely at the Japanese papers, there appear to be distinct biomarked groups of people that the Japanese appear able to do better than, say Folfox+Avastin, with higher quality, longer life, at 1/100 the cost to me for cocktails of their chemo.
This is short, touching on cytokines, from a recognizable MSM source:
PSP MSKCC
That link just takes me to a Memorial Sloan-Kettering main page.
By searching the site I found this reference, which discusses potential uses for one type of mushroom extract (reiki-derived).
Checking what appears to be the most relevant journal citation, there was a short-term study on extract use in advanced-stage cancer patients, reporting an increase in some markers of immune status. Levels of helper and suppressor T-cells were not significantly changed. No information is given in the abstract on whether the immune marker differences translated into better health and/or ability to tolerate chemotherapy.
If there are more impressive clinical studies than this, it should be easy to post one.
It seems highly likely that if any of these extracts was ready for prime time, drug companies would be leaping to sell it, seeing how huge the market would be for a drug widely applicable to use in cancer chemotherapy, and which (as prn believes), could make it possible to administer more chemo safely, thus boosting sales of other drugs. That such "immune boosters" aren't being churned out says to me more about limitations in knowledge about safety and efficacy, as opposed to supporting dark intimations about FDA obstruction and Big Pharma skulduggery.
And of course, there still hasn't been any evidence posted to support the idea that naturopaths are pioneering in effective health care along these lines.
IE: link clicked, MSKCC page intercepted and wanted a cookie.
link right clicked, "in new tab", opened correctly
http://www.mskcc.org/mskcc/html/69194.cfm
Not a heavy duty paper, just a consumer summary showing MSKCC acknowledgement of Coriolus extracts.
You're speculations ignore one reality, the mushroom extracts are already relatively dirt cheap in the US. To demand a high price, presumably it is going to take an an active product to the capitalize millions for the FDA NDA and registration. Perhaps like the Imprime PGG trial, Biothera's yeast based beta glucan sponsored with Merck KGA, to prop up Roche's failing Avastin. Here's MSKCC trying to cut itself in on yeast based beta glucans.
Since Biothera has the original MIT patent portfolio and key people, presumably they already locked up some important parts, as they have already stomped a few in court. It will be interesting to see the corp. court actions for infringement then mergers and acquisitions at play if few more successful trials are published.
Sorry, the PSK recommending naturopath was ahead of US oncs on this one. Perhaps not ahead of the old Japanese researchers that he referenced.
As for the Coriolus extracts, the evidence in favor of any beneficial immune-stimulating or antitumor effects appears mixed and preliminary at best. Some of the most optimistic research comes out of China, which raises a red flag given the demonstrated tendency of Chinese researchers to claim virtually 100% positive results for any Chinese herb or supplement tested.
MSKCC acknowledges a potential problem with Coriolus supplements on the market varying in strength/purity, which would make you wonder about how useful any of them used by naturopaths are, assuming naturopaths prescribe and get good results from them - evidence we do not have.
As for speculations about why such products aren't in wide use in U.S. oncologic practice - it gets confusing. Either these fantastic supplements aren't on the market because they're too cheap for Big Pharma to profit from, or there in fact are profits to be made by patenting them, which just goes to show you how evil Big Pharma is.
I'm having trouble reconciling these perceptions.
I would be careful about the stereotyping. The Chinese papers I read reflected the WBC results I measured, and perhaps, by inference, the other results, too. Commercially speaking, strength and purity are merely matters of specification and correlation to materials used in the literature. Typically the material is a selected strain of mushroom fungii grown on a particular substrate, extracted by described processes, with a chemical product characterization.
PSK and PSP are not FDA approved, hence are not reimbursable US oncology. That PSK/PSP are relatively inexpensive supplements suggests they will remain non FDA approved. US doctors largely avoid, ignore or disparage non FDA approved materials, including foreign approved ones. The naturopaths may necessarily rely, in part, on foreign evidence sources for PSK.
Biotech companies will invest in patented materials that they can gain exclusivity for. That they demonstrate superiority to PSK would be distantly secondary, they only have to demonstrate superiority to a placebo, or an empty FDA category to gain exclusive access to the insurance reimbursible oncology market worth billions.
The "evil pharma" discussion is not about patents and profit, it is about patterns of interference, subterfuge, recklessness, corruption, harm and rent seeking behaviors by legislative and regulatory manipulation.
Biostatistician R. Barker Bausell's book "Snake Oil Science" makes some interesting comparisons between Chinese alt med research and that coming out of Western nations. His review found positive results by Chinese researchers approaching 100% of tested propositions, while in Europe and the U.S. the rate of positive findings was much closer to 50%.
Either it's a case of the Evil Western Reductionists engaging in a pattern of "interference, subterfuge, recklessness, corruption, harm and rent seeking behaviors" (whatever the hell that last one means), or there's a tendency among Chinese authors to exaggerate the benefits of "natural"/traditional remedies.
As someone with a skeptical, nonconspiratorial mindset, having a familiarity with overblown claims for Chinese modalities like acupuncture and herbal remedies like ginkgo and ginseng, I think it's reasonable to view preliminary studies and claims emanating from China with caution.
"The "evil pharma" discussion is not about patents and profit, it is about patterns of interference, subterfuge, recklessness, corruption, harm and rent seeking behaviors by legislative and regulatory manipulation."
Why engage in interference, subterfuge, recklessness, corruption, harm and rent seeking behaviors by legislative and regulatory manipulation, if not for profit? Just for pure evil? For the benefit of Lord Draconis (may his talons be ever sharp)?
LW@127
Yes, the "bad" ones do bad things for the money they could not earn honestly. Sort of like the stick up guys doing time. But there is such a thing as an honest Buck. However, lately I'm getting worried he's missing and may have emigrated.
DB@126
I think it's reasonable to view preliminary studies and claims emanating from China with caution.
Good idea generally. I am glad I waited before placing any order for Baycol, Fen-Phen, Vioxx, Bextra, Rezulin, Raxar, A/New Jersey/76/Hsw1N1 vaccine 1976, or even Avastin.
I sure wouldn't want anyone to get mixed up with any crazy, cancer causing homeo- or naturopathic stuff like Chinese horse piss extract, like premarin. Oh, wait. Sorry, about the abused mares in Singapore, Wyeth. I see now that it is FDA approved...
The "china" parts of your "one-fits-all" book I reviewed seemed to focus on ancient Chinese CAM/TCM therapies. PSP is a recent biotechnical development of ca 30 years.
Actually, Vioxx worked just fine for me. I would cheerfully take it again if I needed it, and could get it. I do have a couple of pills left that I'm keeping in reserve.
As is adding melamine to pet food ingredients in order to fool a protein assay.
LW@129
Fen-phen works pretty well, too.
MA@130
Perhaps specifically melamine yes. Similar stuff went on in the US, including formaldehyde into milk.
Now we're more sophisticated. Companies add stuff that could be other building materials straight to our packaged food, and don't even call it "imitation" anymore. Now that's progress.
prn: "I am glad I waited before placing any order for Baycol, Fen-Phen, Vioxx, Bextra, Rezulin, Raxar, A/New Jersey/76/Hsw1N1 vaccine 1976, or even Avastin."
I sure wouldn't want anyone to get mixed up with any crazy, cancer causing homeo- or naturopathic stuff"
I hope your sense of caution extends to drugs, supplements and their raw ingredients imported from China.
I'm sure you recall the scandal over tainted heparin which is blamed for 19 deaths in this country.
"Baxter International, the Wisconsin-based maker of the recently recalled heparin, gets its raw ingredients from another US-based company, Scientific Protein Laboratories (SPL). SPL, in turn, imports the ingredients from its factory in China, Changzhou SPL.
Changzhou SPL buys its raw ingredients from a system of consolidators who buy the ingredients from thousands of small, unregulated, producers, which are often family-operated, home-based businesses. Tests conducted by SPL indicate the contaminant was in the crude heparin before it was sold to the Changzhou factory.
The active ingredient in heparin is made from pig intestines which are dried in homes and small factories before sending it further along the supply line. China is the worldâs largest supplier of this ingredient.
Most of the shops that produce the crude heparin are not licensed or regulated by the State Food and Drug Administration. The Chinese government considers them chemical companies, not drug makers, and therefore not subject to meeting the standards for making drugs in China."
And then we have continued reports of tainted supplements coming from China, some involving TCM products, in other cases less "traditional" supplements like the ones for weight loss found to contain nephrotoxic aristolochia (result: renal failure and death) and others adulterated with unlabeled prescription drugs.
Of course, a key difference between these supplements and the prescription drugs you're lumping into a single fuzzy category is that the Evil Pharma drugs actually worked. The tainted Chinese supplements did not have demonstrated effectiveness, plus placed users at risk from hazardous ingredients. Additionally Chinese oversight of their drug and supplement industry is primitive compared to their U.S. counterparts.
See the differences?
Before anyone else jumps on the mushroom extract bandwagon, they might want to consider how to verify the reliability of the manufacturer, the purity of the listed ingredients and how much faith they have that substances not listed on the label are finding their way into the product.
prn: "I am glad I waited before placing any order for Baycol, Fen-Phen, Vioxx, Bextra, Rezulin, Raxar, A/New Jersey/76/Hsw1N1 vaccine 1976, or even Avastin."
I sure wouldn't want anyone to get mixed up with any crazy, cancer causing homeo- or naturopathic stuff"
I hope your sense of caution extends to drugs, supplements and their raw ingredients imported from China. From a link about the recent heparin scandal, in which tainted product is blamed for 19 deaths in this country (I tried posting the actual medheadlines link, but the Conspirators blocked my post). :(
"Baxter International, the Wisconsin-based maker of the recently recalled heparin, gets its raw ingredients from another US-based company, Scientific Protein Laboratories (SPL). SPL, in turn, imports the ingredients from its factory in China, Changzhou SPL.
Changzhou SPL buys its raw ingredients from a system of consolidators who buy the ingredients from thousands of small, unregulated, producers, which are often family-operated, home-based businesses. Tests conducted by SPL indicate the contaminant was in the crude heparin before it was sold to the Changzhou factory.
The active ingredient in heparin is made from pig intestines which are dried in homes and small factories before sending it further along the supply line. China is the worldâs largest supplier of this ingredient.
Most of the shops that produce the crude heparin are not licensed or regulated by the State Food and Drug Administration. The Chinese government considers them chemical companies, not drug makers, and therefore not subject to meeting the standards for making drugs in China."
And then we have continued reports of tainted supplements coming from China, some involving TCM products, in other cases less "traditional" supplements like the ones for weight loss found to contain nephrotoxic aristolochia (result: renal failure and death) and others adulterated with unlabeled prescription drugs.
Of course, a key difference between these supplements and the prescription drugs you're lumping into a single fuzzy category is that the Evil Pharma drugs actually worked. The tainted Chinese supplements did not have demonstrated effectiveness, plus placed users at risk from hazardous ingredients. Additionally Chinese oversight of their drug and supplement industry is primitive compared to their U.S. counterparts.
See the differences?
Before anyone else jumps on the mushroom extract bandwagon, they might want to consider how to verify the reliability of the manufacturer, the purity of the listed ingredients and how much faith they have that substances not listed on the label are finding their way into the product.
Lots of rhetorical xenophobia.
Any Western company that didn't have an intensive QA/QC program in place for Chinese products from the beginning needed its collective head examined, and its MBAs recycled. I've seen far better QA/QC from undercapitalized 3rd world companies than what Baxter did. What was described was criminal negligence on the western side - everyody in the industrial complex knew the limitations of the chinese by this time, for decades.
I can't imagine how many staffers and red flags Baxter must have ran over or eliminated from basic, good manufacturing practices for that to happen. Incredible. If you buy cheap, QA is an absolute, otherwise you are not supposed to stay a major corporation when the lawyers and regulators get done after a catastrophe. Although we've had a lot of recent failures there, too.
You'll notice I did wind up with the American manufacturer. What I didn't mention is that my Chinese trial stuff came through a US corporation that specified some level of QA and had years of prior experience with the material.
If you are breathing and not an superorganic dirt farmer, it is not likely that you avoid the chinese biochemicals and food complex. Really, you might be surprised.
There are cases were the only western source for a life essential ingredient maybe a single plant in Europe. In one case, fighting overprice and undercapacity, since the Chinese wholesale prices are less than 1/5 the Euro price last time I checked. And the chinese specs and availability were significantly better.
In fact, the surest way to avoid chinese products as an individual, right now, would be to stop breathing. With self sawed trees, a self assembled pine box, and a hand dug hole, and no preservatives. That simple.
Pointing out biases in Chinese research and the pervasive problem of contamination/adulteration in drugs and supplements imported from that country is not "rhetorical xenophobia", it's acknowledgement of reality.
And while it's true that Chinese foods and medicines (or their raw ingredients) are commonplace in U.S.-sold products, it does not automatically follow that we should jump to consume Chinese supplements that lack proven efficacy and safety.
Heparin is a lifesaving product that many people need. TCM herbal mixtures, weight loss aids and mushroom extracts...not so much.
You twist and conflate two known, and solved, peripheral problems to help create your conclusion.
The PSK mushroom extract, based on extended Japanese literature and clinical experience, does appear to address life and death important morbidities. Morbidities that have been routinely resolved in Japan as its #1 selling cancer medicine for many years that are not so well addressed in western medicine.
No relevant literature citations presented, reliance on anecdotes, Western Medicine Is Bad, same old.
Apparently you didn't click, read or understand any of the beta-glucan discussion or the Cancer UK's 250+ page Med'l Mushroom monograph, previously linked @100, @107.
Even the mildest attempt with Google brings up many additional papers, mostly from Japan, on PSK use for cancer. Here's another, Anticancer Res. 2002 May-Jun; Anticancer effects and mechanisms of polysaccharide-K (PSK): implications of cancer immunotherapy.
Apparently you didn't click, read or understand any of the beta-glucan discussion or the Cancer UK's 250+ page Med'l Mushroom monograph, previously linked @100, @107.
Even the mildest attempt with Google brings up many additional papers, mostly from Japan, on PSK use for cancer. Here's another, Anticancer Res. 2002 May-Jun; Anticancer effects and mechanisms of polysaccharide-K (PSK): implications of cancer immunotherapy.
Apparently you need a refresher course in linkology - your latest one takes me to a Respectful Insolence main page.
I did a search on that article title in PubMed (why do I do your work for you?) and found an abstract from 2002 discussing the compound's "potential". A companion link to a 2009 update included this comment:
"So far, no good quality clinical trial data is available on assessing the effectiveness of purified beta-glucans among cancer patients. Future effort should direct at performing well-designed clinical trials to verify the actual clinical efficacy of beta-glucans or beta-glucans containing compounds."
It seems that despite the hoopla, there's still a lack of compelling data supporting use of this stuff either in cancer treatment or "immune boosting", which would explain why the Evil Reductionist Western Medical Mafia hasn't embraced it yet.
Look, it's nice that you feel an experimental supplement is helping you. That does not prove that a) it should be in universal use, b) physicians/oncologists in western nations are reprehensible for not employing it, or c) naturopaths are using it and getting terrific results, thus proving that naturopaths are superior to physicians in taking advantage of valuable new medical developments (a claim you've been making all along). The reality is what Orac's article illustrates - naturopathy is loaded down with homeopathy and other forms of quackery, and therefore cannot be taken seriously.
db@140
Yeah, [Ctrl+C]"copy-paste" doesn't always grab the text properly. Sorry. [Proper link, below:]
I'm sure your full title recopy swipe and Google(Anticancer Res. 2002 May-Jun; Anticancer effects and mechanisms of polysaccharide-K (PSK): implications of cancer immunotherapy) were a major research effort. :)
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DB, re your reference, a good review article, Chan (2009) "The effects of β-glucan on human immune and cancer cells":
Non-prescriptional use of medicinal herbs among cancer patients is common around the world.
PSK is has been a licensed, prescription cancer medicine in Japan since the 1980s.
In fact, Chan's paper directly acknowledges PSK as working therapy, as proteoglycans, not pure glucans:
Two proteoglycans from Coriolus versicolor (Yun Zhi) â PSK (Polysaccharide-K) and PSP (Polysaccharopeptide) â are among the most extensively studied β-glucan containing herbs with clinical trials information. However, both PSK and PSP are protein-bound polysaccharides, so their actions are not necessary directly equivalent to pure β-glucans
In the end, I consider Chan(2009) to be exercising a slight cautionary note, somewhat academically, that generally in vivio testing on various glycan extracts with more long term follow up and phase III type trials should be done.
By the time all the tasks Chan et al listed are finished, I suspect (proteo)glycans may be used as vaccine adjuvants.
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it's nice that you feel an experimental supplement is helping
A supplement based on acknowledged Japanese prescription medicine. That, anecdotally, a dozen lab measurement sets show the sharp reversal of 5FU toxicity induced declines in CBC parameteres in 10 days, or less.
b) physicians/oncologists in western nations are reprehensible for not employing it
...physicians/oncologists may be missing an important opportunity for some patients
c) naturopaths are using [PSK] and getting terrific results,
Certainly I, the lab measurements, and the Japanese, think so. Credit where credit is due.
thus proving that naturopaths are superior to physicians in taking advantage of valuable new medical developments
That naturopaths sometimes might know what they are saying, that their best advice is not readily available "elsewhere", and that physicians should consider complementary uses more carefully.
The reality is ... naturopathy is
going to make serious inroads until MDs wake up and pay attention to the parts that do have a strong biological benefit and basis. Only solid competition, rather villification, will change that.
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It is difficult to progress past ones' own shortcomings through provocative dismissal.
I've seen a lot of ad hominem on about biological items that the "regular" medical practice world should have studied more accurately, or at all, decades ago - and still hasn't, or dismissed its own positive results.
I'm lost why a naturopath would want to prescribe medications. I don't see how that category falls under natural.
I'm lost why a naturopath would want to prescribe medications. I don't see how that category falls under natural.
"There's more to the picture than meets the eye."
Hey, hey.
My.
My.