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I have produced this page, like many others, for my benefit but hope that others will find it helpful. It comes from my annoyance with the way in which alternative medicine enthusiasts, nutritionists, conspiracy theorists and journalists mislead us, often for their personal profit. I had often wished I had a quick source of facts and arguments to use when discussing such topics. I have now collected some of the material I have found useful.
|Contents of this page:||Alternative therapies||Nutritional supplements & Therapy||Important writers and websites|
|Anti-quackery sites||Excellent books|
Summary of alternative therapies
The four main types of alternative or complementary medicine
This section is followed by brief summaries of all other alternative medicines (click here)
Homeopathy is a system for treating illness based on the premise that like cures like. The homeopath treats symptoms by administering minute or non-existing doses of a substance which in large amounts produces the same symptoms in healthy individuals. Homeopaths focus on treating patients as individuals and claim to be able to treat any ailment, from colds to heart disease.
Conclusions: There is a mountain of evidence to suggest that homeopathic remedies simply do not work, which is not surprising as they typically do not contain a single molecule of any active ingredient. Any observable effects are due to the placebo effect.
Example of herbal remedies for which there is evidence of efficacy
|Herbal remedy||Condition treated||Known risks|
|Devil's claw||musculoskeletal pain||interaction with anticoagulants|
|Echinacea||treatment and prevention of common cold||linked with asthma|
|Garlic||high cholesterol||may lower blood sugar|
|Hawthorn||congestive heart failure||may amplify effect of blood pressure and heart medications|
|Horse chestnut||varicose veins||could interact with anticoagulants and antidiabetic drugs|
|Kava||anxiety||associated with skin problems and liver damage|
|Ma huang||weight loss||contains ephedrine which stimulates the nervous and cardiovascular systems and can cause hypertension, myocardial infarction and stroke|
|Red clover||menopausal symptoms||associated with bleeding, and may interact with anti-coagulants, the contraceptive pill and other drugs.|
|St. John's wort||mild to moderate depression||can seriously interfere with other drugs|
|These are almost direct quotes from the excellent summaries that form the Appendix in Trick or Treatment. Note that the conclusions refer to evidence on the effectiveness of the therapy but often there has been little research.|
This is a therapy based on relearning correct postural balance and coordination of body movements;
Their Conclusion: The little evidence is inconclusive, but it might generate benefit for some health problems [especially chronic back pain], provided patients are sufficiently committed and wealthy. No serious risks associated. But a 2008 paper has convincing evidence about back pain ( BMJ. 2008 Aug 19;337:a884. doi: 10.1136/bmj.a884)
Plant essences ['essential oils'] are applied to the skin with massage or used during a bath or just in air.
Conclusion: It has short-term 'de-stressing' effects which can contribute to enhanced wellbeing after treatment. No evidence that it can treat specific diseases. Minimal risk.
Ancient Indian system of healthcare which involves bringing about balance between body and mind.
Conclusions: This complex system cannot be easily evaluated. Some elements are effective [eg yoga has proven benefits for cardiovascular health]. There are some encouraging findings for some herbal compounds but others are essentially untested, or overtly dangerous.
Enemas are used to 'cleanse the body of toxins', administered via the rectum.
Conclusions: None of the waste products of our body 'poison' us; they are eliminated through a range of physiological process [unless suffering from a severe medical condition]. Colonic irrigation is unpleasant, ineffective and dangerous. In other words it's a waste of money and a hazard to our health.
It is claimed that crystals can move, absorb, focus and diffuse healing 'energy' or 'vibrations' within the body, enhancing the patient's self healing abiliy.
Conclusions: Not in accordance with our undrstanding of physics, physiology or any other field of science. No evidence that wearing crystals, or crystal therapy is effective for any condition. No risks associated but if used as an alternative to life-saving treatments crystal therapy would be life-threatening.
Detoxification ['detox'] is the elimination of accumulated harmful substances from the body. Conventional detoxification may be essential after ingestion or injection of poisons. In alternative medicine, however, it is suggested that products of normal metabolism accumulate and make us ill or that too much indulgence in unhealthy food and drink generates toxins that can only be eliminated by a wide range of alternative treatments.
Conclusions: Detox is a scam. The body has wonderful systems for removal of potentially harmful waste products. After over indulgence drinking plenty of water, resting and eating sensibly is enough. There is no evidence that any treatment is beneficial, and some can be harmful. The only substance that is removed from a patient is usually money.
This is the Chinese art of placing objects [in home or office etc] in order to 'optimize the flow of life energy' which is thought to influence health and wellbeing.
Conclusions: Feng shui is not biologically plausible; its basic tenets of Ch'i and yin and yang make no sense in the context of modern science. There is no evidence that feng shui does aynthing but enrich those who promote it.
|These are supplements to increase intake of vitamins, minerals, fatty acids, amino acids etc to maintain or improve health, fitness or wellbeing.
Conclusions: Note that regulation of labels is lax. Medical claims are not allowed but manufacturers can do a good job of implying that a partiular supplement is good for treating some particular condition. Some are beneficial [eg fish oil for reducing risk of heart disease], many are harmless and some are dangerous, especially if they are used for a medical condition instead of consulting a doctor.
Hypnotherapy is the use of hypnosis, a trance-like state, for therapeutic purposes. Autogenic training is a self-hypnotic techinique.
Conclusions: People who are suggestible respond best. Many studies show that it is effective in reducing pain, anxiety, reducing phobias and the symptoms of irritable bowel syndrome. It is not effective for smoking cessation. It is clearly useful for some patients and there is no serious risk but it is not appropriate for people with severe mental problems.
Magnets, worn as wrist bands, leg straps etc are promoted for many conditions, mostly to alleviate chronic pain.
Conclusions: Serious trials have provided no evidence that they offer medical benefit, and there is no reason why they should.
There are many types of therapy, some of which are conventional while others are more exotic.
Conclusions: Massage is beneficial for some musculoskeletal problems, especially back pain, anxiety, depression and constipation. It improves wellbeing in most patients. Adverse effects are rare Exotic forms of massage are unlikely to provide extra benefit.
Similar to some chiropractic therapy but more gentle and uses more massage. Vertebral joints are rarely moved outside their normal range of motion so there is less risk.
Conclusions: Effective for back pain but it would be sensible to move to cheaper equally effective physiotherapy if there is no significant benefit.
Although used in conventional medicines in well-defined situations, as a therapy it is more controversial. It may be administerd as normal oxygen or as ozone [extremely toxic], and may be applied in a variety of ways.
Conclusions: Alternative oxygen therapy is not supported by evidence and is potentially harmful.
Massage of the feet based on the idea that particular areas of the foot correspond to inner organs.
Conclusions: The biological basis is completely implausible. It cannot be used to diagnose health problems nor to treat any condition. It is expensive and is no better than a simple foot massage.
Reiki is a system of spiritual healing or 'energy' medicine similar to laying on of hands.
Conclusions: It has no basis in science and the trial evidence fails to show efectiveness for any condition. There are no direct risks unless it is used to replace effective treatments for serious problems.
These are designed to generate what is known as the 'relaxation response'.
Conclusion: Effective for reducing stress and anxiety and maybe for some other conditions. Not effective for controlling chronic fatigue syndrome, irritable bowel syndrome, dyspepsia and epilepsy.
This is like a Japanese synthesis of accupuncture and massage. the therapist uses his thumb to apply strong pressure on accupuncture points. It can be painful.
Conclusions: Virtually no trials but unlikely to be more effective than conventional massage. Injuries can occur because of the high pressure used. For example there are reports of retinal and cerebral artery embolism associated with Shiatsu massage to the neck or head.
|Nutritionists and Nutritional Therapy; the fallacy of dietary supplements being essential for health TOP|
|Brief summary||Myths unravelled: vitamin c; glucosamine; omega 3; fish oil; antioxidants||PQQ|
|Brief summary of this topic followed by summaries of specific supplements and links to good evaluations of their efficacy.|
|Nutritionists promote the idea that to maintain good health it is essential to have a good diet which is achieved by taking regular dietary supplements which are also promoted as a form of alternative therapy for many (nearly all) medical conditions. This is known as Nutritional Therapy.
Nutritionists and Nutritional Therapists are different from dieticians and those working in the science of nutrition. They often have no science qualifications but have false or unrelated qualifications or have qualifications from their own ‘Institutes’. For example Patrick Holford has a BSc in psychology; his ‘qualification’ in nutrition or related subjects is DipION, awarded by the Institute for Optimum Nutrition which he founded, and where many other nutritionists were trained. Another well-known nutritionist is Gillian McKeith whose ‘PhD’ was bought from a non-accredited US University – as was the PhD of Ben Goldacre’s cat. Most well-known nutritionists (eg Patrick Holford) have their own companies selling nutritional supplements as essential for general health.
Nutritional claims can be advertised, whether tested or not, but medical claims cannot be written on the pill bottles [as there is no medical evidence this is illegal]. They are promoted by the websites, and books of the nutritionists and by uncritical journalists in newspapers or on TV. There is very little evidence for any therapeutic or preventative functions for the supplements they sell. In this way they are similar to other alternative medicine systems. Of course there is a problem that good scientific controlled experiments are often difficult in nutritional studies. But there have been excellent studies of some important nutritionists’ claims: for example, the use of vitamin C to prevent colds; fish oil to improve children’s intelligence; antioxidants to prevent cancer (see sections below).
The books and web sites of nutritionists will have a lot of sound advice but this is available from all good books on diet and on government websites. We do not need a nutritionist to tell us that we should eat plenty of fruit and vegetables, we should not overcook them, we should take plenty of exercise etc.
An excellent book on how supplements and treatments should be evaluated, and on how industries selling dietary supplements (and pharmaceuticals) cheat in their ‘science’ claims, is Bad Science by Ben Goldacre. He has won numerous awards, including “Best Freelancer” at the Medical Journalists Awards 2006, the Healthwatch Award in 2006, “Best Feature” at the British Science Writers Awards twice, for 2003 and 2005, and the Royal Statistical Society’s first Award For Statistical Excellence in Journalism. He also has a useful and amusing (searchable) website which exposes the absurdities published on this topic.
Another excellent source is David Colquhoun’s Improbable Science site.
For general advice on dietary supplements and health the excellent NHS site provides information on what vitamins etc are required, where you will get them in your diet and any known problems.
The most reputable source for reviews of studies of the efficacy of medical or ‘nutritional’ treatments is the Cochrane Collaboration. They publish systematic reviews which can be read online or downloaded as pdf files. The home page of their library has an alphabetical list of everything or the collection can be searched on the home page. Full details of reviews are given together with useful ‘plain language summaries’. Some of their conclusions are discussed below.
Some myths unravelled
Chondroitin and glucosamine for arthritis (From David Colquhoun's site : Chondroitin doesn’t work April 8th, 2007)·
Omega-3 PUFA (as in Fish oil and some vegetable oils) and cognitive function
Omega-3 PUFA for prevention of cardiovascular disease
Fish oil capsules and children’s IQ
Antioxidants. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases
|PQQ (Pyrroloquinoline quinone) TOP
This is a subject close to my own heart. I was one of the first scientists to discover PQQ (in 1967) as an essential component of bacterial enzymes. This aspect of PQQ is covered in my Research Pages and there is further extensive discussion in my Research Pages of proposals of PQQ as a vitamin
PQQ as a nutritional supplement
Some specific comments on the article:
As with other websites the claims of the marketers are often factually incorrect, wildly exaggerated and have many misunderstandings about biochemistry and physiology.
There have been no controlled proper studies on effects (good or bad) of dietary PQQ supplements.
|Links to sites that deal with dubious claims and quackery This has been lifted directly from David Colquhoun's site|
Badscience.net Ben Goldacre's site, with text of his excellent Guardian column too.
Sense about Science an independent charitable trust to promote good science and evidence in public debates.
ebm-first.com: A nice site about the follies of CAM run by an Edinburgh housewife who has suffered from it
The Sceptical Preacher. Sean Kehoe's site. It has had some good stuff recently
UK Skeptics' forum. A new UK forum
Little Atoms. Website of "Little Atoms" Radio show, broadcast fortnightly on Fridays from 16:30 to 17:30 on Resonance 104.4 FM . Little Atoms is a live discussion show, Produced and presented by Neil Denny and Richard Sanderson. Little Atoms explores the science of politics and the politics of science. Download their mp3s.
Skeptico Critical thinking for an irrational world
Francis Wheen's Top 10 Delusions
The Toadstool Millionaires: A Social History of Patent Medicines in America before Federal Regulation, James Harvey Young
The Medical Messiahs: A Social History of Health Quackery in Twentieth-Century America James Harvey Young
Boffin productions Greetings cards for Scientists, Mathematicians, Free-thinkers and Sceptics
REASON Rationalists, Empiricists And Skeptics Of Nebraska
Some links to delusional sites that illustrate how the far the CAM lobby has penetrated the National Health Service
The NHS Alliance A goldmine of misinformation
The Prince�s Foundation for Integrated Health Some of the wackiest views on the web.
|Ben Goldacre Web Site Bad Science
Ben Goldacre is an award winning writer, broadcaster, and medical doctor who has written the weekly Bad Science column in the Guardian since 2003. He appears regularly on Radio 4 and TV, and has written for the Guardian, Time Out, New Statesman, and the British Medical Journal as well as various book chapters.
He has won numerous awards, including “Best Freelancer” at the Medical Journalists Awards 2006, the Healthwatch Award in 2006, “Best Feature” at the British Science Writers Awards twice, for 2003 and 2005, and the Royal Statistical Society’s first Award For Statistical Excellence in Journalism (£250 and an engraved crystal paperweight!).
His recent book Bad Science  is an outstanding contribution to education [Summary below].
His website Bad Science contains many of his Guardian articles and relevant blogs. It has a very useful index to topics on the left hand side and the articles include many relevant links.
Here are a few examples:
Alternative medicine; Acupuncture; Herbal remedies; nutritionists; Brain gym / Dyslexia miracle cure; Detox; MMR; MRSA; Mobile phone masts/suicide rates.
Simon Singh Web Site
|David Colquhoun Web Site: Improbable Science
Professor D Colquhoun, FRS held the established (A.J. Clark) Chair of Pharmacology at UCL, and was the Hon. Director of the Wellcome Laboratory for Molecular Pharmacology.He is now an Honorary Fellow of University College, London. His University College site.
He is a fearless enemy of bad science [especially when used to support alternative medicine] and of bad administration.
His Improbable Science site includes an outstanding, informatitive, authoratitive blog section. I found it best to click on the site and scroll down.
A few examples: The absurdity of University courses in alternative medicine; MMR; Bad science and medicine on the BBC; Degrees without science; homeopathy; fish oil;The dilemmas at the heart of alternative medicine.
A stimulating and joyful read is the Laughter Section.
Sense about Science Website.
|The James Lind Library The Website
Explains and illustrates the develpment of fair tests of treatments in health care. The principles of fair tests are explained in essays containing many examples. The text of ‘Testing Treatments’ – a 100-page book published by the British Library in 2006 - is available here without charge, in the original English, and in Arabic, Chinese, and Spanish translations.To illustrate the evolution of fair tests of treatments from 1550 BCE to the present, the James Lind Library contains key passages and images from manuscripts, books and journal articles.The website also contains many commentaries, biographies, portraits, doctoral theses and other relevant material about the history of fair tests.
|I strongly recommend these books. I found them particularly useful for providing the facts and fallacies relating to alternative medicine, nutritionists' rubbish, conspiracy theories|
|Bad Science. Ben Goldacre: Read reviews on amazon [£3.60].|
|He is a full time medic in NHS and writes the 'Bad Science' column in The Guardian.|
|Dedicated 'To whom it may concern'.|
This book includes outstandingly clear discussions of what makes Good Science in relation to testing the claims of nutrition industry, cosmetics, homeopathy, [etc].
1.Introduction to bad science
Testing treatments: better research for better health care. .
Foreword by Nick Ross
1 New – but no better or even worse
2 Used but inadequately tested
3 Key concepts in fair tests of treatments
4 Dealing with uncertainty about the effects of
5 Clinical research: the good, the bad, and the
6 Less research, better research, and research for the right
7 Improving tests of treatments is everybody’s business
8 Blueprint for a revolution
|Trick or Treatment? Alternative medicine on trial. Simon Singh and Edzard Ernst.|
Read reviews on amazon [£6.29]. Trick or Treatment website.
|Dr Simon Singh is a particle physicist and is a broadcaster and author on Science.|
|Professor Edzard Ernst is the world's first professor of complementary medicine. For a nice jokey article on data-free alternative medicine go to Who Needs Data?|
|Dedicated to HRH The Prince of Wales|
|This is a well-written well-researched inspiring book, starting with a quote form Hippocrates, the father of medicine "There are, in fact, two things, science and opinion; the former begets knowledge, the latter ignorance".|
1. How do you determine the truth. "Truth exists - only lies are invented' [Georges Braques]..
|Voodoo Histories: The role of the Conspiracy Theory in Shaping Modern History.|
|David Aaronivtch. Author, Broadcaster, travel writer and Times columnist|
|Read Reviews on amazon [£12.99].|
|This is was written "to provide ammunition for those (like myself) who have found themselves at the wrong end of a conversation about moon landings or twin towers".|
|In adddition to these two 'conspiracies' he covers most of the commonly quoted conspiracies including Pearl Harbour ['arranged' by Roosevelt], the assassinations of the Kennedy brothers and Martin Luther king, the death of Marilyn Monroe, David Kelly, McCarthyism, The Protocols of the Elders of Zion, and more.|