Edzard Ernst, CAM Critic, Talks with Dr. Brett Kinsler on Chiropractic and Bias

Book by Edzard Ernst complementary and alternative medicine

Professor Edzard Ernst, MD, PhD, FRCP, FRCP holds the Laing Chair in Complementary Medicine at the Peninsula Medical School, University of Exeter and is the Editor-in-Chief of two medical journals. He has also been seen as a major public opponent of chiropractic and alternative medicine. He has devoted most of his career to publishing articles that are critical of complementary and alternative medicine….an unbelievable number of papers. Like 1500 or so. He’s been especially critical of chiropractic and, in the opinion of many researchers, has glossed over important research and exaggerated results. To me, what’s most interesting about Ernst is that he claims objectivity and lack of agenda. This podcast asks some tough questions of Prof. Ernst.

You can get the podcast episode on iTunes by searching the podcast section for “On The Other Hand” or you can just click here.

Thanks to this episode’s sponsor: Audible.com, the audiobook company. Get a free audiobook download just by trying their service free for 14 days.

BMJ Writer Discovers Head Up Ass

photo of a kid on the beach with a clenched fist and the caption "I hate sandcastles."

John C. McLachlan is a professor of medical education who wrote an article in the British Medical Journal (BMJ 2010; 341:c6979) called “Integrative medicine and the point of credulity.”  McLachlan proposed that integrative medicine should not be used as a way of smuggling alternative practices into rational medicine by way of lowered standards of critical thinking. He worries that failure to detect an obvious hoax is not an encouraging sign.

The author, upon seeing a request for presenters at an integrative medicine conference in Jerusalem, submits a paper posing as an embryologist who discovered a new version of reflexology. He explains that he has identified a homunculus represented in the human body, over the area of the buttocks. The homunculus being inverted, such that the head is represented in the inferior position.  As with reflexology, the “map” responds to needling, as in acupuncture, and to gentle suction, such as cupping.

He stops short of telling the conference organizers he has discovered a system whereby the head is up the ass and responds to needles.  Funny, right?  Well, after submission of an abstract with some sciency sounding references, the proposal gets accepted for presentation.  The author declines to present and, instead, publishes the correspondence in the BMJ.

Now, I’m all for having a good laugh at the expense of wacko alternative medicine practices but my goal is clear — I want to help clean up the field in order to highlight the people who are actually doing some good, honest, logical research.  I actually have a problem with what Dr. McLachlan has done.  By poking fun from a distance and walking away without letting the conference organizers in on the joke, the author misses a huge opportunity to educate and possibly improve that which he criticizes. It would have been far better if he accepted a slot at the conference and awaited to see if people would point out the errors in his “research” or simply used the platform to show what bad science is.

The only thing that makes him not a 100 percent coward is that he published his story. Someone who asks difficult questions so that when you answer incorrectly you will learn is called a teacher.   To ask difficult questions and then tell your friends how stupid someone is without letting them in on where their error was is called by a different name entirely.

Remember Smith’s article about how parachutes aren’t evidence based? That one is funny and brilliantly illustrates its point. This article, while funny with its head-up-ones-ass ha ha I get it humor, is really only about as funny as watching your kids get their math homework wrong and, instead of helping them, you call all of your friends and laugh at your kids’ ignorance. Nothing was learned. Nothing was improved and we all feel a little bit sick for participating in the joke.

Yes, it was a hoax but science relies on some degree of honesty and trust.  It is impossible for one scientist to be at the apex of all fields and know all that is known from every discipline.  Isn’t that why we have specialists?  Could it be that the scientific committee accepted McLachlan’s proposal simply in order to learn whether or not this revolutionary discovery was plausible or bunk?  Unlikely, but possible.  Today, I would rather lend the benefit of the doubt to the conference organizers rather than the scientific playground bully.

 

Brett L. Kinsler is a chiropractor in Rochester, NY who writes the RochesterChiro blog and produces the podcast On The Other Hand.

 

Quantum Light Weaving

 

quantumhealing

“Tell me, Doctor, what do you think of Quantum Light Weaving?” my patient recently asked me.

“What do I think of what now?”

“Quantum Light Weaving.”

“You’re putting me on, right?”  My patients know I will usually express my opinion on most things that are wacky and some of them try to get me to take their bait.

“No, it’s a real treatment.  I saw it when I was in California.”

“You’re setting me up for a blog post, right?”

“I have no idea what you’re talking about.  Have you heard of it?”

Well, to be honest, I hadn’t heard of it.  I was almost certain it was something made up and silly.  Light weaving?  Really, now?  I have a friend who was a pretty serious weaver for a while.  I was nearly certain she used wool and fabrics.  Very, very rarely would she weave pure energy or electrons.  Nope, something didn’t smell quite right.  I promised to investigate and get back to this sweet young patient with an opinion.

I performed my usual deep level of research which can be partly reproduced for you by clicking this link.  I learned some amazing facts — and by “amazing” I mean “silly” and by “facts” I also mean “silly.” Quantum Lightweaving is, according to the experts (“salespeople”) “an evolving and ever-expanding body of work that is bringing forth new aspects of spiritual work that embodies The Christos energy from the heart of Creation itself. The vibration is brought forth to this earth and Galaxy through The Council of 14 and your personal healing and support team of masters and angels.”

Okidokie then.  We’re got ancient Christian and presumably Last Supper stuff mixed with galaxy energy and personal support teams of masters and angels.  Hell, I can’t even put together a team that includes a decent plumber, how am I going to get an angel on such short notice?

Have no fear!  Your personal guide is Kenji who teaches you “how to be a miracle man, miracle woman, miracle kid and miracle pet.”  Miracle pet, huh?  Whoa.  Deep, dude.  And for only $25 to $50 there is an assortment of attunements you can download right to your computer.  You can even use your mystical Paypal account!  Let the miracles begin!

Well it all makes sense when you learn that “when we align through the meditative state, or “hook-up,” miracles beyond time and space and distance can occur in the twinkling of an eye.”  Wait…hook-up?  Do they really use “hook-up” to describe a state of being?  How is your hook-upedness today?  I am attempting to achieve the 9th level of hookopcity. Can I hook up my angels to my masters?  Do I need a special adapter? Will that create a miracle pet?  Will my miracle pet still puke on the carpet?

“Lightweaving affects all 144,000 dimensions of your being, or the 12 major levels of your embodiment.”  Awesome.  Lately, I have only sensed like 120,000 dimensions but I thought it was just the weather.  I feel enlightened.  I feel empowered.  I have seen the quantum light show and now know the true answer.  Quantum Lightweaving is…just…another magical way to separate people from their money.

Wash Your Brain With Ionized Water: Mmm Refreshing

 

ionized%20water

Dear RochesterChiro,

What is your opinion of the Enagic and Kangen water ionizers? 

I am told that the alkaline water is microclustered to enhance and speed hydration and that it is a very potent antioxidant. It is said that this technology helps the body heal itself and there are reports that arthritis, fibromyalgia, migraines, high blood pressure, high cholesterol, diabetes and cancer can be helped dramatically by merely drinking alkaline water made by this $4000 Japanese medical device.

Truth or not?

Thanks,

Ed B.

 

Dear Ed, 

Thanks for tossing me this piece of low hanging fruit!  You must know my favorite hobby is keeping my readers safe from (or at least informed about) wacky alternative medical devices.  You’ll be glad to know I have done some research about these water zappers.  Here’s the scoop:  Regular tap water goes in, magical miracle healing elixir water comes out!  Awesome!  These expensive black boxes are purported to:

* Slow the aging process

* Promote weight loss

* Boost the immune system

* Increase absorption of vital minerals and vitamins

* Reverse most chronic diseases

* It slices, it dices, it conceals your bra straps, and gives you rock hard abs.

 

No, wait a second.  That last line is silly.  Or is it all the claims that are silly?  Let’s take a look at what some of these device sellers have to say:

“It is well known in the medical community that an overly acidic body is the root of many common diseases, such as obesity, osteoporosis, diabetes, high blood pressure, and more.”

Really?  This is well-known?  Um, sure it is.  It’s well-known not to be true.   The concept of an acidic body doesn’t even enter into reputable medical literature.

“The water produced by [our] water machine has a pH level of 8.0 to 9.5, which will restore your body to a healthy alkaline state. It counteracts the acidic foods you eat and the harsh elements in your environment, in order to bring the natural balance your body needs.”

Oh, thank goodness it will restore my body to the healthy alkaline state.  Only, how is that alkaline water going to do when it is flooded by the acid in my stomach?  Unless the water is absorbed prior to the stomach (hint: it isn’t – most water uptake occurs in the intestine) once the stomach contents enter the intestine, they are neutralized and made alkaline by pancreatic secretions.  This means that the water you drink becomes alkaline anyway. FOR FREE! What?  And I just wasted four thousand bucks making my water all alkaliny? 

Here’s my fav:

“It enables every nook and cranny of your body to become super-hydrated”

Hold the hell on.  Will someone please tell me why the f*#< I would possibly want to make any of the nooks or crannies in my body “super-hydrated”?  Don’t cells explode when become absorb too much water?  Exploding super-hydration sounds downright uncomfortable to me.

With a little looking, I came across another company that makes acidic water (the opposite of alkaline water) in order to cure ailments like “Hong Kong Foot.”  Twenty-five hundred clams which might be better spent on less pricey acidic liquids at that exotic medical supplier Stop & Shop where you can invest in the acid wonders of orange and cranberry juice.  Lots of acidic water in those.  While you’re at it, better pick up something to spike those juices so you can better tolerate reading the opinions of  “experts” like Dr. Robert Young (author of The pH Miracle).

Oh, thank goodness we can turn to folks like him for good solid information on the subject.  Young’s theory is that there is only one sickness and one disease which is caused by an over acidification of the blood and tissues due to an inverted way of living, eating and thinking. One Disease, One Cure.  Oh, wait, you can stop right there – I’ve heard this one before. 

Unfortunately, the “scientific articles” section on Young’s crapsite lists a long collection of self-serving posts with such catchy titles as “How Acidic are YOU?” and “An Alkaline Lifestyle and Diet May Reduce the Risk of Prostate Cancer” along with a bunch of anti-vaccination stuff and cell phone radiation dangers.  All about as scientific as a magnetic snake oil-filled ear candle covered in homeopathic dust.

Claims about the health benefits of drinking so-called ionized water are not supported by any credible scientific evidence.  Body pH is basically a meaningless concept since different parts of the body can and should have widely differing pH values.  The benefits of alkaline and acidic water won’t be found in any standard biochem textbook.  In fact, pure water is too non-conductive to undergo significant electrolysis by “water ionizer” devices.   Nor can pure water can be alkaline or acidic without containing ions of some kind — most commonly, sodium, calcium or magnesium.   The fact that these things are mostly sold through MLM is like a giant flashing neon sign that says “Stay The Hell Away.”  In case you can’t tell, I am generally not a fan of anything that smells of multi-level marketing but in this case I’d be super-careful of being in anyone’s downline — crap flows downhill.

I’m sorry…have I left you afraid that your body cannot neutralize the effects of acidic food?  Sometimes it can’t.  Like, for instance if you’re dead.  Until that time, you can get rid of all of your excess acid by exhaling carbon dioxide.  Breathe in, breathe out.  That’ll be 4000 bucks please.   

 

Want an opinion on an alternative medicine product?  Dr. Brett Kinsler is a chiropractor in Rochester, NY who writes RochesterChiro.wordpress.com and is happy to give you a piece of his mind – hurry, while supplies last.

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There is no Alternative Medicine…

medicalresearch

“There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking.” — Fontanarosa P.B., and Lundberg G.D. “Alternative medicine meets science” JAMA. 1998; 280: 1618-1619.

This quote was recently presented to me. While I understand what the authors were implying,  something was missed in the execution. The fact is that much of conventional medicine has been unproven and lacks solid data. Diabetes?  Heart disease?  Prostate cancer?  Spinal surgery? We do the best we can with what we have but this quote is an exaggeration.

Certainly the future must be evidence based and we must strive to discover the truth about what is effective, but being evidence-based includes utilizing treatments that the practitioner’s experience deems effective while awaiting evidence one way or the other.

Perhaps it would have been better stated, “There is no alternative medicine; there is only effective medical treatment and treatments that should be discarded.”

 

Dr. Brett Kinsler is an evidence-informed skeptical chiropractor in Rochester, NY

Ear Candling: Sure, It’s Waxy, But Is It Good?

ear_candle

Dear Dr. Kinsler,

What do you think of ear candling?  My sister swears by it but I’m skeptical.

P.M.

Cleveland, OH

Stop me if you’ve heard this one… 

A guy walks into an alternative medical provider’s office.

AltMed Guy: Can I help you?

Guy: What?

AltMed Guy: Can I help you?

Guy: I can’t hear so well.

AltMed Guy: I SAID “CAN I HELP YOU?”

Guy: I heard what you said.  I think I’ve got wax in my ears.

AltMed Guy: Well allow me to stick this cone in your ears and light it on fire to draw out the wax using negative pressure.

Guy: Hahahahahahahaha

AltMed Guy: What’s so funny?

Guy: I thought I heard you say you were going to stick something in my ears and light it on fire.  Wow, my hearing must truly suck!

AltMed Guy: Actually, that’s what I said.

Guy: Oh, okay.  Well, while you’re doing that, could you poke something into my eyes and set that on fire, too?   

You’ve heard of this I’m sure.  Ear Candles. Also known as thermal-auricular therapy.  A hollow candle is placed in the ear and the end sticking out is lit on fire.  Supposedly, the heat from the candle creates a vacuum thus drawing out wax in the ear.  The proof is in the formation of a dark residue inside the candle.

Only, it’s not proof because ear candling is crap.  And dangerous crap at that.  In fact, studies have shown that ear candling not only doesn’t create negative pressure…the same junk is found inside the candle whether or not it’s lit inside someone’s ear. candlecompare

Sounds like it’s a better idea to just light money on fire and see if that helps your ears.  Except the danger from ear candling isn’t limited to its scamminess.  There have been reports of serious damage from the practice.  Hmm…fire near the face inside an opening of the skull…nope, I don’t get it.  Hot wax placed next to the eardrum?  No, I still don’t see the issue.  Open flame and hair?  I just don’t see what you’re driving at.  Anyhow, I’m not sure where the danger comes from but nonetheless I must recommend against this one.

Bottom line: ear candles lack any evidence of efficacy for any condition and do more harm than good.  Period.

Say what, now?

Dr. Brett L. Kinsler is a Rochester, NY chiropractor and produces the skeptical podcast On The Other Hand.

Saline Irrigation for Sinuses – Fact or Full of Snot?

Oh, thank you U.S. researchers, for your cleverness and sense of humor.  Thank you for having the courage to shoot salt water up the noses of 121 adults with chronic nasal and sinus symptoms (stuffiness, congestion, or thick/ discolored nasal discharge).   Thanks for referring to part of the procedure as a large volume nasal irrigation flowed into the nostril and drained out the mouth.  Well, maybe not so many thanks for that as I am actually choking in the back of my throat a little just thinking about a large volume of anything being instilled into my nostril and drained out my mouth.  Echh.

The patients in this study were evaluated using a previously validated instrument, a 20-item Sino-Nasal Outcome Test.  Yes, this tool is called…are you ready…the SNOT-20.  (Thanks for, without a doubt, my favorite named clinical measurement tool to date).  Interestingly, this study showed SNOT scores improved approximately twice as much on average in the irrigation group versus the group that just had regular old saline spray.  There were significant changes at both 4 and 8 weeks.

Bottom line: Nasal irrigation using a stream of normal saline, is more effective in decreasing general nasal or sinus symptoms than saline spray. The saline can be made at home, purchased as a kit, or administered using a neti pot (online videos in places like YouTube will have demos of this).

I know you’re excited but I feel it is my duty to warn you not to go randomly shooting large volumes of liquid up your nose and out your mouth at home without at least doing a smidge of research first.

 

Source: Arch Otolaryngol Head Neck Surg. 2007 Nov;133(11):1115-20

Dr. Brett Kinsler writes RochesterChiro, the skeptical chiropractor in Rochester, NY.

Ionic Foot Baths: Fact or Flush ’em?

I received the following e-mail today:

Dear Dr.  Kinsler:

I saw your website’s page and felt that you have a wonderful resource which can be of interest to users on my website who are looking for Foot Bath Detox. I have a site that provides…Water Ionizers and Ion Foot Bath Detox Units for Professional & Home Use. Our systems are a safe and effective treatment.
 
I hope you will find my website another good resource to be added into your website. Kindly revert back with your preferred linking code, hoping for a positive response from you.
 
Link Manager

Detox ionic foot baths, you say?  Sounds high-tech and healthy!  Actually, it sounds a lot like the detox foot pads I wrote about back in May and decided they were crap.(https://rochesterchiro.wordpress.com/2008/05/15/do-detox-foot-pads-really-work/)

The device is a foot bath connected to an electrical source.  The person’s feet are bathed for 30 minutes in salt water that is subjected to a low-voltage current transmitted through an electrode assembly.  Companies claim the device produces a frequency of positive and negative ions, which resonate through the body and stimulates all the cells within it, rebalance the cellular energy, facilities better organ flow and release any toxins that may have built up.  How do you know it’s working, you ask?  During the process, the water typically turns reddish brown indicating the successful “ionic cleansing.”  Different colors in the water are said to indicate toxins from different organs (yellow for kidneys, etc.)

Does it really work?  Sorry.  It looks like, once again, the detoxification apple doesn’t fall too far from the scam tree.  Multiple experiments with ionic foot baths of many brands and laboratory analysis of the water post treatment show no difference in the amount of “toxins” (like heavy metals) between samples that had feet in them and samples that had no feet in them! It seems that a chemical reaction between the salt water and corrosion from the electrodes produces a change in the water color.

Neat parlor trick, yes.  Cure for autism, liver disease and skin conditions, hardly.

It is, however one more interesting way for unethical healthcare practitioners to magically separate patients from their hard-earned money.

 Dear Scummy Internet Seller of Worthless Quasi-Medical Products:

Thanks for pretending to read my blog.  It is clear you didn’t, otherwise it is extremely unlikely you would have asked me to place a link to your silly, dishonest quackbath.  I will not be providing a link to you nor will I recommend your crappy electronic water box of lies.

Have a great day!

 

Brett L. Kinsler, DC is a skeptical chiropractor in Rochester, NY.  If you have an alternative medicine product you’d like an opinion about, let us know at blog [at] rochesterchiro.com

Well, thank you!

Our blog is being featured on the alternative medicine page of WellMix 360 run by Wellsphere.  Thanks!

Alternative Medicine

Do Detox Foot Pads Really Work?

I have been asked a few times recently about these detox foot pads.  They are supposed to rid your body of heavy metals, parasites, toxins, chemicals, etc, etc. In short, I really do not think these things will work as advertised.  The second part to the short answer is that these things are a scam.  In fact, Dr. Ed Zimney, in his “Dr. Z’s Medical Report” , stated in no uncertain terms, “This is such a blatant scam that it gives other scams a bad name! “

 

You see, substances placed on the outside of the foot and substances circulating within the body will not flow freely from one side of the skin to the other. The skin is simply not a semi-permeable membrane.  Even if it was, this would not remove “toxins” from the body. Real detox occurs in the liver and then the blood if filtered by the kidneys.  The skin has no involvement in the process of detoxification any more so than the eyes are involved in urination. As far as the reflexology tie-in, the entire premise is crap.  Most nerves in the body do not actually end in the foot, and there are no anatomical pathways between the foot and internal organs as depicted in reflexology charts. Moreover, there is no physiologic mechanism whereby stimulating the foot can influence the health of internal organs. What a load of nonsense.

 

As far as the pads turning colors when left on the foot, there are some demonstrations circulating on the Internet that show the pads turning brown simply with the addition of water.  Reminds me of a similar scam – ear candling.  While these pads can’t pull the toxins from your body, if you are allergic to your money, you can easily have that pulled from your wallet.

 

I have also learned that the Federal Food and Drug Administration (FDA) is cracking down on one supplier, Kinoki, whom they indicate has made false and misleading claims about their products.

 

 

 

 

Dr. Brett Kinsler is a chiropractor in Rochester, NY who tells it like it is and doesn’t recommend goofy, unscientific treatments like detoxification foot pads.

 

 

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