Tag Archives: Science-Based Medicine

Why Do People turn to Alternative Medicine?

via Science-Based Medicine
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Any sociological question is likely going to have a complex answer with many variables that are not easy to tease apart. We should therefore resist the temptation to make simplistic statements about X being the cause of Y. We can still, however, identify correlations that will at least inform our thinking. Sometimes correlations can be triangulated to fairly reliable conclusions.

When the data is complex and difficult to interpret, however, evidence tends to be overwhelmed by narrative. The recent Sandy Hook tragedy is an excellent example. No one knows exactly why the shooter did what he did, so it is easy to insert your own preferred narrative as the explanation.

miracle-hat_300pxAnother example is the phenomenon of so-called complementary and alternative medicine (CAM). Why has it been increasing in popularity (and is it, really?). Is it slick marketing, relaxed regulations, scientific illiteracy, a gullible media,  or the failures of mainstream medicine? You can probably guess I think it’s all of these things to some degree. The most common narrative I hear by far, however, is the latter – if people are turning to CAM it must be because mainstream medicine has failed them. This version of reality is often promoted by CAM marketing.

The evidence that we have, however, simply does not support this narrative. Studies show that satisfaction with mainstream medicine is not an important factor in deciding to use CAM, that CAM users are generally satisfied with their mainstream care, and they use CAM because it aligns with their philosophy, and they simply want to expand their options.

None of this is to imply that mainstream medicine has no problems or failings – it does. We should, however, be working toward keeping and improving what works and fixing what doesn’t, not discarding science and reason to embrace fantasy as an alternative. This is often the false choice presented by CAM proponents, and is analogous to creationists pointing out alleged weaknesses in the theory of evolution as an argument for creationism as an alternative.

Continue Reading @ Science-Based Medicine . . .

Aspartame – Truth vs Fiction

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If you believe everything you read on the internet, then is seems that a chemical found in thousands of products is causing an epidemic of severe neurological and systemic diseases, like multiple sclerosis and lupus. The FDA, the companies that make the product, and the “medical industrial complex” all know about the dangers of this chemical but are hiding the truth from the public in order to protect corporate profits and avoid the pesky paper work that would accompany the truth being revealed. The only glimmer of hope is a dedicated band of bloggers and anonymous e-mail chain letter authors who aren’t afraid to speak the truth. Armed with the latest anecdotal evidence, unverified speculation, and scientifically implausible claims, they have been tirelessly ranting about the evils of this chemical for years. Undeterred by the countless published studies manufactured by the food cartel that show this chemical is safe, they continue to protect the public by spreading baseless fear and hysteria.

Hopefully, you don’t believe everything you read on the internet, and you don’t get your science news from e-mail SPAM, where the above scenario is a common theme. While there are many manifestations of this type of urban legend, I am speaking specifically about aspartame – an artificial sweetener used since the early 1980s. The notion that aspartame is unsafe has been circulating almost since it first appeared, and like rumors and misinformation have a tendency to do, fears surrounding aspartame have taken on a life of their own.

Keep Reading: Science-Based Medicine » Aspartame – Truth vs Fiction.

Galvanic Skin Response Pseudoscience

steven_novellaby via Science-Based Medicine

Selling snake oil is all about marketing, which means that a good snake oil product needs to have a great angle or a hook. Popular snake oil hooks include being “natural,” the product of ancient wisdom, or “holistic.”
Perhaps my favorite snake oil marketing ploy, however, is claiming the product represents the latest cutting-edge technology. This invariably leads to humorous sciencey technobabble. med_xray_specs_300pxThere are also recurrent themes to this technobabble, which often involve “energy,” vibrations and frequencies, or scientific concepts poorly understood by the public, such as magnetism and (of course) quantum effects. Historically, even radioactivity was marketed as a cure-all.
One category of technical pseudoscientific snake oil measures some physiological property of the body and then claims that this measurement can be used for diagnosis and determining optimal treatment. For example, machines might measure brain waves, heart rate variability, thermal energy or (the subject of today’s article) the galvanic skin response.
These are all noisy systems – they are highly variable and produce a lot of random results that can be used to give the impression that something meaningful is being measured. Systems that rely on these measurements to make highly specific determinations are no different than phrenology or reading tea leaves, but they look scientific.

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The galvanic skin response

I was recently asked to look into a product called Zyto technology. This is an electronic device that you place your palm on top of so that it can read your “galvanic skin response” (GSR) to specific stimuli. It then uses your responses to prescribe a specific treatment.

The GSR is actually an older term for what is now called electrodermal activity (EDA), which is simply the electrical conductance of your skin (Harriet Hall has written about such devices before). Skin conductance is primarily affected by sweat, as salty water is an excellent conductor. So essentially the machine is measuring how sweaty your palms are.

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Glyphosate – The New Bogeyman

steven_novellaby Steven Novella via Science-Based Medicine

There is an ideological subculture that is motivated to blame all the perceived ills of the world on environmental factors and corporate/government malfeasance. Often this serves a deeper ideological drive, which can be anti-vaccine, extreme environmentalism, or anti-GMO. Screen Shot 2015-01-06 at 6.09.56 PMThe latest environmental bogeyman making the rounds is glyphosate, which is being blamed for (you guessed it) autism.

Glyphosate is the active ingredient in the herbicide Roundup. It has been widely used for about 40 years, and with the introduction of GM crops that are Roundup resistant, its use has increased significantly in the last 20 years. It has therefore become a popular target for anti-GMO fearmongering.

round upGlyphosate is one of the least toxic herbicides used. It inhibits the enzyme 5-enolpyruvylshikimic acid-3-phosphate synthase which interferes with the shikimic pathway in plants, resulting in the accumulation of shikimic acid in plant tissues and ultimately plant death. The enzyme and pathway do not exist in animals, which is why toxicity is so low. Still, chemicals can have multiple effects and so toxicity needs to be directly measured and its epidemiology studied.

A systematic review published on 2000 found:

Experimental evidence has shown that neither glyphosate nor AMPA bioaccumulates in any animal tissue. No significant toxicity occurred in acute, subchronic, and chronic studies.

and

Therefore, it is concluded that the use of Roundup herbicide does not result in adverse effects on development, reproduction, or endocrine systems in humans and other mammals. For purposes of risk assessment, no-observed-adverse-effect levels (NOAELs) were identified for all subchronic, chronic, developmental, and reproduction studies with glyphosate, AMPA, and POEA.

As pesticides go, glyphosate has very low toxicity, and any dose a person is likely to get exposed to is well below the safety limits.

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False Memory Syndrome Alive and Well

steven_novellaby Steven Novella via Science-Based Medicine

It is disheartening that we have to return to pseudosciences that have been debunked decades ago, because they continue to linger despite being eviscerated by scientific scrutiny. Belief systems and myths have incredible cultural inertia, and they are difficult to eradicate completely. That is why belief in astrology, while in the minority, persists.

Professions, however, should be different. A healing profession should be held to a certain minimum standard of care, and that standard should be based upon something real, which means that scientific evidence needs to be brought to bear. Professionals are not excused for persisting in false beliefs that have long been discredited.

The Courage to Heal, the source of many beliefs about false memory syndrome

The Courage to Heal, the source of many beliefs about false memory syndrome

The 1980s saw the peak of an idea that was never based on science, the notion that people can suppress memories of traumatic events, and those repressed memories can manifest as seemingly unconnected mental health issues, such as anxiety or eating disorders. The idea was popularized mostly by the book The Courage to Heal (the 20th anniversary edition was published in 2008), in which the authors took the position that clients, especially women, who have any problem should be encouraged to recover memories of abuse, and if such memories can be dredged up, they are real.

The notion of repressed memories led in part to the satanic panic of the 1980s, and many of those subjected to recovering techniques not only “remembered” being abused, but being part of satanic ritual abuse.

Recovered memory syndrome was a massive failure on the part of the mental health profession. The ideas, which were extraordinary, were never empirically demonstrated. Further, basic questions were insufficiently asked – is there any empirical evidence to support the amazing events emerging from therapy, for example? Is it possible that the recovered memories are an artifact of therapy and are not real?

Now, with three decades of hindsight, we can say a few things with a high degree of confidence.

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