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@growhope

First, I never said Bausell was an authority. The argument from authority is fallacious anyway, as you should know. Bausell is, however, capable of perusing Cochrane systematic reviews, and the results of such an analysis are clear: there are almost no high quality systematic reviews of any alternative therapy that result in support for the therapy.

Second, as you also should know as a scientist, it is up to the people making claims to produce the evidence for those claims. And when the claims are as eyebrow-raising as "natural substances are better than synthetics", or "diluting a substance makes it more potent", or "manipulating the back cures colic", the evidence had better be pretty impressive. It's not up to me to produce this evidence. Perhaps you could cite some specific references.

posted 3 years, 12 months ago
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@ drjeffclark

I think we understand that medicine is practiced one person at a time. That's why I go to see my doctor when I'm sick, he examines me, and figures out what to do to help me get well. He doesn't treat all patients as 'the average patient' and prescribe the same thing regardless of what's wrong with them.

Nevertheless, if he gives me a prescription, that drug has typically been tested in trials that prove beyond a statistical point of reasonableness that it is (a) safe and (b) effective for a particular ailment. Thus, if that ailment is diagnosed in a patient, it would be appropriate to prescribe the drug to treat it. I'm assuming you don't disagree so far.

What you do disagree on is that double-blind studies are not the only way to get at the truth about whether something works. Unfortunately, the history of science suggests otherwise. There are many ways in which a remedy can appear to work, even when it has no effect. And the only way to exclude these effects that we know of is to perform double-blind, placebo-controlled trials. That's just the way it is - this is not an opinion of mine, it's been borne out time and again, and it's not going to change.

The corollary is that any medical study that is not performed with adequate blinding or placebo control (especially studies involving pills and similar remedies, which are the easiest to control) is immediately at least suspect, and probably worthless. This is not dogma, and it's not a bias against alternative medicine. We just know from experience that the results of such trials are not reliable and repeatable.

The fact is that most alt med practices, and naturopathy is definitely among them, could be investigated using sound techniques. That would involve things like formation of a hypothesis, random and representative sampling of the population, a statistically large sample size, double blinding, appropriate placebo control, statistical analysis, independent verification, peer review, and so on. It's a lot of painstaking work, but that's how scientific medical research is done, and it is the only way that we know of to be sure that the multitude of potential confounding variables are excluded from the results.

If naturopaths are not willing to do this kind of work, we have to reluctantly conclude that what they are doing is not scientific. That means that what they do may or may not work, but we will never know until someone does the science.

posted 3 years, 12 months ago
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Well, if it's popular in Europe, it must be true!

"Just because some pharmaceutical company hasn't run a study on something doesn't mean it doesn't work." You are right. What we do know, however, (and this applies to several of the posts on this page) is that there are many ways that a remedy can *appear* to work, when actually some other factor is responsible. The placebo effect and regression to the mean are two examples, but there are many others.

The point of double-blind placebo-controlled studies is to eliminate these and other confounding factors, leaving (hopefully) just the effect of the thing you are testing. This is very difficult to do properly. It requires training, dedication, the ability to detect flaws in procedure, and honesty, not to mention time and money. Nevertheless it is the *only* way we know of to eliminate the common confounding factors, and therefore the only reliable way of getting at the truth.

This much is well known, and the desire of alternative practitioners to circumvent this by asserting that therapy X is not conducive to double-blind testing, or that double-blind testing is not the only way to get at the truth, does not change the facts. By now, the need for double-blind testing in medicine is so well understood and documented that to assert that it's not necessary, or not appropriate, seems like deliberate deception.

I'm glad that Vertigoheel worked for you. That may be because it actually contains something (I see from a site selling it that it contains 210 mg of cocculus indicus, for example; I have no idea what that is, but 210 mg of the stuff sounds far above typical homeopathic levels); it may be because your condition went away on its own; it may be because of something else. I have no idea, and neither does anyone else, because it hasn't been tested. For every person like you that had good luck with it, there might be 10 for whom it does nothing other than drain their wallets. Again, no-one has any idea, because the company selling it hasn't done the research, and never will. Personally I think this is a disgraceful state of affairs - we are back to the time of roving patent medicine salesmen and caveat emptor - but you are entitled to spend your money on whatever you want.

posted 3 years, 12 months ago
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@growhope

I'm happy to be in the minority. A discussion about naturopathy in Portland is always going to be an irrational love-fest, and it's important that the scientific point of view be put forward.

I am quite familiar with both PubMed and the history of medicine, but thank you for your advice.

Meta-analyses of alternative medicine studies show that there are vanishingly few that are rigorous, properly conducted, and statistically significant (see Bausell, "Snake Oil Science", for a good overview). And anecdotally it is clear that most naturopaths reject science-based medicine, to the point of questioning vaccination, the germ theory of disease, etc. This is sheer idiocy, and it's dangerous.

posted 4 years ago
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First, there is no such thing as an effective homeopathic remedy. These substances are diluted to the point where typically not a single molecule of the 'active ingredient' is actually present. Scientifically implausible (to put it mildly) assertions by homeopaths about the magic of succussion and water memory aside, this means that the remedy is nothing more than sugar or lactose or whatever the pill happens to be made of. You cannot cure a bacterial infection with a placebo.

If you are using antibiotics as a 'last resort', that means that a potential bacterial infection is growing inside you or your children while you are wasting time with homeopathic placebos and unproven and untested naturopathic remedies. I cannot imagine why you would think this is desirable, or even acceptable. When applied to your children, it sounds to me like gross negligence.

posted 4 years ago
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@starushka

Well, it's not just "my" scientific medicine, it's yours too. You benefit from vaccination even if you don't get vaccinated, thanks to herd immunity. You benefit from proper sanitation, even if you don't believe in the germ theory. You will certainly benefit from the ER should you ever need it.

The reason the US is 37th in the the industrialized world is that there are 36 countries ahead of us, all of whom use scientific medicine as well, and most of whom have some form of socialized medicine. What is your point?

There are no doubt arguments to be made regarding the way that medical care is meted out in the US. This has absolutely no bearing at all on whether any alt med practice is valid. These modalities should stand on their own, regardless of any problems plaguing the healthcare system in this country.

posted 4 years ago
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You don't have to "believe" the body has an amazing ability to heal. Everyone knows that. We have all gotten sick and then recovered. Your implication is that non-NDs do not understand that.  I don't believe you have any basis for such an assertion.

You state "I don't believe that permanently medicating for symptoms is an acceptable alternative to true health". Skirting the meaning of "true health" (I for one have no idea what it might mean), let's be aware that the entire field of alternative medicine relies on permanent medication, or at least regular visits. Chiropractors are notorious for pushing "maintenance" sessions on their clients. Naturopaths devise complex nutritional supplement regimens that are regularly tweaked, ostensibly to "maintain health". That sounds like permanent medication to me, regardless of how you would prefer to classify your prescriptions.

Ultimately, naturopathy simply does not have a body of evidence to which it can point to support its assertion that it "helps [people] regain health". Rather, this is simply stated as an undeniable truth. Rational people would like to know where this certainty comes from. When someone is making such a definitive statement, asking for evidence is the least we can do.

posted 4 years ago
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From a homeopath. They may not be licensed, but they can certainly practise (at one's own risk, of course). Still, why you would bring up the royal family's healthcare choices is beyond me. Since when are they the arbiters of what works and what doesn't?

The Queen Mother, for example, had cataract surgery, a hip replacement, and a blood transfusion, among many other interventions. You can be sure that none of them involved a homeopath.

posted 4 years ago
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First, you seem to be equating "medications" with "conventional, FDA approved drugs". But a medication is any substance used to treat a disease. This then implies that you consider the non-FDA substances you prescribe to be qualitatively different from the conventional treatments. Why do they deserve this distinction?

Second, you state that "naturopathic therapies... work incredibly well to prompt innate healing mechanisms in the patient". How was this fact arrived at? What is the mechanism by which this occurs? What is the active ingredient that promotes this healing? How is it a diagnosis and appropriate course of treatment determined?

The evidence suggests that naturopaths do not have any factual basis for the assertion that their therapies promote healing mechanisms in the patient. The fact is that most patients, for most diseases, get better on their own. This is a consequence of having an immune system. Something, of course, that was discovered and understood by scientific medicine.

posted 4 years ago
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If I understand you correctly, what you are saying is that homeopathy, chiropractic etc are better than orthodox medicine was in the 19th century. Terrific. Unfortunately since then these modalities, like all belief systems, have not moved on and learned from new information. Homeopaths still maintain that their remedies are effective, despite Avogadro's number having been determined in the meantime, utterly destroying the entire field of homeopathy. Straight chiropractors and naturopaths still base their notions on vitalism (indeed the very word was used above by Ms Beck), a thoroughly discredited and naive metaphysical concept, and eschew the germ theory of disease.

In the meantime, scientific medicine has discovered everything we know about the body and disease. Life expectancy has risen enormously and continues to rise; infant mortality has decreased and continues to decrease; once terrifying diseases have been eradicated or are easily treatable. All of the progress in medicine in the last century has been science-based. The NDs and DCs have had nothing to do with it.

And please, stop bleating about 'funding' being the reason that 'natural' medicine is a total failure. The NCCAM is enormously well funded but to date has produced nothing of significance. It is in the best interest of the alternative medicine community to learn how to perform rigorous experiments of their treatments, but judging by the lack of high quality trials in this area, the evidence suggests that they are simply not interested in doing so.

posted 4 years ago
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First, let's please ditch the ridiculous and intentionally pejorative term "allopathic", which is only used by alternative practitioners, and is not recognized by anyone else familiar with the English language. The correct word is "scientific".

It is stated that ND students receive the same training as medical students in all the fields that matter (biology, chemistry, etc). Yet after all this apparent training in the sciences, they emerge with an utterly non-scientific view of the world, in which placebo-controlled double-blind testing is not required and even disdained; where "natural" substances are somehow qualitatively different from, and superior to, "synthetic" substances; and, commonly (though not stated above) where vaccination is stated to be ineffective.

What this suggests is that the ND education system does not emphasize, or perhaps does not even teach, the scientific method, and that naturopathy is not, therefore, a scientific endeavour. Rather, it is a belief system. The public is entitled to believe whatever it wants, but government endorsement and enabling of these beliefs is not in the best interest of society, particularly when it conflicts with well established knowledge obtained by the scientific method.

The majority of states in the US do not regulate or license naturopaths, and the practice of naturopathy is banned in two of them. The UK does not recognize or regulate naturopaths at all. In short, naturopathy is far outside the mainstream. The suggestion above that "modern medicine is beginning to recognize that integrating the best of traditional with the best of the modern benefits the patient..." is completely unsupported, and I suspect that it will stay that way.

posted 4 years ago
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This looks like another step down the slippery slope which leads to anyone being allowed to call themselves a doctor, regardless of training, and prescribe nostrums of all types, whether proven safe and effective or not. We already struggle with chiropractors and naturopaths calling themselves 'doctor'. Now we have to deal with them extending the charade by prescribing actual drugs.

Blurring the line between scientific medicine and unproven therapies can never be good for patients. Allowing naturopaths to prescribe drugs which have been through rigorous testing and peer review sounds like a good idea (it sure beats the other therapies they offer - a quick look at Ms Tricarico's site shows that she practices homeopathy and chelation therapy, amongst other nonsense). But the highly unpalatable side-effect is that it is no longer clear who is an actual science-based doctor who went to medical school, and who is merely a practitioner of new-age mumbo-jumbo with nothing to back it up beyond anecdotal evidence. Which, as anyone who is familiar with the territory knows, is not evidence at all.

We are fortunate to live in a time when vaccination, sanitation, knowledge of disease epidemiology, and high quality nutrition are widespread, allowing our society to be largely healthy and disease-free, whether the naturopaths are peddling their trade or not. Just keep your fingers crossed that when people get diseases that don't get better on their own they'll go to a real doctor for treatment.

posted 4 years ago
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