From today's Consumer Health Digest:
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Top "CAM" researcher slams homeopathy.
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For more on the MMR controversy, see this thread:
Anyone following the MMR vaccine and Autism debate? -
re Homeopathy
Dear All,
I have always found the concept and philosophy of Homeopathy fascinating.
Take one patient with symptoms.
Take a detailed history , probably including whole family history.
Then decide on the therapeutic ingredients to treat the presenting syptoms.
Then ensure that your medicament contains ABSOLUTELY NONE OF THE ACTIVE INGREDIENT. :eek:
Next offer invoice for £60.00
Receive payment.
Placebo effect will have a positive effect on the pt for a period of time. :confused:
regards David.
ps as an aside i have previously worked in a multidisciplinary clinic with a Homeopath for about 7-8 years.
My thoughts on herbal medicine are not much better.
I am an enthusiast for Accupuncture though. -
This study has just appeared on the use of complementary medicine in Australia:
The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004
MJA 2006; 184 (1): 27-31 -
The Nov 17 Issue of The Lancet carried this:
Pressure grows against homoeopathy in the UK
The Lancet 2007; 370:1677-1678
and this Editorial:
Benefits and risks of homoeopathy
Which promted this article in Chiropractic Economics:
Lancet article slams homeopathy and causes stir
and this Press Release:
Nov 27, 2007 19:46 ET
Boiron Laboratories Disputes British Journal's Editorial on Homeopathy
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The BBC are reporting:
NHS trusts 'reject homoeopathy'
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Quackwatch are reporting:
Research insider blasts "CAM" as worthless.
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I was surprised to find out that herbal medicines are considered worthless. Herbs are the basis of most of our common drugs, so to say they can't do anything seems biased.
Red rice yeast is an example of this:
http://heartdisease.about.com/cs/cholesterol/a/Nrxcol_rry.htm
Makes you wonder about the rest of the stuff on the site. -
New book just launched call 'Trick or Treatment' Alternative medicne on trail
also Timeonline have a report on that.
http://entertainment.timesonline.co...tainment/books/non-fiction/article3764173.ece
Somuz -
Ant The Times is reporting today:
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Love it.
If a herb contains a theraputic effective component then this will be apparent in trials.
And regardless, it cannot be considered "worthless" because placebos have value. But what Dr Barker actually SAID was that
Regards
Robert -
I am having a difficult time following your reasoning.
Red rice yeast had issues because it contained the exact chemicals as drugs, not because of trials. So your standard for evidence does not exist.
You say if something works it is not CAM, therefore all CAM is ineffective. The problem with this reasoning, is that all herbal medicine is considered CAM, not whether the herb works or not. Just read your Quackwatch.
Do you wonder about the coincidences that certain herbs have been used for centuries for a certain effect without trials, and the drug that is used for the same purpose is derived from the same herb? For instance Belladona is used as a mydriatic, and Atropine which is one of the Belladonna alkaloids is also a mydriatic. There were no studies on Belladonna, but it worked, or do you doubt it? (By the way if you read quackwatch, you will see that this reasoning is number 5 of the Seven Warning Signs of Bogus Science).
Correct my reasoning if I am wrong: Chemical A causes a specific reaction, then chemical A will cause the same specific reaction. Atropine is Atropine. Statins are statins. The trials came many years after these herbs were used medicinally, so that does not mean that the herbs did not work before that time.
I think that there are two ways of looking at the information. 1. No trials were done to prove something, therefore it doesn't work; or 2. No trials were done, so we don't know whether something works. It seems as if you are using #1 for your reasoning. I am using #2.
By the way, I don't use herbal medicine in my practice. (except for black tea soaks).
Regards,
Stanley -
The trials came many years after these herbs were used medicinally, so that does not mean that the herbs did not work before that time.
I think that there are two ways of looking at the information. 1. No trials were done to prove something, therefore it doesn't work; or 2. No trials were done, so we don't know whether something works. It seems as if you are using #1 for your reasoning. I am using #2.
Mark Crislip MD from the excellent Quackcast podcast http://www.quackcast.com covers herbal remedies in episode 13 of this highly recommended podcast.
Some herbs do contain active pharmacological agents, but how do you determine dosage? how do you know if the herb is from a reputable source? do you trust it isnt contaminated? Pharmaceutical companies have made a significant amount of money discovering what the active ingredients are and how they work and safe effective dosage. If a herb works the drug derived from it will work better.
I think i will stick to an asprin pill and not chew on some willow bark. -
Ginkgo for memory enhancement: a randomized controlled trial.
JAMA. 2002 Aug 21;288(7):835-40.
I knew that I had read that Ginko had been shown to be helpful. So I found this site from the Mayo Clinic, which is probably the most respected medical instituion in the US. http://www.mayoclinic.com/health/ginkgo-biloba/NS_patient-ginkgo
If you were to compare the study quoted by quackwatch to the synopsis by the Mayo clinic, you will find that the study was done on an area that does not have much evidence, and the evidence shows that at the dosage used, it is too small to be effective.
http://www.planetherbs.com/articles/STANDARDIZED edited 3.html
Chris, I don't prescribe herbals, but I need to know more about them than my patients who come in and ask me questions about them, or are on them prior to surgery.
It sees that you have changed the discussion from herbals are useless, to herbals are something I am not familiar with, therefore since drugs are easier to prescribe, they are superior. Is that how you see it?
Another CAM thing that is interesting is colored light therapy. It is said to be quackery, but my daughter was born with jaundice and they gave her a blanket that had green lights. Seems to be another contradiction. Does anyone know how the lights eliminate the jaundice?
Regards,
Stanley -
Have you ever heard of standardized herbal extracts? The real herbalists, however, are not impressed by this. The following link will explain it to you.
http://www.planetherbs.com/articles/STANDARDIZED edited 3.html
Thanks for the links i will give them a good looking over.
When you send a patient to a vascular surgeon, how do you know he is competent? In both cases, I think you need to find out. Going to herbal seminars will give you a familiarity of the knowledge and intergrity of the herbal companies and their consultants.
When i refer patients on to other healthcare professionals i know they have had rigorous training and thanks to peer review and continued professional education i can trust they will have attained required levels of education. I do however have reason to be suspicious of herbal companies and practitioners who are trying to make profits. I dont doubt some individuals have great intergrity and truly believe in what they are doing, but i intergrity and belief do not equal effective medicine.
If you remember pharmacology, there are several drugs which are based on one herb (a class), but there are many herbs that there are no classes of drugs (cholegogues, immune modulators, emmagogues, etc.) At the herbal medicine seminars, they discuss the different constituents and actions of each herb, without the assistance of the vast sums of pharmaceutical money discovering the active ingredient. Drug companies will take the active ingredient, make changes to it, and then patent the drug, so they can charge high prices.
Am i correct that you see this as a bad thing? The price reflects to process of isolation and testing that these drugs have to go through which can take many years and cost an awful lot of money. Of course profits have to be made but these do help with further r and d.
As far as safe and effective dose, herbs have different constituents that modulate the effects, so as to balance, rather than to surpress or stimulate, so that there is greater safety in a majority of herbs. Has there been testing to prove this? is the dosage received from the herb standardised? is there proof of the effect other than anecdotal?
The chemical alteration of the active ingredient of the herbs result in a more toxic chemical that is harder for the liver to metabolize. And testing is carried out to establish toxicity levels and dosage levels.
Just look at all the drugs that have been taken off the market. And look at all the drugs which are on the market that work as stated and save countless lives as a result!
Just be careful. More people die of stomach bleeds each year due to NSAIDS, then die from AIDS. While you are at it, keep away from the NSAIDS that have been taken off the market: Zomax, Duract, Bextra and Vioxx. Also make sure you do not prescribe the safe antifungal Nizoral for your patients with mycotic nails.
Chris, I don't prescribe herbals, but I need to know more about them than my patients who come in and ask me questions about them, or are on them prior to surgery. I dont prescribe them either and i agree that we should be informed of the range of CAM's that are out there, and the more informed i become the more against them i become.
It sees that you have changed the discussion from herbals are useless, to herbals are something I am not familiar with, therefore since drugs are easier to prescribe, they are superior. Is that how you see it? NO. Let me clarify my position. I am familiar with a great deal of CAM's, i feel it is my responsibility to be educated on these matters. The vast majority of CAM's offer nothing more than placebo effects at best and at worst offer nothing but risk. The risk comes not only from the product the patient is taking to the attitude of the people treating them ie the number of chiropractors who are strongly anti-vaccine. The pharmaceutical product my patients are prescribed have been through stringent testing regimes and are proven to work but multiple studies on them. To return to the original topic of homeopathy the better designed and independent studies show no effect, modern medicine is not dogmatic, if something doesnt work or does not have the desired effects or outcomes then protocols are changed. CAM's are strongly dogmatic reject criticism and negative studies and they continue doing the same things now that have always been done.
Another CAM thing that is interesting is colored light therapy. It is said to be quackery, but my daughter was born with jaundice and they gave her a blanket that had green lights. Seems to be another contradiction. Does anyone know how the lights eliminate the jaundice?
Actually the mechanism of this is very well understood. The specific wavelength of green light isomerises bilirubin (the chemical responsible for jaundice) into byproducts that can be easily excreted by the body. It is physics not quackery.
The quack aspect comes in when it is claimed "that a therapist trained in chromotherapy can use colour and light to balance energy wherever our bodies are lacking, be it physical, emotional, spiritual, or mental" When you here the word energy in relation to any CAM be very very skeptical. It is the height of nonsense.
Kind regards
Chris -
http://www.americanherbalistsguild.com/
There is a similar organization in the UK which I am not familiar with:
http://www.nimh.org.uk/
You seem concerned about the profits that are made in medicine. Herbalists are not highly paid. Drug companies, on the other hand, are rather highly compensated. Lamisil in the US was $1200 for a 3 month prescription. Now that it is generic, it can be obtained for $12. There is $1188 in profit for a drug that was in Europe for 10 years prior to coming to the states. In a previous post you mentioned the cost of doing research to substantiate the cost of the drugs. I was up one night watching C-span, and they had congressional hearings into the cost of drugs. Part of the development cost of the drugs includes the cost of the warehouses and the trucks to deliver them. Also drug companies trade research, that is Company A will pay Company B $1,000,000 dollars for research on its drug, and Company B will pay Company A $1,000,000 for research on its drug, even though no research was done. All this does is increase the cost of the drug’s development by $1,000,000.
Upper GI ulcers, gross bleeding, or perforation caused by NSAIDs occur in approximately 1% of patients treated for 3-6 months, and in about 2-4% of patients treated for one year. These trends continue with longer duration of use, increasing the likelihood of developing a serious GI event at some time during the course of therapy.([url]http://www.drugs.com/pro/ibuprofen.html[/url])
There are many questions about vaccinations that need to be answered. The biggest one for me is if the immune system does not develop until 6 months of age and we inject an antigen in a 2 month old child with no working immune system, then what happens? Other questions are why do we inject live vaccines into children, knowing full well that this can cause a disease (The biggest cause of polio right now is vaccinations).
Regarding the efficacy of homeopathic remedies, the best place to find out if these can do anything at all would be with animal studies rather than on humans, so we can eliminate the placebo argument. I looked in Google, and I found this:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1475939.
Just because the ancient Greeks thought that Apollo was crossing the sky in his chariot, does not mean the earth doesn’t rotate to give the image of the sun crossing the sky. The wavelength you talk that isomerizes bilirubin is a frequency and has a quanta of energy associated with it. So in effect the green light is adding energy to the patient. The question is whether the body is lacking this frequency, or whether the frequency is just a tool in isomerising the bilirubin. There is no way to know, but the myth fits. The key is not to focus on the imprecise language or explanation, but rather to find if something works and how to apply it. In this case we see that a certain frequency is used to help a certain medical condition. What other conditions can be helped by certain frequencies? One that we know of is psoriasis, which is helped by UV light. But how many others are there?
Kind regards
Stanley
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