"Alternative" medicine? You misspelled "not".

By Phil Plait | June 10, 2009 2:46 pm

Here’s a shocker for you: after a decade and 2.5 billion (with a b, folks) dollars spent, a government study shows that almost no alternative medicines worked.

Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine. The lone exception: ginger capsules may help chemotherapy nausea.

So, they used actual scientific testing processes instead of anecdotes, and found that most of these simply don’t work. Like I said: shocker.

Let me be clear: I am not opposed to testing any so-called alternative medicines. A lot of our medicine today is based on herbs and such; aspirin comes from willow bark, for example, and ginger has been tested before for nausea and shown some promise. A lot of people comment on my blog when I talk about this stuff and call me closed-minded, which makes me chuckle ironically, since most of these people are so anti-science their minds are clamped tight. And in fact I want to test these techniques to separate what works from what doesn’t.

But I am decidedly against these techniques that have been tested and shown to be no better than placebos. This includes homeopathy, intercessory prayer, and the like. Chiropractic, which I dissed just today, may have some efficacy for some skeletal issues, but curing a toothache? C’mon.

My point: when the tests are done, and the technique is shown not to work as promised or even at all, then into the trash bin it goes. That’s science. That’s reality.

Of course, that’s if the tests are done correctly. According to the MSNBC article linked above, that wasn’t always the case. Not surprisingly, when the testers have some stake in the tests then science is out the window.

But even so, the studies have shown that most of these remedies don’t work. And will this change the minds of their advocates?

HAHAHAHAHAHAhahahahahahaha! Oh man, sometimes I crack myself up.

This is just one more arrow in our quiver, but the alternative medicine believers will continue to move the targets around. Stay vigilant, and remember: people waste money, people get sick, and people die because of this antiscientific thinking. That’s why testing this, publicizing it, and fighting the misinformation is so important.

Tip o’ the child-proof cap to Krelnik.

CATEGORIZED UNDER: Antiscience, Piece of mind, Science

Comments (135)

  1. Jeremy

    Interesting that ginger was the exception, since Mythbusters found it to be effective against sea sickness as well. It sounds like we have a genuinely medically useful substance in amongst all the expensive worthless crap.

  2. tjm220

    I’m not terribly surprised by the results either there Phil.

  3. Fedaykin

    Chiropratic medicine is an interesting half woo, half valid (at least potentially) practice.

    I had always thought of Chiropractic techniques as at least logical (though I’d never studied the scientific literature). Of course, that was before I realized that some Chiropractors claimed to be able to cure diseases not related to the skeleton and muscles (e.g. curing cold, toothaches, etc.).

    I felt rather embarrassed when I found out about the obvious woo side of the practice.

  4. andy ross

    That quiver is bursting, none of the alternative believers seem to feel them when they hit though.

  5. If people still call you closed-minded after reading this, they really need to look at their ability to process information (as if that wasn’t already the case).

    Like I have said many times before (as someone that has to consume medical treatments more than an average person) show me real studies regarding the effectiveness of alternative treatments and I would gladly use them. But until then, I will stick to what the tested medical community advices me to do after I have done my own research on that advice as well.

    Personally I do not think it wise to accept any treatment without looking into all of the pros and cons of said treatment. It is part of being a knowledgeable consumer and giving informed consent. Maybe if more patients asked questions of their health care providers instead of looking at them as a god people would start to take responsibility if treatment does not go as expected. However that will probably never happen. People will continue to find blame at the BigPharma and medical community because they do not want to take responsibility for what they consume or their actions.

  6. Sir Craig

    You misspelled “mispelled,” by the way…just thought you should know (unless it was intentional – my irony meter is shot to hell).

  7. Acronym Jim

    While 2.5 billion dollars is a good chunk-a-change, if it keeps the woofacturers from making at least that amount from the malinformed, it’s money well spent.

  8. JLP

    The list of drugs with origins in the tissues of plants, animals, or microorganisms actually runs much deeper- about 40% of those prescribed, with standouts like hirudin from leeches (anticoagulant,) vincristin from periwinkle and taxol from yew (chemotherapy agents,) L-Dopa from velvet beans (Parkinson’s suppressant,) digitoxin from foxglove and atropine from belladona (cardiac regulators) and others. So, as you say, it makes perfect sense to go shopping in the natural world for drugs-evolution has made every species a veritable chemical arsenal dedicated to keeping it in action. However, shopping for interesting macromolecules is a very different process from going on a bender one night and brewing your lawnmower clippings, as the study shows.

  9. Steve

    The reality is that some alternative medicine works and some of it doesn’t. This testing proved that several common “remedies” do not work in the slightest. Invariably others, like ginger, will be proven to have some value. My only concern with your posts on the subject is you’re so vigorously against the alternative medicines that you end up seeming somewhat unscientific.

    Chiropractic care, for example, does work. Or, perhaps more to the point, I can speak specifically to a loved one who got chiropractic care and it changed them from being barely able to get out of bed to being fully functional. This was not made up. However, there is a lot of overlap between the woo quackery and some chiropractors.

    You’ll also see plenty of studies that indicate that massage has many therapeutic benefits. However, there’s also a segment of those who practice massage that get into aligning chakras, etc, that are pretty quacktacular.

    So all I would say is to be genuinely scientific and avoid throwing out the alternative medicine successes with the vast amount of bathwater they might be in.

  10. Charles Boyer

    People call you closed-minded because your viewpoint doesn’t agree with theirs, plain and simple. All you have to do is look at the inevitable ant-vaxxers that show up with their data and their inevitable conspiracy theories when you post any article on the subject.

    They know more and their knowledge is above contradiction. And when contrary facts are presented, one is in the pocket of a sinister secret organization, e.g. “Big Pharma.” Oh, what I would give to receive an invitation to the Big Pharma board meetings, so I could learn their evil plans in advance. I suspect that their clubhouse would make a James Bond villain consider re-decorating his island lair.

    Seriously, these folks do not want scientific debate. They only want you to sign off on their beliefs, and they find it threatening when people don’t do exactly that. Scientific rigor, where one has to accept criticism and the need to resolve contradicting evidence never enters into their minds.

  11. Hugs are the best medicine. Well, hugs and Paxil.

  12. rob

    Charles B:

    ant vaxxers?

    ants are social insects. it would be a terrible thing to give them MMR vaccine and cause autism. poor ant colonies wouldn’t function with many ants displaying delayed socialization skills and repetitive behavoirs.

    don’t vaccinate ants! let them suffer from measles instead!

  13. Joey Joe Joe

    When will people realise…

    “Mainstream” medicine = Those medicines which have been demonstrated to work.

    “Alternative” medicine = Those which have not.

    If an alternative were shown to be effective, it would no longer be alternative.

  14. And just in case anyone says, “Let them believe in this woo, it’s harmless.” point them to http://whatstheharm.net

    And yeah, studies… Do I need to put up that belief graph again?

  15. Cue the conspiracy theorists who will chalk up these studies as proof that the government is in the pocket of big pharma…

  16. PhilB

    Huh, it is neat to see some evidence backing up ginger for nausea. My wife used it a lot for her morning sickness and that was the first I’d heard of it.

  17. Breklor

    Echinacea doesn’t work? I thought I had read that according to some fairly decent testing, it was an effective immune booster when taken during the first stages of an illness. Taken regularly, it doesn’t work, because (IIRC) the immune system gets “tired” of the boost and drops back down to normal function. I could be wrong though. :)

  18. Nathan

    so where do we place accupuncture? and please don’t flame me, I’m genuinely curious. It seems to be taking hold fairly well now, and I wonder about its effectiveness. Is it really useful in some situations? I currently see it like chiropracty. Good, if my spine is what’s causing me problems. (I’ve used it for backpain before, and it worked, much like assisted stretching) But haven’t really ever had a chance to do much in-depth study

  19. Pete

    “aspirin comes from willow bark” ?
    :-)
    I hear ya, but that’s a very very condensed explanation!

    It’s no longer willow trees all the way down.

  20. Hendi

    Echinacea is as much a immune booster as s.h.i.t. is. it simply looks for everything that enters your body. Order your cheap all natural, nobigpharma, body-warm immune booster from the next farm now!

  21. Yojimbo

    @10

    What about uncles?

  22. Timothy from Boulder

    Phil, a tangential topic I’d like to see addressed (which I haven’t seen any info on anywhere) is how do you find a doctor that is free from “alternative medicine”. As a fellow Boulderite, you know how prevalent (and praised) “alternative medicine” is around here.

    I’m currently searching for a new primary care physician because the one I go to now has increasingly incorporated “non-Western medicine” into his practice. He hasn’t offered any to me, but I feel it reflects poorly on his judgment and overall credibility.

    It’s not as easy as you’d think to just call up a doctor and get an idea of the doctor’s philosophy on treatment. For all the practices I called, you can never just talk to the doctor for 5 minutes on the phone, everything is routed through the receptionist. And I’d rather not drop a $30 copay on a random doctor just to come in and have a chat. The best I got was “Come in when you have a minor issue, and then you’ll have an opportunity to talk with the doctor.” This actually worked out for me and I saw a new PCP, and she was better, but not ideal. But at the rate I usually see doctors, I could go decades and not find one who was a serious, skeptical, no-alternative-medicine physician.

    Most patient reviewed “Rate My Doctor” websites are useless, due to lack of detailed descriptions, and the fact that most doctors just aren’t reviewed.

    If you’re chatting around the skeptic community, or have a good set of ideas on the subject, I’d really like to hear it.

  23. Timothy from Boulder

    Nathan> Depends on what you expect it to cure. There are some indications that it can cure pain (whether an actual physiological effect or placebo doesn’t matter, if you have less pain, you have “cured” the symptom). It’s when acupuncturists start claiming the cure of other maladies that I run screaming in the other direction.

  24. Old Geezer

    Again, we should separate skepticism from denial. The guy who sells X-ray glasses is not an indictment of the entire field of Optometry. My wife swears by Chiropractic and obtains genuine relief from it for back problems. It does nothing for me (and has, in fact, caused great pain) but neither of us believe it has value for toothache. Acupuncture has helped my chronic neck and back pain due a long-ago auto accident. It does nothing for my wife. Does it re-align my chackras or channel my chi? No, I don’t think so.

    Skepticism should be a filter, not a closed door. The above studies are an appropriate filter regarding the items that were tested. Those that have not been tested should not be dismissed and those that have been found to have a placebo effect greater than no treatment at all should be studied further before they are rejected in whole.

  25. Old Geezer

    @Timothy from Boulder

    I’m intrigued by your two posts. In the first, you reject out-of-hand any doctor who might consider “non-Western medicine” yet in your second post you acknowledge that an acupuncturist might create a “cure” by even a placebo-effect treatment.

    Uh…isn’t that “non-Western medicine?”

    I’m pleased that my present GP has an open mind. He has never suggested a woo treatment, but has told me that he respects those of his patients who come to him with alternatives that work for them as long as they don’t harm themselves. His filter is, “First, I will do no harm.”

  26. Yes, I corrected my misspelling of misspelled. Irony is really ironic sometimes.

  27. @Old Geezer “Those that have not been tested should not be dismissed and those that have been found to have a placebo effect greater than no treatment at all should be studied further before they are rejected in whole.”

    That sentence confuses me. I don’t understand how there can be a placebo effect greater than no treatment at all since some sort of treatment has to be administered to study placebo effect

    To be very basic this is how placebo effect is tested.

    Group A gets so called medicine. Group B gets a “sugar pill”. The participants do not know if they are getting the stuff being tested or sugar pill. In really good studies, the people carrying out the study have no idea who got what until its time to interpret the data.

    So say Group A 60% report feeling better after treatment. Group B there is a statistically equal number who report same effects.

    After crunching all variables and numbers and figuring out statistical probability (there is a lot more to it than what I have said, I am trying to explain this as simply as possible) the researchers can then say medication is bogus or conclude more testing needs to be done.

  28. Chris A.

    “It’s good to have an open mind, but not so open that your brains fall out.” -Source unknown

  29. Grant H

    I find this a little surprising. Herbs and plants have chemicals, pharmaceuticals contain chemicals. I always figured that natural remedies and pharmaceuticals did the same job because they contained the same active “ingredients”.
    I thought pharmaceuticals would obviously be more refined and and have higher concentrations of the active components, so would be more effective.
    I’ve been running on assumption, perhaps the subject’s a little more complex than I thought.

  30. spencer

    Tim Minchin said it best “Know what they call Alternative medicine that’s been proved to work? Medicine”

  31. Old Geezer

    @Jules(Julia)

    A better test will have three groups. These will be the Groups A and B you mention, together with a third “Control” group getting no treatment at all. Often, these studies show that Group A may get an “X” improvement, Group B a “Y” improvement and then each is compared to the No-Treatment control group.

    These are generally used to test the efficacy of the medicine/procedure against the placebo effect of the sugar pill, against no treatment at all. An example of this is the recent study (sorry no cites, but you can find it) where acupuncture was tested against the use of needles that did not pierce the skin, and against a control of no treatment for back pain. As I recall, both the acupuncture and the fake needle (placebo) beat the no-treatment alternative.

  32. Jeff

    Glucosamine and chondroitin for arthritis

    seems to work for my old cervical vertebrae

  33. JimB

    Acupuncture – Wasn’t there a double blind study the results of which were published a while back. 1 or 2 years ago? And it showed that acupuncture did perform better than placebo at relieving pain.

    The kicker, was that it didn’t matter where the needles were stuck in.

    Thru all that chi doo doo right out the window.

    I remember it because I thought the way they faked the needle insertion (for those getting the placebo acupuncture) was pretty cool.

  34. @ Old Geezer

    My mistake for leaving out control group. I realize a 3rd group would be even better and I do not know of any study that does not have a control. What I was trying to illustrate was single blind vs double blind study.

    I was just curious as to what you meant by placebo effect greater than no treatment at all.

    However both A and B showing improvement over C is placebo since both groups think they are receiving treatment. Of course there will be an effect greater than no treatment at all.

    Now say A shows improvement. B shows some improvement but not to the same degree as A. C is the control. The data would have to interpreted to see if the difference between rates of A and B is statistically significant to be able to say that A should be studied further or that even so the rates differ, the significance is not and thus falls under placebo or other catagory.

    The reason why placebo and acupuncture both beat no treatment is because acupuncture was shown to be no better than placebo and thus fell to placebo effect.

    I think I may have just confused this.

  35. Old Geezer

    @Jules(Julia)

    Let’s see if I understand. You believe that if A shows a significant improvement over C, but it is statistically no better than B, it is automatically worthless? Thus, if I want relief for my spinal injuries, and have had good results from acupuncture in the past, I should abandon it in favor of fake treatment because it is “just as good?’

    “The reason why placebo and acupuncture both beat no treatment is because acupuncture was shown to be no better than placebo and thus fell to placebo effect.” Or, it might be because both ways work equally well, but differently? I didn’t throw away all of my aspirin when acetaminophen came on the market.

  36. @Old Geezer

    Maybe not all acupuncture is worthless but in that study and in that case, yes it was placebo. Your mind and body think it will work and as a result you think you are receiving a benefit and feel better as a result from said belief that you are receiving a real medical treatment.

    Acupuncture was not being tested vs an alternate tested method that was found to be beneficial. You cannot use aspirin vs acetaminophen as an analogy since both were tested separately vs a placebo for effectiveness.

    Testing something vs a placebo and both showing the same effectiveness means that acupuncture, in that study, may as well been a sugar pill.

    However, if you were to test acupuncture say against cyclobenzaprine (which is a tested proven muscle relaxer) vs placebo and found similar results for acupuncture as cyclobenzaprine vs placebo, then you may have something and could say acupuncture is a viable option against muscle pain.

  37. Bennett Todd

    When (a) the nostrum is harmless, and (b) medical science is helpless, the placebo effect is non-zero for the faithful ignorant, and kinda tempers my contempt.

    And re ginger and nausea, distance sailing racers prone to sea-sickness can largely manage their problem with Bonine, but when nausea overwhelms it they pull out their stash of crystalized ginger, the only thing I’ve heard of that will stop it once it’s started. Bonine, Scopolamine, and maybe Dramamine may improve the odds that it won’t start, but once it does they’re useless.

  38. John

    Nice to see the article mentioned acupuncture as being one that did help with many ailments. It’s the only alternative therapy I’ve had success with.

    Disappointing to see phil didn’t read that far.

    Even more disappointing to see phil using, ahem, MSNBC for his research. if he were ever to go near journal a grown-up scientific journal like SCIENCE or NATURE he’d find swathes of research into alternative remedies that are used as the catalyst for more conventional medicines.

    Still, as long as he has that baby vaccinated before he throws it out with the bathwater, all is good.

  39. Michael Gray

    I have a campaign to relabel “Alternative Medicine” as
    “Alternative TO Medicine”.

    Not much success in getting this meme to stick!

  40. My mom has been using tart cherry juice (which reportedly contains glucosamine) and she insists that it has eased her arthritis noticeably since starting. Is it placebo effect? Probably. Am I going to argue with her about the truth? No. She’s almost 70, and if she found something that seems to work, regardless of how, I don’t see the point at this juncture to stepping all over that. Besides, the cherry juice concentrate isn’t terribly expensive, and it actually tastes pretty good.

    I am a scientist to the core. I want things tested and proven or dis-proven. At the end of the day, though, she hurts less than she used to. I can live with that.

  41. Old Geezer

    @Jules(Julia)

    One last thought and then I think we should both go get dinner>

    I have Cyclobenzaprine and Vicodin in my medicine cabinet and I have had acupuncture treatment. Guess which of the three lasted for more than four hours!

  42. @ Old Geezer

    Just because it has worked for you does not mean it will work for the large majority. Now if the results you have personally felt can be found time and time again in a larger body of people after repeated testing in a controlled environment and not anecdotal, if it can stand up to scrutiny, then acupuncture may have something to it.

    Until then I will stick to treatment that has withstood peer review and results that have been duplicated time and time again.

  43. Speaking of chiropractic, that’s a practice with some real-world efficacy, some techniques that can (and have!) been adopted by reality-based medicine. It would behoove the evidence-based practictioners of chiropractic (so-called “mixed chiropractics,” in reality a majority of practicioners) to bring their profession into the mainstream (much as osteopaths have done in America.)

  44. Acupuncture is an effective placebo. That’s what all the tests tell us. It’s just as effective as sugar pills: if the recipient believes they work, sometimes (and only sometimes) they work.

    Of course, acupuncture is only one of many effective placebos, and as treatment-by-placebo goes, it has some significant down-sides. I’d probably prefer hypnosis. No needles being stuck in me.

    Look up the placebo effect. It’s fascinating. It proves out a key (also unifying. Possibly unique) fact that SCAM practitioners have been telling us all along: (sometimes) the mind can encourage the body to heal itself. Which doesn’t make SCAM (in reality, placebo-treatment) a viable alternative to reality-based medicine.

  45. Eric RoM

    @Jules: “large majority”? How about if a given treatment worked for a minority?

    I’m reminded of the initial confusion around Familial Mediterranean Fever (FMF), that confused practitioners until theypercieved ‘ the connections.

    Various medical practices have fallen in and out and BACK INto favor for specific diseases. When one finds that “yeah, we used to treat this via foo, then in the eighties we didn’t, but now we use foo again” it rather shakes one’s certainty about ‘medical truth’. The scientific and medical world are much more prone to fashion than practitioners would like us to believe ::cough:: plate tectonics ::cough::.

    Or, read this: http://www.slweb.org/HRT-commentary.html

  46. thaneb

    IMO it is a sorry state that the industry that touts and sells these “alternative remedies” and “supplements” does not have to foot the bill for staged clinical trials to demonstrate their safety and effectiveness. We have Tom Harken, among some others, to thank for this and the boom in growth of this industry with their specific exemption from FDA oversight.

  47. John

    @jedibear

    Acupuncture has an empirically measurable effect on the entire nervous system.

    Now that’s not a placebo, although i don’t doubt the placebo effect increases the effects, especially when treating pain.

    I would put acupunture in the same box as osteopathy and chiropractry.

  48. David D

    I’d like to point out that Sen. Tom Harkin, a Democrat, was instrumental in creating NCCAM, a taxpayer sponsored research center that spends a lot of money on all things woo.

    Anti-science is not confined to only one side of the political aisle.

  49. @John

    Oh yeah?

    Prove it.

  50. Michael Kingsford Gray

    46. John Says:
    … I would put acupunture in the same box as osteopathy and chiropractry.

    Then what would you do with that box?

  51. John

    @jedibear

    1. I don’t have any of the equipment or a willing subject
    2. I’m not qualified to conduct the necessary fMRI or PET brain scans, or acupuncture
    3. It’s already been done, and the results were pretty conclusive.
    4. Don’t be lazy, google “fmri acupuncture”

  52. shawmutt

    They misspelled “not”, or left out the “to” in alternatives “to” medicine.

    @post #9 from Steve

    Calling someone “unscientific” and following up with an anecdote about why you believe a certain modality works is kind of silly.

  53. Mark

    Meh…
    I take Glucosamine sulfate because the research i did seemed to sugest it would help my joints due to the heavy work out i do. Seems I’m wrong

    …Here is where I am at a loss.
    Where do skeptics go to look this stuff up?
    Wikipedia is not much of a help…

    I took Ginsing for a long time and then stopped for the same reason.

    WHERE IS THE SEARCHABLE DATABASE!?!?!
    ARRRRGGGGG!!!!!!!!

  54. John

    @jedibear (again)

    I have to be honest and say that my opinion of acupuncture has been biased by hugely positive personal experience with the treatment. Some of which could be attributed to the placebo effect and in one case, definitely not.

    I originally tried it to giving up smoking, and it reduced the cravings considerably. It also had the surprise side-effect of completely resetting my sleeping pattern, something I had not been warned about, but learned later is a common phenomenon.

    Being able to fall asleep at 11 and wake up at 7 without feeling tired during the day was something I’d not been able to do for years.

    And I concede, personal experience != scientific method.

    I think more research is definitely required. In the meantime I’d recommend it for anything pain, craving or sleep-related.

  55. Chris

    i think this is a pretty good article on acupuncture:

    http://www.skepdic.com/acupuncture.html

    to sum up (probably badly): a placebo opiod (pain relief) type effect occurs amongst many of those receiving traditional treatment (needles placed in specific traditional points), at the same frequency as when the needles are inserted randomly AND when the needles only appear to be inserted but ARE NOT INSERTED AT ALL.

    the common thread as i read it seems to be that the patient believes he improves after undergoing treatment (or sham treatment) from a (supposed) professional in a clinical setting – it doesn’t work if you do it yourself. basically, having someone who seems to know what they are doing fuss over you for an hour makes you feel better. you get some attention from somebody – which Western med can be kind of bad at sometimes. personally i wouldn’t bother with it.

    massage, otoh, may or may not have any medicinal value. don’t know, don’t care – it still feels really good.

  56. Greg in Austin

    @Mark,

    Try WebMD.com

    8)

  57. Chris

    @Mark

    i like http://www.skepdic.com/ for an assuredly skeptical viewpoint.

  58. Greg in Austin

    John said,

    “Acupuncture has an empirically measurable effect on the entire nervous system.”

    Please provide a link to the research study (or studies) that supports this claim. I’m especially interested in the study that shows how poking your foot with a needle can relieve allergies, as some acupuncturists claim.

    “I originally tried it to giving up smoking, and it reduced the cravings considerably. It also had the surprise side-effect of completely resetting my sleeping pattern, something I had not been warned about, but learned later is a common phenomenon.”

    I had the same thing happen to me… I lost weight, felt better, and was cured of my years of insomnia and depression. I sleep like a rock and have more energy than I’ve had in 20 years. Oh, but I’ve never had acupuncture. I simply got off my butt and exercised 4-5 times a week while training for a marathon. Its amazing what some medically proven diet and exercise can do for a person.

    Please forgive me if I sound skeptical. Do you think the real cause of the change in your sleeping patterns could possibly have been the reduction in nicotine intake?

    8)

  59. John

    @Greg

    Haha. Forgiven.

    “Please provide a link to the research study (or studies) that supports this claim.” – already answered this one.

    Yes, going to the gym worked pretty well for me too. No need to confine yourself to one kind of therapy. Good point though, regular exercise, sleep and a good diet trumps all other alternative and conventional treatments. Preventative medicine I think they call it.

    I never said my nicotine intake was reduced, just that the cravings were, I had to remind myself to smoke, sometimes even forgetting I smoked for hours at a time. I had insomnia before I started smoking too, so I doubt nicotine is the cause.

    Poking your foot with a needle can’t stop allergies, as far as I know. No need to clutch at straw men.

  60. Mark

    @Greg
    Good call.

    Just spent 20 min looking through that site, trying to make a fool of you for suggesting it.^1
    No such luck :)
    DAMN! they even list journal articles and study sources!

    …bookmarked for future reference. :D

    1: I have a natural tendency to reject any information from such “corporate” looking and advertising sites. My own irrational bias, to be sure… problem solved and corrected :)

  61. Timothy from Boulder

    Old Geezer, Re: Post #26>

    I do not “reject out-of-hand any doctor who might consider ‘non-Western medicine'”–in my search for a primary care physician that most closely matches my philosophy, I have chosen to narrow my search in an efficient manner by searching for ones who do not subscribe to “non-Western medicine.”

    Yes, I acknowledge that an acupuncturist might create a “cure” by even a placebo-effect treatment, but placebos are a part of “Western medicine”. And while I do acknowledge it may work for some patients, I suspect it wouldn’t work for me because I don’t expect it to “cure” me.

    I simply choose to search for a doctor that subscribes to a particular line of thought.

  62. Greg in Austin

    @John,

    I stand corrected. Its not the foot, its the elbows and eyebrows that “help” with allergies.
    www .geocities.com/jrh_iii/acupressure/acupoints.html

    This is from the American Academy of Medical Acupuncture:

    “I find it gratifying to treat seasonal allergies with acupuncture. There is often a quick response. Often patients get some relief during the first visit while lying on the exam table with their acupuncture needles in place”

    www . medicalacupuncture.org/acu_info/articles/allergies.html

    And I must have missed it. I didn’t see a link to a study in any of your posts. Oh, do you mean when you said,

    “3. It’s already been done, and the results were pretty conclusive.
    4. Don’t be lazy, google “fmri acupuncture””

    Forgive me if I don’t take your word for it. You made the claim, you have to provide the evidence. Either provide the source of your claim, or admit you made it up.

    8)

  63. John

    @Greg

    elbows and eyebrows? never knew that. If i ever suffer an allergy ill be sure to consider it, but only if the anti-inflammatories don’t work. I still have some faith in conventional medicine, even though it’s failed me on occasion.

    “4. Don’t be lazy, google “fmri acupuncture””

    dude, seriously…. ok in lieu of your missing keyboard: I made it up.

  64. Greg in Austin

    John said,

    “Good point though, regular exercise, sleep and a good diet trumps all other alternative and conventional treatments. Preventative medicine I think they call it.”

    Actually, I wouldn’t say that trumps conventional treatment, I’d say it is conventional treatment. Its not preventative if you are already overweight and have health problems. Its just treatment. ;)

    8)

  65. Greg in Austin

    John said,

    “If i ever suffer an allergy ill be sure to consider it, but only if the anti-inflammatories don’t work.”

    Why would you use an anti-inflammatory to combat allergies? Maybe you meant antihistamines?

    8)

  66. John

    antihistamines – yes. I’m not a doctor, you know that right?

    allergies can cause inflammation though, im sure it would be worth a try ;)

  67. David Fox

    Perhaps the FDA should have Gestapo – like police powers and put all these fraudsters out of business, shutter the doors of business that cater to medical fraud, such as GNC.

  68. Greg in Austin

    @Mark,

    Don’t you know, if its on the intertubes, it MUST be true!

    I hope it helps! I’m not a doctor, and I certainly don’t recommend using website instead of seeing a real doctor for a real problem. But I first heard of WebMD from a magazine I picked up, believe it or not, in the waiting room of my doctor’s office.

    8)

  69. John

    @David

    Would you include dangerous and controversial conventional treatments likes ECT?

    or conventional medicines that have been shown to be no more effective than placebos, like certain anti-depressants?

  70. Greg in Austin

    @John,

    I ain’t edumacated enuff to be no doctor neither!

    Right after I posted that, I realized that some allergies probably do cause inflamation. Bee stings and seafood allergies come to mind.

    No worries!

    8)

  71. No one in any of these posts has mentioned what I feel is the major drawback to “alternative” medicines like echinacea: they’re classified as “dietary supplements” and subject, in the U.S., to ZERO regulatory oversight. You can have no confidence that a bottle of “echinacea” or “St. John’s wort” or whatever even contains any of the active principle, or how much. So even if they did work (and it’s clear from this study that they don’t), how could you get valid results without any confidence in the dosage level?

    Obviously this doesn’t apply to acupuncture or chiropractic. I’m as skeptical about these practices as anyone. I went to a chiropractor for a stiff neck, many years ago (and I can’t use a telephone any more unless it’s plugged into a headset…), and he told me he could also cure the allergies for which I was getting (at that time) 4 shots a week. I declined.

    @Larian Le Quella, thanks for the link to What’s the Harm – I’ve bookmarked the site.

  72. John

    In an ideal world, we’d be able to separate the the bogus quacky stuff from genuine medicine by referring to the labels ‘alternative’ and ‘conventional’

    Unfortunately it’s not that simple. There’s plenty of bogus conventional medicine and enough valid alternative practices to make this distinction fail horribly.

    I think that’s been my point all along.

  73. Steven

    Actually, I like to keep a bottle of Echinacea around for colds. The liquid stuff.
    When I start to feel a cold coming on I just think about drinking some Echinacea and my body, panicing at the thought of having to drink something that tastes THAT BAD, kicks the crap out of the cold before I make it to the cupboard.

    Not only does it work, but it’s cheap! One bottle is all I need forever. Bawhahaha.

  74. John

    Steven, that’s negative reinforcement. Positive reinforcement is more fun.

    It’s amazing how quickly a cold disappears if a naked woman is presented to you.

  75. Miranda

    For everyone that’s been asking for a reliable source, I have two suggestions.

    1. Read the book Trick or Treatment, by Simon Singh and Edzart Ernst. They explain in very understandable detail how double blind clinical trials work, what the placebo effect is and why it matters, and how studies have been created to test alternative medicine. They have compiled the research of dozens of studies on many, many different alternative medicine and therapy techniques, and they go into particular detail on Chiropractics, Acupuncture, Homeopathy and Herbal medicines.

    What I found especially interesting is that they also address the risks of these alternatives and weigh them against any benefits that have been proven in clinical trials. For example, Chirpractics has been shown to possibly have a slight benefit for certain types of lower back pain (over placebo) BUT … it seems the risks of injury to the cervical artery associated with neck adjustments could be as high as 1 in 100! So it’s important to consider alternative medicine in this kind of context … just how much better is it than conventional therapy AND what are the associated risks.

    They have also presented some thoughtful arguments regarding the unintended dangers of alternative medicine (for those of you who think ‘placebo improvment is better than nothing’), which range from the risk of abandonment of proven conventional therapy, risks regarding dosage and contamination of unregulated alternative drugs, risks of injury or death from physical therapies like chiropractics and acupuncture and so on.

    2. The website http://www.cochrane.org compiles volumous independent trials of alternative medicine into a kind of meta-data analysis (the best way to gather enough individual data points from various small and statistically insignificant studies to make for a decent clinical trial from which to draw conclusions). Their results are extremely honestly represented, including whether they had to include lower quality studies in order to obtain a large enough data set. All of their analyses on alternative or complimentary medicines can be found here: http://www.cochrane.org/reviews/en/topics/22_reviews.html

  76. Sorry Phil — since Science does not understand much of human physiology, your argument fails. Science cannot be cut and dried when it, at best, can only explain a tiny fraction of the phenomena it attempts to examine. Your dogmatism is showing. Also, you are way out of your scientific specialty, astronomy. Stick with your authoritative specialty.

  77. @John:

    The distinction doesn’t fail.

    There’s very little bogus medicine on the “conventional” side of the line, and very little legitimate medicine on the “alternative” side of the line.

    Especially as (and this is the cool thing) one of the things scientific (“conventional”) medicine does is investigate the claims of folk medicine, and put them into use if they have any efficacy at all. As Phil mentioned, this is how we got aspirin. It’s also part of how we got vaccines, and a rather surprising raft of other stuff.

    For the record, there have been some positive results from studies on acupuncture, but because procedures are notoriously difficult to control for, these don’t really confirm the efficacy of the treatment, nor necessarily suggest a functional mechanism distinct from the placebo effect (which can be powerful. Especially for the relief of pain.) There have been a fair number of negative studies as well. More (and better) research should probably be done, and you can bet that it will…

    …since that’s what science does. It studies things.

  78. @Doug Watts

    What was Phil’s argument exactly, and how did it fail?

    Your own argument doesn’t really come to a point, short of telling Phil to shut up for an absolutely asinine reason. It does start with an absolutely hillarious fallacy though.

  79. MadScientist

    I wonder if any group like Quack Watch maintain a list of folk cures proven to be ineffective.

  80. Phil, on second thought, the flaw in your post is that you are trying to prove a negative. As an example, as far as I know, no materialistic, bio-chemical explanation exists for the placebo effect, even though it is well documented empirically. This suggests that there is a lot we don’t know about human physiology. What makes it work? Why only some times, to some degree, in some cases, but not others? We don’t know. The placebo effect exceeds our limits of understanding at present. This is all in a way of suggesting the studies you have cited are the beginning of the exploration, not the end.

  81. I would also suggest that the terms “alternative medicine” and “conventional medicine” are poorly descriptive and dilatory. Most medicines are either naturally produced by plants or are refined and modified versions of chemicals naturally produced in plants. The entire pharmacopia of medicine is built on the foundation of refining and use of plant materials dating back in human history for more than 100,000 years. The techniques of medicinal testing today are much as they were when Neanderthals were around: trial and error. Test for an effect. If there is a noticeable, positive effect, continue use. If not, try something else. By saying this, I do not intend to condone quack medicine hucksters eager to make a buck off others’ discomfort. Just the opposite.

  82. LukeL

    The problem with these studies is they test the product after the person gets sick, it is like testing a rust inhibitor on a car that already has rust, the damage is already done.

    I would like to see studies where a person is given high dose vitamin C or other natural treatments for weeks or months and is then infected with the pathogen that it is suppose to protect against.

    Much anecdotal evidence is out there that those who take supplements, eat right and exercise more have fewer infections and when they are ill they have shorter illnesses.

  83. I have been known to use “alternative medicine” as what I think of as a placebo inducer. Only once that I can think of, during pregnancy. Placebos are about all you can take during pregnancy, so I figured it was worth a shot.

    I’m not sure what that says about me, or how I thought a placebo could work if I didn’t really believe the treatment could be effective… Whatever happened, I got the outcome I wanted – placebo, coincidence or effect. However, I do sometimes wonder about the validity of a placebo inducer.

  84. Peter B

    #87 LukeL said: “The problem with these studies is they test the product after the person gets sick, it is like testing a rust inhibitor on a car that already has rust, the damage is already done.”

    My understanding is that these products are tested in exactly the same way that they’re intended to be used. That is, if they’re supposed to be given to someone after they show symptoms, then that’s when they’re given in the tests.

    Now this isn’t to say that potentially useful products have been scuppered in tests, but if so, that means *everyone* who’s using those products has been using them incorrectly.

  85. Charon

    Doug Watts: “as far as I know, no materialistic, bio-chemical explanation exists for the placebo effect, even though it is well documented empirically”.

    That’s because you haven’t looked into this, have you? As far as I know, there’s no granite in Australia or internet access in Ecuador, but I haven’t freakin’ checked, so I’d hesitate to make a pronouncement about it. Wait… you were the one who just chided Phil about sticking to his specialty. Goodness, you are so precious!

    Read _Snake Oil Science_ by R. Barker Baussell. He explains a substantial body of work that has gone into finding some of the actual physical pathways by which the placebo effect works.

  86. Charon

    I also want to point out how science often works. It finds some phenomenon, then tries to come up with explanations for it, test those explanations, refine them, etc. There is thus a period during which there are no or no good explanations. In my field (physics), a great example is atomic spectra, discovered in the 19th century and put to good use, but which had to wait until at least 1913 (really the 1920’s) for any good explanation.

    When there’s something you don’t understand, you don’t just say, “Magic!” and declare that science will never figure it out. Historically that bet has always been on the losing side.

    Not that this applies to the placebo effect anyway. But it did in the 1950’s, for example.

  87. JB of Brisbane

    Doug Watts calling the kettle black –

    “…since Science does not understand much of human physiology, your argument fails. Science cannot be cut and dried when it, at best, can only explain a tiny fraction of the phenomena it attempts to examine.”

    Sounds pretty dogmatic to me.

    BTW Charon – There is a FRAKKIN’ lot of granite in certain parts of Oz. Try Googling Australia “Granite Belt”. Or better yet, get onto Google Earth, call up Stanthorpe, Queensland, and have a pan around.

  88. Michael Kingsford Gray

    56. John Says:
    ../Some of which could be attributed to the placebo effect and in one case, definitely not.

    Ah yes: the very sad, very old, and thoroughly illogical argument “from personal incredulity”.
    How unconditionally pitiful.

  89. kikilis

    At last some superb article appeared. I often argue with dumbasses about alternative medicine, and i always say it is proven not to work, and i’m always being asked to give them the proof.. So here it is, in my bookmarks now… and ooh, i guess i will be asked for a proof, that this article is true..

  90. Grand Lunar

    Wait, Echinacea doesn’t really work?

    Is it good for anything, other than reducing the mass of people’s wallets?

    I’d really like to know, since my family regulary uses this to get over a sickness quicker.
    I have to wonder if our seemingly quick recovery from certain illnesses is just a placebo effect.

  91. Colin

    Echinacea doesn’t really work as a CURE for the common-cold. There is no known cure for the common cold.

  92. Ginger GIVES me nausea! Bummer.

  93. Chris

    @95 Colin

    We can put a man on the moon (depending on who you ask), and a robot on Mars, but we still can’t cure the common cold! It’s a revoltin’ developmink I tells ya!

  94. Gary Ansorge

    The biggest problem with alternative medicines is that they are touted as alternative MEDICINE, rather than ALTERNATIVE medicine.

    Hope that’s not too subtle,,,

    I’ve tried Glucosamine and chrondroitin, etc and it had exactly
    ,,,zero effect(but then, I’m also not a very good subject for hypnosis).

    I tried Saw PAlmetto for my BPH(based upon in vitro studies that suggested it could interfere with 5 alpha reductase) and, so far, I’ve seen exactly,,,zero effect.

    What DID have a very significant effect was,,,(wait for it),,,sulfa drugs. They decreased prostate enlargement by 50 CCs. Gee, I guess I had an INFECTION??? Who’d a thunk it?

    ,,,and, for minor joint pain, an extract of the willow tree worked quite well,,,

    Pharma cos. search the world for bioactive plants and try to identify active ingredients. Why? Because plants have had a billion years of trial and error to produce the chemicals of life and some of those are useful to us, read, potentially health enhancing, life extending and profit making(Ooh, maybe I shouldn’t have included that last one).

    I’ll just note, in passing, that one of my favorite bioactives benefitted from the woo factor when it was realized it actually had anti-nausea and pain relieving effects for victims of aids and cancer(early reports were declaimed because they were all anecdotal). That made it a medicine instead of just an intoxicant,,,(oh, you want to know which bioactive I’m referencing? Let’s just say that under current federal guidelines, it’s still illegal,,,)

    I think people should be legally allowed to experiment with whatever drug, therapy, gadget they want, but for societies profit, they should be required to log their experiments with a central registry. Then, if something actually shows some significant effect, scientists can search that database for correlations(could also document the undesirable side effects, with self selecting human guinea pigs).

    I will end this diatribe with one comment about massage. I like it a lot, as long as it’s carefully applied to the proper area of the body,,,

    Gary 7

  95. Gary Ansorge

    96. Colin

    Actually, there is a very effective cure for the common cold. It’s called time and a functioning immune system,,,

    GAry 7

  96. Lawyer

    While Alternative medicine is all fun and interesting…. something really big is going on that going to effect many Americans, especially those with Health Insurance…

    The American Medical Association has said it would go to all out war to prevent legislation put forth by the Obama admin ( http://www.huffingtonpost.com/2009/06/11/american-medical-associat_n_214132.html – there’s a funny “socialist” medicine Reagan Rant video on the link)

    Wouldn’t be the only time the Republican’s and AMA got together for a Grand Ole Party!

  97. Miranda

    Doug Watts,

    Just because science can’t fully explain the placebo effect doesn’t mean we can’t measure it’s effect. And in being able to measure it, we can also compare it to other effects. In the simplest example, if 100 people are given a placebo and 20 show some kind of improvement, while 100 people are given a particular drug or therapy and 20 show improvement, we can conclude that the drug or therapy is no more effective than placebo which in turn leads to the conclusion that the therapy itself is not effective in treating the problem. It makes no difference how the placebo effect works, it just matters that we know it exists and have learned to account for it.

    However, if 100 people are given a certain therapy and 90 show improvement, we can conclude that the therapy is better than placebo in treating the ailment. And this is really the key. If I have a disease and I have been openly presented with the options of one therapy giving me 20% chance of improvement and the other giving me 90%, I’m going to choose the second. Of course, this choice becomes more complex when taking the risks of each into account but again, fair representation of those risks is all I’m asking for and all too often alternative therapies fail greatly in this respect.

  98. Andy A.

    I know this post pertains to human alternative medicine, but I have a story about pets and alternative medicine. I have a 100lb. Great Dane named Shadow. She will be 9 years old this September. She has never weighed more than 105 and our vet has always said that she is the ideal size and weight for her breed and gender. Large breed dogs, especially in their advanced years, are very prone to arthritis and joint issues. Our veterinarian suggested that we start her on glucosamine and chondroitin supplements a few years ago and we did. She has been getting around fine when she is on it. However, we have run out a few times for extended periods, weeks at a time, and she becomes a totally different dog. Lethargic, has trouble getting up from laying down, going up and down stairs, not playing with her toys. Obviously not very comfortable. Then, once we get some pills in, after about a week she is back to her playful energetic self. So I don’t think there is a placebo effect for her since she also takes other pills for a liver problem and allergy issues. All she knows it that she gets chucks of hot dogs throughout the day. In my admittedly unscientific study, glucosamine and chondroitin seem to work for my canine.

  99. Robert

    I’m surprised to see glucosamine and chondroitin on that list. I know I’ve seen a good study shoing that it does work [I’ll try to find it]. And (anecdotal I know), it does work for me — I can tell a reall difference in the “ratcheting” in my knees when I am on it and when I am not; and so can those around me who hear me pop and snap.

  100. @Andy A.

    Regarding the placebo effect and animals, there are several factors to consider. First off, when you run out of pills, does she still get the same amount and sizes of chunks of hot dogs at the same schedule as when you have the pills? That’s a variable that needs to be controlled. Second, and perhaps most importantly, is that you are aware of when she receives her pills, and so your perceptions of how she is doing can, unaware to you, be a source of bias. That is perhaps the biggest reason to have the experimenters blinded during clinical trials.

  101. For information on echinacea, here’s the first link that came up when I searched the NCCAM web site: http://nccam.nih.gov/news/newsletter/2005_fall/echinacea.htm

    It concludes that echinacea does not affect whether someone will become infected with the common cold, nor the severity or duration of the cold.

  102. TheBlackCat

    To echo what Todd said, google “clever hans phenomena” to see exactly how large of an impact the researchers can have on an animal’s response to tests. To put it in short, a miraculous horse that was apparently able to do fairly complex math by tapping his hoof to give the number of the answer was actually just tapping its hoof until the people watching gave it a subtle cue that it had tapped its hoof the correct number of times. It fooled a bunch of scientists, though, because proper controls were not used. The people doing the testing knew the correct answer, as soon as people knowing the answer were isolated from the horse its ability disappeared.

  103. Gary Ansorge

    AH! Placebo effect,,,so many endorphins, so little cost,,,

    I’ll note here: the placebo effect even works for low sentience critters who are first given their placebo with a bioactive compound, then when given just the placebo, they continue to react as though they had been given both. We call that an associative stimulus effect, like Pavlovs dogs,,,no intelligence required.

    Too bad we haven’t determined how to utilize the placebo effect to make people smarter,,,

    GAry 7

  104. Charon

    JB of Brisbane: I believe you about the granite in Oz. I was trying to think of examples of things that probably were true, but that I had never heard any information about, and therefore didn’t know were true (and thus by Watts’ “logic” should conclude aren’t true).

    So I showed my ignorance about Australia and Ecuador… would like to go visit both places at some point. *sigh*

  105. I’m sick.

    And as I write this, there are 4 echinacea tablets lining the function row of my keyboard. I had taken them once before at my housemate’s suggestion when I complained of coming down with a cold, and I noticed a markedly quick turnaround time from sick to healthy.

    However, I know now that the brain is easily-fooled organ, and that the placebo effect is not only a real, but very powerful phenomenon. I confess to being a newbie when it comes to skepticism, having been in the game barely a year. It had never even crossed my mind that something as casually acceptable as echinacea, available at any CVS, might not be a scientifically-acceptable remedy.

    So, thank you. Each time I read something like this, it’s a reminder for me that every facet of my life needs to be approached with a critical mind, not just “big” issues like religion or politics.

  106. John Randall

    Darren: The product you are referring is call Fruit Advantage Cherry Prime. My mom takes this product too. It is the first to combine the anti-inflammatory properties of tart cherries with glucosamine and chondroitin. She found out about Cherry Prime because my sister’s friend works for the firm that helped them get their patent on Cherry Prime. My mom swears by it and has been taking for a over a year. Here is a link http://www.traversebayfarms.com if you are interested. You can get it directly from the company

  107. Here’s what it boils down to, at least in the U.S., when it comes to alt-med (for medicines, anyway):

    If a box has the little label that says “This product has not been evaluated by the FDA and is not intended to prevent, cure or treat any disease or condition” you’re probably better off not using it. Why? Because that little label means that it is not really regulated. The product most likely has had no studies down to a) show that it is effective, b) that it is safe, c) that it is a stable formulation or d) that it actually contains what it says it contains in the amount it says it contains.

  108. drewski

    Grand Lunar – fun experiment. Tell your family that echinacia doesn’t make sickness shorter or help you recover, that’s it’s just a placebo and all in their heads. Then continue to take it, along with your family. See if you can induce the placebo effect KNOWING it’s a placebo effect.

  109. John

    @ Michael Kingsford Gray

    “Ah yes: the very sad, very old, and thoroughly illogical argument “from personal incredulity”. How unconditionally pitiful.”

    I alluded to your point in my post, quite clearly.

    I was explaining my position, not throwing forth proof.

    Failing to read an entire post is ‘unconditionally pitiful’

    Nice putdown btw, i’ll save that one.

  110. John

    @ Gary Ansorge

    “Too bad we haven’t determined how to utilize the placebo effect to make people smarter”

    You’d be surprised how much better people do in exams when they’re relaxed and believe they’re going to do well.

    I wonder if study drugs like ritalin/adderall have a placebo effect?

  111. Davidlpf

    Speking of medical frauds Kevin Trudeau now has a book out giving finanicial advice, “Debt cures, they don’t want you to know about.”

  112. Scientific studies of alternative medicines have traditionally been designed to prove that alternative medicines do not work. When you enter into a scientific study with a bias or a preconceived notion about a relationship between variables, then your study is flawed. Kids working on science fair projects, particular medical ones, need to enter with an open mind so that their results are viable and not biased or corrupt.

  113. The Ill Tempered Klavier

    @Medical Science Fair Projects

    A major objective of a well designed scientific study is to prevent the personal bias(es) of anyone involved from affecting the outcome.

    This is what double blind is all about

    The people administering the substance under test don’t know if they are administering the the real substance or just handing out sugar pills, injecting distilled water, or whatever.

    The subjects don’t know what they received and the people evaluating effects don’t know who got what.

    Considerable care is also generally taken to keep conditions as close as practical to optimum for the treatment under evaluation.

    Regardless of how firmly careful and accurate recording of data is emphasized (“The results are the results. They may not be what we want or think we should get, but they are what we get and what we write down.” I remember those lectures from Dr. Sieler, Mr. Purdy, Mr. Linder, Mr. Force… very well.), it’s nearly impossible to go out to record data without some expectation of what the data are going to be. Good experimental design builds in compensation for this.

  114. John

    @ The Ill Tempered Klavier:

    Within the scope of one set of results that works perfectly.

    The decision about whether to ignore, publish or widely publicise those results can be based on other criteria, as can the decision about which variables to test in the first place.

  115. TheBlackCat

    @ Medical Science Fair Projects: The problem is that the NCCAM is not known for being pro-science, skeptical organization. It has been known overwhelmingly as an organization that is more interested in giving credibility to alternative medicine than testing anything. The studies it has funded have been generally worthless, it’s staff has a huge pro-CAM bias, and all in all it has been a total waste of time and money. There have been demands for years to shut it down because it has done absolutely nothing to actually see whether CAM treatments work or not, it has been nothing but another CAM PR stunt.

    I think the whole reason the NCCAM was set up is very telling:

    the conduct and support of basic and applied research…research training, the dissemination of health information, and other programs with respect to identifying, investigating, and validating complementary and alternative treatment, diagnostic and prevention modalities, disciplines and systems.

    Nowhere does it say it is supposed to test the effectiveness of CAM, it is suppose to “validate” it. So the organization is set up from the get go with the assumption that CAM works, and their job is merely to demonstrate this.

    That is why the current study is so significant. The organization’s bias has been overwhelmingly in favor of CAM, not against it. That makes these results, frankly, shocking. I would never have guessed the NCCAM would ever, under any circumstances release any information even the least bit critical of CAM. The fact that they did should tell you a great deal about how conclusive the studies were.

    I’m actually surprised Phil didn’t bring up this issue. I think it tells us a great deal about how strong the studies were. Well, I guess you know what they say about stopped clocks.

  116. sm

    I think people sometimes misunderstand the placebo effect — they assume that it’s simply a form of reporting bias, in which respondents under-report symptoms because they have been “fooled” into doing so. But in fact, there’s a lot of evidence that the placebo effect achieves _real_ reductions in symptoms, even when those symptoms are being objectively measured, and I think that in cases in which no more effective treatment exists, the placebo effect should be embraced, regardless of how it is achieved.

    In other words, acupuncture may simply “work by placebo,” but in at least some cases, that’s fine — it doesn’t mean people shouldn’t ever get acupuncture. It’s an effective procedure that achieves real effects.

    The question then becomes not “should we accept alternative medicine” but rather, “how do we discern between placebos.” If two placebos achieve equal effects, then I suppose we should go with the cheaper one. But given the complexity of the placebo effect, it’s possible that — as crazy as this sounds — the more expensive treatment might work better! In that case, how are we to make a sound ethical judgment? I’m not saying we shouldn’t be skeptical of alternative medicine; but it’s important to weigh the benefits and costs of different approaches to the problem. I think the issue of determining scientific truth is different from the issue of determining proper medical treatments, and they won’t always agree.

  117. TheBlackCat

    @ sm: You are both wrong and right in several regards. First, the placebo effect can manifest as changes in reporting and/or perception of symptoms, and that works for a wide variety of different symptoms. Second, it can lead to relaxation which allows the body to move out of fight-or-flight mode. Fight-or-flight mode supresses the body’s healing and disease-fighting systems, as well as a lot of other systems not needed for immediate survival like digestion, so resources can be used exclusively by the skeletal muscles and senses. The placebo effect can also lead to a real reduction in symptoms beyond simple relaxation, but from everything I heard this only works when the symptom in question is pain. Based on FMRI studies it appears to work by triggering the endogenous opiod system, the body’s built-in pain killer system.

  118. Rachel

    Ginger is good stuff. I’m the queen of motion sickness, as in, I manage to get car sick while driving, and it seems to do the trick in keeping my lunch where I prefer it stay. Peppermint also works.

    I’ve been lucky enough to find a good chiropractor, to whom I go semi-annually when my back is so knotted up, I look like a hunchback at the ripe old age of twenty-four. Instead of any gimmicky things, he keeps a massage therapist on staff, who does way more to loosen muscles than needles, electrodes, or other such things ever will, at least in my experience. I grew up in the health food business, so I’ve met my fair share of the other type, and it is a shame that they often ruin the reputation of the entire field by trading any logical procedures for fanciful nonsense to cater to the whims and wallets of woo-woos.

  119. Marc

    “I’ve been lucky enough to find a good chiropractor, to whom I go semi-annually when my back is so knotted up, I look like a hunchback at the ripe old age of twenty-four”

    You realise that if the problem is your back, then you treat your back? Any good physiotherapist would probably do the same thing and give you exercises you can do to fix the problem.

    Saying that chiropractic is sometimes effective, is sort of like saying homeopathy is sometimes effective since if you drink enough solution, you will quench your thirst.

  120. sm

    @TheBlackCat: I see how your reply suggests that I am right in certain regards, but I don’t see anything in your reply suggesting that anything I said was wrong. Could you elaborate?

  121. CelticMinstrel

    Breklor (#17) Said:

    Echinacea doesn’t work? I thought I had read that according to some fairly decent testing, it was an effective immune booster when taken during the first stages of an illness. Taken regularly, it doesn’t work, because (IIRC) the immune system gets “tired” of the boost and drops back down to normal function. I could be wrong though. :)

    Grand Lunar (#95) Said:

    Wait, Echinacea doesn’t really work?

    Is it good for anything, other than reducing the mass of people’s wallets?

    I’d really like to know, since my family regulary uses this to get over a sickness quicker.
    I have to wonder if our seemingly quick recovery from certain illnesses is just a placebo effect.

    Indeed, my first thought on seeing this post was surprise that, “wait, echinacea doesn’t work?” And so I did some research (on Wikipedia, which is admittedly not the best source; though the particular article in question had appropriate citations, which increases its reliability a little).

    And I realized that I was thinking of something slightly different.

    I don’t use echinacea to cure colds. The only time I use echinacea is in cough drops – ie, for relieving coughs and sore throats. And while I admit again that Wikipedia is not the best source, it said one thing in particular that interested me:

    According to Wallace Sampson, MD, its modern day use as a treatment for the common cold began when a Swiss herbal supplement maker was “erroneously told” that echinacea was used for cold prevention by Native American tribes who lived in the area of South Dakota.[4] Although Native American tribes didn’t use echinacea to prevent the common cold, some of the tribes did use echinacea to treat some of the symptoms that could be caused by the common cold: The Kiowa used it for coughs and sore throats, the Cheyenne for sore throats, the Pawnee for headaches, and many tribes used it as an analgesic, including the Sioux from South Dakota.

    (and Wikipedia cited this as the source for that; I’ve no idea how reliable the book is)

    SO, echinacea does not cure colds. It would appear, however, that it works reasonably well for relieving sore throats. Are there any studies on that?

    JediBear (#82) Said:

    There’s very little bogus medicine on the “conventional” side of the line, and very little legitimate medicine on the “alternative” side of the line.

    (emphasis mine)
    Very little? Maybe in terms of percentages, but I can think of a number of things that would probably be considered “alternative” medicine yet are most definitely legitimate: willow bark tea instead of aspirin, certain poppies as a painkiller, indeed anything that led to the discovery of some “conventional” medicine. I won’t speak for how effective they are, but they seem to classify as “alternative”, and they must work or they would not have been used to create a “conventional” medicine.

    It would probably be better to avoid the tags “conventional” and “alternative” altogether, and simply refer to it as what it is.

  122. QuestionEverythingPhilly

    In research, sometimes the results are disappointing, or unsatisfying. Does this make the process of research invalid or the money spent invalid? It’s not a black and white issue.

    Research is a process. Sometimes the results are ‘we found this… but it needs more research’.

    I ask the blogger, Bad Astronomy – Is it more shocking to you that they spent billions of dollars or that they even challenged common alternative healing methods/medicines? Do you really find it inappropriate or surprising that someone is trying to scientifically challenge alternative medicine claims?

    Science needs to challenge these claims, especially the more popular methods of alternative medicine, because people are using them and they could be dangerous or even effective. I hope we can agree that, science can be an important tool to help defuse false believes.

    The idea of the article is to try to debunk the some of the myths in alternative medicine. I appreciate the skepticism. Yet, the way the author presented the ideas in the article are seemingly bias and could be confusing for the average reader. For example, the author found a quote on Acupuncture and then talks about the Acupressure study which are two different things. I feel the author should have distinguished between the two or at least defined the terms. There are scientific studies supporting Acupuncture models are valid.

    The author also quotes, Dr. Edward Campion from the New England Journal of Medicine who says – “There’s very little basic science behind these things. Most of it begins with a tradition, or personal testimony and people’s beliefs, even as a fad. And then pressure comes: ‘It’s being popular, it’s being used, it should be studied.’ It turns things upside down,” I’m a little skeptical that ALL the alternative medicine research submitted to the New England Journal of Medicine has little basic science. It’s his job to wade through that research that deserves merit. There are researchers who are building on prior scientific research. If research submitted to the journal has no scientific basis, don’t publish it. I don’t see how an unapproved, unpublished research can “turn things upside down”. What is the issue? What is he referring to? His job? Does it turn his job upside down? Does it make him work a little harder, then maybe he might like?

    The real question is: Are these particular studies valid enough to justify the cost? Yes, alternative methods need to be challenged, BUT my criticism is that studies need to be challenged in the best way so that taxpayer money is not wasted. This can be achieved by 1) building upon previous studies 2) choosing more popular techniques or methods. 3) testing different methods against each other for a reasonable, rational purpose. (Example: 1 acupressure point for a certain amount of time vs. 9 acupressure points for a limited amount of time for anxiety. These would yield different results, or no results at all. Contributing to a bigger picture of acupressure.)

    The author presented the study regarding Acupressure to help loose weight.
    A more pertinent question is does acupressure techniques change a behavior patterns (like overeating)?

    The study only used one set of acupressure points, between the eyes. Different methods of acupressure could make different results. There are such a variety of different acupressure techniques. One example is EFT (Emotional Freedom Technique) that use a specific acupressure technique with multiple points. EFT is a popular method of changing negative thoughts and/or behavior patterns. I’ve observed that many people in the alternative medicine field are familiar with this technique and encourage patients to use it for calming, changing poor self-image, or even allergies. I have spoken to a number of people who testify that they find this technique effective at calming anxiety. Is it a placebo effect or not? This particular technique’s effectiveness needs to be determined and studied. If results show that it’s ineffective, patients would be encouraged by their practitioner to use anti-anxiety medication. BUT, if the results show that it’s effective, use of the technique would be an alternative to anti-anxiety medication, reducing the risk of negative side-effects that come from using a drug. It’s a win-win situation.

    It’s interesting that the Acupressure weight study challenged this particular accupressure technique, but it’s results do not indicate that ALL acupressure or acupuncture is invalid or a hoax. This article is a little misleading and should explain (or give an example) of the ways science have proven alternative medicines to be effective (like acupressure and acupuncture). Overall, the article seems biased to me. For example, the author states this generalization, “As for therapies, acupuncture has been shown to help certain conditions, and yoga, massage, meditation and other relaxation methods may relieve symptoms like pain, anxiety and fatigue.” Then, the author give no examples of studies or quotes surrounding this statement, but gives plenty of evidence supporting his obvious bias against alternative medicine.

    Scientists have started mapping out some ways which Acupuncture works, and have documented neural pathways, chemicals released, and hormones released during treatments. Personally, I haven’t seen too many studies regarding Acupressure.

    The article states “However, the government also is funding studies of purported energy fields, distance healing and other approaches that have little if any biological plausibility or scientific evidence.”

    I have worked for the government with researchers. It’s a fact that government research needs to go through boards who approve the validity of the research first, before they can recruit for a particular study. They require some supporting documentation before they can even embark on a study. The author seems to be uninformed.

    Here is an example of a government study with a favorable outcome about Acupuncture. A study was done by University of Pennsylvania and Veteran’s Health Administration (VHA) on “Efficacy of Acupuncture as a Treatment for Chronic Shoulder Pain” this study, with whose conclusion reads: “The results suggest that acupuncture, combined with a home exercise program, may be an effective treatment for chronic shoulder pain. There may be no difference in efficacy between individualized and standardized acupuncture treatment. The use of standard points may make treatment easier for patient care and for further research studies, while not providing a significant disadvantage in outcome.” The study did indicate some success, and distinguished that in this case, there may be no difference in the outcome when using different methods of treatment. So, not all government studies are as disappointing as the author claims.

    Bad Astronomy, you have the right to wave this seemingly biased article as your flag against alternative methods for healing, but it makes you look uninformed. I encourage you to remove your own personal bias and educate yourself more on both sides of the issue. Build the evidence yourself, instead of relying on seemingly bias journalism. Then maybe you could write something more educational and helpful to the public.

  123. QuestionEverythingPhilly (#129): You say I look uninformed, but you also ask me how I feel about people testing these claims.

    Here’s something for you. Scroll up. Go to the actual blog post. Y’know, the one I wrote? Just above here, on this very page? Look at the first sentence in the second full paragraph, where I say, “Let me be clear: I am not opposed to testing any so-called alternative medicines.”

    And then you say that the idea of my article was to debunk alt med. Bzzzt! Wrong again! I guess I wasn’t clear when I wrote (again, in that article above, the one you’re ostensibly commenting on), “But I am decidedly against these techniques that have been tested and shown to be no better than placebos.”

    And I’m the one you think looks uninformed. Sometimes, before going off on a rant, it helps to read, y’know, what I actually wrote.

  124. Joey

    It is my contention that the nature of the article “Alternative medicine? You misspelled ‘not'” — and that of many of the comments on it — is not scientific at all, or even skeptical, but fundamentally religious. The article’s author, Phil Plait’s, call to prevent scientific investigation of “alternative” approaches has its basis not in scientific findings but in fear and intolerance.

    I say this notwithstanding Plait’s casual containment of his criticism (repeated ad nauseum by Plait and by Ben Goldacre, whose thinking he emulates in similar articles with no specific reference to the source of his beliefs) to “these techniques that have been tested and shown to be no better than placebos”. This is because Plait illogically treats any study failing to find, for a medicine (or technique), an effect differentiable from placebo as having disproven the effectiveness of that medicine (or technique) — or even of the entire system of treatment that it represents.

    Plait and his fellow “skeptics”, here and in their other lairs on the web, repetitively make three bold assertions: that any orthodox western medicine must work, because it has been scientifically tested for efficacy; that it must be safe, because it has been scientifically tested for safety; and that any “alternative” treatment that is effective (which we could charitably interpret as efficacious) and safe has already been recognised as such by adoption into orthodox medicine.

    The nature of such declarations couched in terms of science’s reliability to weed out drugs that are unsafe or inefficacious before they go to market or the reliability of science to make efficacious “alternative” methods “mainstream” is that of expressing a faith not in science at all but in the machinery of business: that the rationality, ethicality, and accuracy of the pharmaceutical industry causes it always to use science in that way. Expressed in the article above and in many of the comments on it is the inevitability that the machinery of business — technological advance, patent advantages, regulation, marketing, sales, profits, shareholder votes — will weed out products that are unsafe or ineffective and will base any decision not to manufacture and market a product purely upon its inefficacy or dangers. Put simply, the ideology at work here is that a product is manufactured and marketed by the pharmaceutical industry if and only if it is shown to be safe and efficacious.

    This is a wonderful belief, and if true would lead to ever more interesting and efficacious remedies and even preventives with never a drug disaster, and I can understand the comfort that it gives those who hold it.

    But a single exception disproves a generalisation. We have already heard here more than a single instance of a drug that has been on the market for many years before being shown to be unsafe or inefficacious or both (need I remind you of the recent meta-analysis of the ineffectiveness of SSRIs, or of the suicides they have become known to cause?). We have already heard here more than one instance of an “alternative” treatment of preventive that, though efficacious, has not been taken to the heart of the pharmaceutical industry or even to the heart of every “mainstream” practitioner. Even the mechanisms by which these failures occur are well understood and have been raised in this discussion.

    Moreover, many other examples of efficacious “alternative” treatments and preventives are on easily accessible public record and have even passed muster in various meta-analyses — but remain “alternative”. Yet, from those most devout in their express faith in “science”, the most rational response to such freely available evidence has been to the effect “I wouldn’t even read it”.

    As a study in religious fervour, it doesn’t get much more interesting than this: that those who profess that their divinations are based in something as utterly rational and potentially corroborative and self-correcting as the scientific method refuse to read or consider the product of that method that offers answers offending the beliefs of the devout.

    The subject actually under discussion in the article and most of the comments on it is not that of science or its findings but that of the understandable but irrational forces that drive human beings to clod together: their fear of the outsider, the uncertain, the different. So far the discussion has largely ignored method and its merits, fact and its observability, wisdom and its getting, in favour of the acceptability of various flavours of attitude, dogma, dissidence, and — most tellingly — utter refusal to consider or even to read contrary findings.

    Those readers who remain unconvinced that such attempts at social control are religious rather than scientific in nature might consider the various calls that the discussion has included to prevent scientific investigation — with the unwelcome possibilities it offers — of the “alternative” methods under fire, and the suggestions that no findings in favour of the efficacy of “alternative” methods should be permitted publication; that those who investigate “alternative” methods should lose funding and position; that those teaching or those using “alternative” methods should be imprisoned or even tortured.

    Those offering such suggestions are not attempting to promote the free communication of ideas; to establish open dialogue as a basis for approximating to the truth; to confer, debate, or investigate. They are attempting to stamp out what they perceive to be competing beliefs.

    The urge to eradicate beliefs contradicting one’s own is a mark not of scientific rationality but of religious fundamentalism. It is a type of insanity, dangerous to the individual and to society. The forces that drive it and the irrationality it signals are, as ever in religious circles, invisible to those so afflicted.

    In the present case, those forces appear to be the link between the unquestionability of the “orthodox” consensus and the availability of funding to do science, and the resultant cultural taboo among scientists to investigate or even discuss rationally anything that has been stigmatised as irrational, from parapsychology (which nevertheless enjoys a great deal of military attention) and astrology all the way to vaccine safety and the efficacy of homoeopathy and acupuncture.

    To touch any of these subjects (and, of course, others) is commonly regarded by scientists as the kiss of death to all potential for a stellar career in science. Yet the stigma of these topics’ irrationality arises not from their inherent irrationality at all but merely from a failure to conceive an explanation for the findings alleged in each of these areas. Far from arising from factual findings (attempting to discuss which would invite open contempt), the wall of silence on these topics arises from the clash between their unorthodox alleged findings and the believer’s orthodoxy.

    Without pronouncing judgement either way upon, or even discussing, the validity or otherwise of any factual allegations in any of the subject areas effectively forbidden scientific investigation, it is possible to evaluate how closely scientifically “informed” conclusions as to their factuality or otherwise have been based in the scientific method.

    Most pertinent here, of course, is the kind of article, and the kind of comment, upon “alternative” treatments and preventives that — without particular (not vague) reference to any investigation, or at least without the courtesy of taking into account substantial criticism of such a reference — assumes as a given their inefficacy and upon that basis their irrationality; refuses all discussion of the truth of its own premises; and treats anybody questioning those premises as beneath contempt or as warranting opprobrium of a kind usually reserved for child molesters.

    Is that science? Is it rationality? Is it sanity? No: it is fundamentalism, pure and blind.

    As a footnote, I note that the very body referred to in the newspaper source that the above article relies on for its scientific findings is the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, a body notorious for declaring all treatments other than very expensive ones “unproven” regardless of the state of the evidence — and that even so, its web site offers access to a host of studies on alternative medicine. Following up merely the a fraction of those on the topic most ridiculed by Plait — homoeopathy — reveals a large number of studies, published (despite efforts such as the above) in real (not fake Merck-funded) journals, that report positive and interesting findings, clinical, biological, and physical, concerning homoeopathy.

    That the author of the above article (not to mention the authors of the comments on it similarly censoring scientific research potentially threatening their beliefs) and articles like it consistently attacking anything threatening to his beliefs failed even to look beyond a newspaper report for his sources of information does not reflects poorly on the journals publishing scientific work or on the worth of funding investigation of “alternative” treatments. Clearly it reflects instead on the integrity and rigorousness of the author too lazy, unwilling, or inadequate to think independently, discuss reasonably, or investigate openly any matter with the potential to shake the edifice of his poor understanding of the world to its wilfully ignorant foundations.

  125. Rick

    > When will people realise…
    > “Mainstream” medicine = Those medicines which have been demonstrated to work.
    > “Alternative” medicine = Those which have not.
    > If an alternative were shown to be effective, it would no longer be alternative.

    There’s another way of looking at this. Treatments that used to be alternative but have become mainstream didn’t suddenly start working when they became mainstream; they worked before, and mainstream practitioners adjusted their beliefs and practices when forced to. By analogy, some treatments that are “alternative” now will one day be seen to be valuable; the people using those treatments now may be ridiculed by the establishment (and many people on this blog) now, but what they’re doing suddenly becomes reasonable when the treatment is shown to work.

    From a totally ahistoric perspective, rejecting all alternative treatments is a reasonable stance (“I’m sensible: I just use treatments that have been shown to work”) but when you start taking into account changes over time it starts to make a bit less sense. And then it starts making even less sense when you or a loved one has a condition that conventional therapies can’t alleviate: the “alternative” treatments you clutch at then may turn out to be straws, or they may simply be yet-to-become-mainstream treatments.

  126. Oh dear, some alternative medicine quacks have managed to raise $20,000 in the fight against logic and reason (in the form of a medical board.)

    http://www.indiegogo.com/takingonthemedicalboard?c=comments&a=689615

    I think it’s time the internet to unite in support of the medical board!

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