/ Health

Had dodgy advice from a nutritional therapist? We have!

Have you ever visited a nutritional therapist? In this month’s Which? magazine we investigated the profession and found some worrying practices, such as therapists advising against going to your GP.

One therapist advised our researcher, who was posing as a cancer sufferer, against having conventional treatment (a lumpectomy and radiotherapy), saying that she should try for three to six months to rid herself of the cancer through diet (by cutting out sugar).

Nutritional therapy can be big business; therapists charge up to £80 for a consultation and often prescribe expensive supplements on top. So we wanted to investigate whether it was worth the money.

How our investigation worked

We asked five undercover researchers to each visit three therapists. Each researcher was provided with a scenario.

One researcher (in her early 30s) had been trying to conceive unsuccessfully for over a year. Two (in their 50s) had been suffering from severe tiredness for the past three months. And two women (in their 40s) had recently been diagnosed with DCIS (Ductal Carcinoma in Situ), the most common type of non-invasive breast cancer.

A panel of experts (a dietitian, a GP and a Professor of Pharmacology) then assessed recordings of the visits and any other information the therapists provided to the researchers, including prescriptions for supplements.

Are nutritional therapists worth the money?

Our expert panel concluded that visiting a nutritional therapist wasn’t worth the money – and in some cases could have actually endangered the health of the researcher. Six of the fifteen consultations were rated as ‘dangerous fails’.

This could have been down to a number of reasons:

  • The advice given by the therapist could have potentially harmed the researcher.
  • Therapists were diagnosing conditions without relevant testing (even though their Code of Practice says they shouldn’t diagnose).
  • Researchers were advised not to visit their GPs about the problem, recommending unproven testing such as hair mineral analysis, and the case above, advising against cancer treatment.

Of the remaining visits, eight were rated as ‘fails’ and only one was graded as a ‘borderline pass’. Our experts were disappointed by the advice given by therapists and concerned at their poor knowledge of the body and how it works.

The experts were also worried by some therapists using non-evidence-based testing to diagnose symptoms. These tests included iridology (studying the patterns, colour and other characteristics of the iris), hair mineral analysis and a researcher being given several liquids to hold in his mouth before being told he had a chromium deficiency.

Are the recommendations right?

Twelve of the therapists prescribed supplements to the researchers, costing up to £70 a month. Researchers were told not to buy them from Boots or other high street chemists as they weren’t ‘pure enough’ and you were effectively ‘flushing your money down the loo’. Instead, they were asked to buy them from the retailers recommended by the therapist.

Of course, there is benefit in following healthy dietary advice, but most of what was provided by the nutritional therapists is freely available on websites such as the NHS site.

Plus, most of the therapists in our investigation recommended quite restrictive diets that excluded several foods (predominantly dairy and wheat) and taking expensive supplements.

If you do have a medical condition that you are concerned about, your first port of call should be your GP. If necessary they can then refer you to a dietitian. We have contacted the British Association of Applied Nutrition and Nutritional Therapy (BANT) with our findings and concerns.

People who have visited nutritional therapists emailed us to say that they found the diets recommended to them difficult to maintain over a long time and eventually gave up.

Have you visited a nutritional therapist? What was your experience like – do any of these findings ring true or did you have a more positive experience?

Comments
Member

Stuart,
re’ acupuncture and its effectiveness from just some scientific studies………………………

http://www.rawstory.com/rs/2010/05/30/researchers-prove-acupunctures-effectiveness-pain-therapy/
http://www.vanderbilt.edu/ans/psychology/health_psychology/Acupuncture.htm
http://www.roseglavin.com/conditions/studies.html
http://www.thenewmedicine.org/timeline/acupuncture_study

So please, I would appreciate that you do at least conduct some rudimentary investigations before making any rash comments.

Thank you

Member
Stuart says:
5 February 2012

Scientific papers please, peer reviewed in good quality journals, Prefereably those where they have been replicated by independent researchers.

Acupuncture doesn’t work. It’ll take more than a few poor quality websites claiming it is to change that.

Member

Agreed, Stuart, but let’s have peer reviewed reviews that present a balanced view of the subject, making use of all the evidence, be it positive, negative or neutral. The idea of using a balanced approach could be novel to those who cherry pick information to support their argument.

Member
Selina Import says:
5 February 2012

Thank you Chris you have given me lots of exciting information to look into. Also thank you Tony Isaacs

Member
Selina Import says:
5 February 2012

There is one thing I am ashamed of. Until I was 18 I believed what I had been told: that the people of a religion I did not belong to had their belief because they weren’t bright enough to know any better. I gradually came to understand that I belonged to my religion because I wasn’t bright enough to know any better either. My biggest lesson in life I believe to be beyond judgement.

Member

Stuart,
you mean these peer-reviewed studies in journals of repute……………………….
http://www.guardian.co.uk/science/2011/sep/05/publish-perish-peer-review-science

It isn’t only quack journals that have failures in peer review. In June, the British Journal of General Practice published a paper, “Acupuncture for ‘frequent attenders’ with medically unexplained symptoms: a randomised controlled trial (CACTUS study)”. It has lots of numbers, but the result is very easy to see. All you have to do is look at their Figure.
A figure accompanying an acupuncture research paper A figure accompanying an acupuncture research paper. “Outcome data over 52 weeks (acupuncture group received acupuncture weeks 0–26, control group received acupuncture weeks 26–52)”.

It’s obvious at a glance that acupuncture has at best a tiny and erratic effect on any of the outcomes that were measured. The results are indeed quite interesting because they show that acupuncture doesn’t even have a perceptible placebo effect. But this is not what the authors said. Their conclusion was: “The addition of 12 sessions of five-element acupuncture to usual care resulted in improved health status and wellbeing that was sustained for 12 months.”

Now please Stuart don’t give me the respectable Journal nonsense and peer-reviewed nonsense.

Or this one supported by the BMJ………………………….
http://aim.bmj.com/

Or may be this one………………..
http://www.liebertpub.com/ACU

Peer reviewed literature: 459 articles appear on a PubMed search of “acupuncture + benefit” and 280 articles for a search of “acupuncture + metan-analysis”. For those that don’t know, a meta-analysis analyzes many articles on the same topic to get a more thorough overview of the success or failure of a treatment or disease. To have 280 meta-analyses on acupuncture alone means that there is a vast body of peer-reviewed scientific literature that has been published on acupuncture. A search for “acupuncture” alone results in 17,272 papers in PubMed.

Stuart,
Is that enough peer-reviewed scientific literature for you? or would you like some more?

Member

chrisb
Peer review is not a guarantee of quality, but that is common knowledge at least in the scientific community. Research workers are under increasing pressure to publish their work, the reviewers are usually unpaid and the number of papers to be refereed seems to grow by the day. Having said that, it is the best quality control system we have. Perhaps you see why I am so keen for conclusions to be based on the conclusions of all the evidence available.

Now you are trying to discredit the peer review system. In this case you are unlikely to find many people writing to say how well it works, in the same way that the news reports motorway pile-ups rather than telling us about the days when there was no pile-up.

A good scientist will never cite an article without looking at the full paper. This allows the reader to gain an insight into whether the main results and conclusions summarised in the abstract is likely to be valid.

Some put a lot of faith in the number of times a paper is cited in subsequent papers. In popular fields such as medicine and health, a poor paper may clock up more citations than one of much higher quality in a less popular field. I have a review that has over 1500 citations but I don’t see it as my best contribution to the literature.

Sorry to be critical again, but I think you are using PubMed in a rather strange way. You many have identified thousands of papers that mention acupuncture, but what are the authors saying in these papers?

Peer review may have its flaws but compared with some of the websites you have recommended to me, it is wonderful.

Member
Stuart says:
6 February 2012

“Acupuncture for ‘frequent attenders’ with medically unexplained symptoms: a randomised controlled trial (CACTUS study)”.

If you’d read and understood this Chrisb you would have noticed a problem with the experimental design i.e the control is not satisfactory i.e. no placebo. The test group gets intervention immediatley, the control group ater 26 weeks. It would have been better to include a placebo acupuncture using dummy needles during the initial session. The results are hardly starting.

Also the outcomes were measured through a questionairre, so subjective assessments of outcome only. Just ripe for placebo and abosoutely no evidence. Medically unexplained symptoms are basically attenders that may have nothing wrong with them.

“To have 280 meta-analyses on acupuncture alone means that there is a vast body of peer-reviewed scientific literature ”

And what do they say, because that is what is important not how many have been done. Perhaps look at a recent one?

Also if there are so many meta analysis why cherry pick a single study as evidence? (again). I suppose its progress from quoting a pill salesmans website.

Member
Stuart says:
6 February 2012

Just an after thought, how do you design a questionairre to measure outcomes when the patients have ‘unexplained’ symptoms?

Member

Stuart
If as you say……………….
“There is clear evidence that not only do some supplements give no benefit, but some are actually harmful to health”

Then I would like you to produce the evidence for that statement in several peer-reviewed Journals of some repute.
You may find evidence of harm for inferior and substandard supplements, just as you would for substandard pharmaceutical drugs, but many are now pharmaceutical grade.

Better still, this discussion/debate would be better served if you contact PROFESSOR A.H.BECKETT, O.B.E., B.Sc, Ph.D., D.Sc., FRPharm.S., Hon DSc.’s (Heriot Watt, Leuven, Uppsala), concerning supplements and Nutritional Science.
He is the Professor Emeritus, University of London
CHAIRMAN, VITABIOTICS (1992 – 2010)

About Professor Beckett, OBE (1992 – 2010)
Professor Beckett was Head of the School of Pharmacy at Kings College, London for 25 years. He published 465 research papers, and was founding editor of the distinguished international journal of Medicinal Chemistry. His professional posts included President of the Royal Pharmaceutical Society, and the Medicinal Commission of the International Olympic Committee.”

Member

I wouldn’t bother, Chris. Vitabiotics is another website selling chemical supplements to people who probably won’t benefit from them, possibly using the name of a retired prof to add respectability. It might be nice if Vitabiotics pointed out that most people do not need their products and that eating these chemicals may not be without risk.

Member
Stuart says:
6 February 2012

Read this thread and you will see an example – Vit D. I believe the papers are there too.

The DOSE makes the poison, ever heard that?

Water is lethal if you have too much.

Member
Stuart says:
6 February 2012

“About Professor Beckett, OBE (1992 – 2010)
Professor Beckett was Head of the School of Pharmacy at Kings College, London for 25 years. He published 465 research papers, and was founding editor of the distinguished international journal of Medicinal Chemistry. His professional posts included President of the Royal Pharmaceutical Society, and the Medicinal Commission of the International Olympic Committee.”

Appeal to authority. Has no bearing on whether he is correct or not.

Member
Selina Import says:
5 February 2012

Chris, In the 30 years since you found a way to overcome your leukaemia, how have conventional methods fared? I seem to remember there has been some improvement. Has anyone asked you how you did it?

Member

Selina,
I’m not sure as I haven’t inquired to make any comparisons.
A number of people have asked how I did it, but when I tell them they have this incredulous look on their faces, so I hardly bother now.
Of course I have been asked for proof that I did have Leukemia, and how I overcame it but the primary-care trust whose province I was under did not keep my records as I moved away from that area about 28 years ago. It is policy, or was policy not to keep medical records for a patient any longer than seven years, after they moved away from the area in which the diagnosis was made. Unfortunately.

Member

Wavechange,
Professor Beckett instigated Vitabiotics in collaboration with a medical Doctor, so he was in from the beginning as a perceived need to improve peoples health.
Just one of their products (Neurozan) was instrumental in curing my lifelong depressive illness.
It is clear that both you and Stuart along with David have preconceived and biased prejudices against anything that resembles Nutritional Medicine so my involvement ends here.

Member

chrisb

I have never said that I am opposed to supplements, only that they (like a GPs drugs) should not be used without without evidence of need or a good reason for taking them. You might be interested to know that I have worked on two EU-funded biotech collaborative projects doing research on the production of supplements, though I had no involvement whatsoever with the medical aspects of their use.

I think it would be a good idea if Vitabiotics included a prominent caution on their website, as Fuhrman does.

I am sorry to hear about your health problem and glad to hear that it has been resolved. My main health problem (severe asthma) is so well controlled with inhalers that my problem is remembering to use them. No more carrying inhalers, emergency injections or courses of oral steroids and worrying myself silly about having an asthma attack in a foreign country.

If my GP was profiting from the sale of drugs I guess that she might be tempted to prescribe more drugs than I need. Thank goodness the NHS has (I believe) addressed the problem of drug reps offering incentives to prescribe certain brands of drugs. I use the brands that the pharmacist can buy most cheaply and it works every bit as well as the well-known brands, saving the NHS money.

Let’s leave it there and not comment on each other’s views. It’s good that we have both found solutions to our health problems.

Member
Stuart says:
6 February 2012

Thats a good thing, since you have been endorsing bogus treatments such as Vit C for cancer.

Member
Stuart says:
6 February 2012

No, my issue is people who are not qualified recommending things to people which may not work and may be dangerous.

As Which? identified.

Member
Selina Import says:
6 February 2012

To all practicing NTs I wish you well and know that you will enable many many people to be well and in as natural a way as possible.

Member

Wavechange,
I am sorry to learn that you have to live with the medical condition of asthma.
Just in case you have a more open mind than other people here, the beneficial effects of fasting in asthmatics have been well documented in the Russian medical literature. Their clinical trials illustrated that more than 75 percent of patients had greatly improved conditions or never had symptoms of asthma again after fasting.
http://www.iumab.org/index.php/2002-conference/291-investigation-of-bronchial-asthma
http://eatingandfasting.blogspot.com/2009/07/intermittent-fasting-is-natural.html
http://www.youtube.com/watch?v=4m3yLwN1fcM&feature=player_embedded
http://jeune-et-randonnee.pagesperso-orange.fr/devries.pdf

For what it’s worth, living with asthma does not have to be your only option, as it can be permanently remediable if you investigate further.

“Everyone has a physician inside him or her; we just have to help it in its work. The natural healing force within each one of us is the greatest force in getting well. Our food should be our medicine. Our medicine should be our food. But to eat when you are sick is to feed your sickness.” – Hippocrates

“Instead of using medicine, rather, fast a day.” – Plutarch

Member
Stuart says:
6 February 2012

Hippocrates also said:_

“There are in fact, two things, science and opinion; the former begets knowledge, the latter ignorance”

You’re quote mining.

Member
Stuart says:
6 February 2012

Also appeal to authority. Logical fallacy.

Member

Thanks chrisb. Even if fasting worked for me, I’m not sure that I would have the self-control or motivation to go through with it, and I am certainly not keen to do it. I would probably have a genuine need for supplements if I did. 🙂

When I was 11 I moved from a village to the outskirts of a filthy, smoky city, where I promptly started to suffer from asthma. The GP failed to recognise this, despite my mother’s correct diagnosis of the problem, and gave me cough linctus and other ineffective treatment. After I suffered from several asthma attacks we moved to another GP, who prescribed the best treatment that was available at the time. I still regret that for over a year I was allowed to suffer because my GP had less knowledge than my mother, who had at least done her best to learn about my condition and the medication available via the NHS.

I have said many times that it is wrong to give unnecessary treatment but as others have pointed out, withholding medication that could help can have serious consequences.

Member

Stuart,
I think you have more of a problem with the evidence than wavechange, as his replies to my own posts are more civil. Still where there is breath there is hope, but to say that………………

“since you have been endorsing bogus treatments such as Vit C for cancer”

…………………is beneath contempt, and especially so when IV Vitamin C Therapy has been used successfully in treating cancer, by Professor Ian Brighthope and other distinguished and highly qualified Medical Doctors.
The mind boggles.

Member
Stuart says:
6 February 2012

Sigh, papers please. Evidence or GTFO.

What is beneath contempt is giving false hope to dying people and their families, whilst milking them of their savings.

Just FYI anyone in the UK who said they could treat cancer with Vitamin C woudl be potentially liable to prosecution. And rightly so.

Member
Stuart says:
6 February 2012

I’m still waiting for you responses on Acupuncture, seem to have gone quiet.

Member
natasha says:
6 February 2012

In most cases I have noticed that Wavechange argues his case with respect for others who have opposing opinions and I therefore have respect for him even though i may not agree with all he says. I have also sympathy for his condition. The point I want to make is that I found out the hard way that my asthma was not responsding to NT and taking supplements (even though Wavechange it could be worth having an open mind and looking up the studies that relate to magnesium deficiency and reactivity of the airways – as I do think that my lung fuction is better when i am magnesium sufficient) I discovered that it was living for many years in a property with condensation and mould spores that was the killer for me – keeping me quite ill – when I moved to a modern house I was fine and off all inhalers and have been ever since unless i spend more than 24 hours in an old musty house.. I also think that a big thing was also improving lung fitness through approppriate exercise. I think that a good so called ‘anti inflammatory’ diet does help too (using contaminant free fish oil – worth looking up those studies in relation to asthma too) as I can get a little wheezy after a binge. The points here are diet/nutrition was not enough to overcome the environmental effects of mould (thank goodness for drugs at that time) and there is no reason, in my opinion to get extreme and do fasting perhaps more people’s asthma can be improved with a bit of detective work..

Member

I usually try to be respectful to others, Natasha, and I know I have been a bit rude in some of my messages on this topic.

Moulds are one of my problems too. I suspect that it is moulds in dust that are responsible for my dust allergy. House dust does not affect me much (I live in a dry modern house) but dust in damp garden sheds is a problem. Moulds in grasses used to cause me a problem and once landed me in hospital. Blue cheese would cause intense itching of my throat, presumably because of the mould content. I had a several incidents with muesli, presumably because it can contain small amounts of mouldy nuts or cereal and I recall the fancy stuff from health food shops was worst. After a frightening incident my GP gave me an injection for use in emergency. I still have a problem with damp dust and avoid blue cheeses, but the other problems have gone. I can eat any brand of muesli and walk in the countryside without problems.

You are absolutely right to be worried about mould. Many people live in poorly ventilated houses. Double glazing is marvellous but draughty old windows did at least provide some permanent ventilation. There is another Which? Conversation covering damp problems and lack of ventilation is the most common diagnosis of the problems posted. Even those without asthma would do well to avoid exposure to moulds.

Allergies are unpleasant but fascinating conditions, and the only one who can really research the problem is the sufferer. My friends find it amusing that I can stroke one dog but unable to stay in the same room as another dog!

I have experimented with diet and will do so more now that I have retired. Fortunately, I have access to many journal articles that are not available to the general public, which is useful for keeping in touch with current understanding.

Member
Elizabeth says:
6 February 2012

Re. Stuart.
It is worth bearing in mind that attacks can be made by people with strong opinions who are not prepared to look at other approaches, however helpful they may be to suffering people.
Last year the GMC reinstated (with no case to answer) a pioneering, open minded doctor who had been suspended and forced to practice medicine under severe restrictions.
In another fitness to practice hearing at the end of last year, Clinical Scientist Stuart Jones was found guilty of professional misconduct by the Health Professions Council for making “disparaging, inappropriate and unprofessional comments in a public forum” about this doctor.
This council found Stuart Jones’ fitness to practice is “currently impaired by reason of misconduct”.
It gave him a two year caution order.
He had reported this doctor to the GMC over concerns about her website which offered support information for her patients. Jones had used the website run by Ben Goldacre to campaign against her, calling her an “uber-quack”.
He commented that he had done this deliberately to give her extra admin and increase anxiety levels in her patients “very pleasurable indeed”.
So there are “qualified” people out there who can be pretty awful in the way they operate.

Member
Katie says:
6 February 2012

Elizabeth

im sure alot of us know exactly who you are talking about – it was shameful – patients have a right to choose their treatment regardless I believe.

Member

I quite agree with you Elizabeth, and no-one is pretending that orthodox medical care is perfect or necessarily up-to-date. I’m sure that NHS advice on diet will change as we learn more about how our health is affected by diet.

I am concerned about certains aspects alternative therapy and that some of it exploits sick people who are desperate for a solution. Does iridology work? Does ear candling work? Does it make sense for anyone to take multivitamin tablets without any evidence that they will be of any benefit?

I am glad that Which? did this investigation and I hope that it will raise awareness of the need for effective regulation. As I have said numerous times I believe that NTs can provide individual support that would not be possible under the current NHS system. NTs who want to help people and not be associated with quackery should welcome this, and I fear that they are the ones who will have to push for reform.

Member
Stuart says:
6 February 2012

People can do whatever they want and choose their own treatment. Thats whats so great about the UK. Freedom.

When people want nonsense therapies from the NHS, or to propogate dangerous lies to people they need to be challenged.

Elizabether doesnt name the Doctor so it difficult to see what point she is making. Seems like the GMC ruled on the inappropriate behaviour and made a ruling.

The trouble is we live in a PC world where even those without evidence think they have a right to spount nonsense. When that endangers peoples health that should be allowed.

Member

Stuart

I’m not entirely happy with complete personal freedom where children and other dependants are involved. I believe it is wrong to deny anyone NHS treatment and I could be quite rude about those who would want to deny anyone a blood transfusion.

Although I have no problems with individuals having personal freedom to choose treatment for themselves, I share your concern about misinformation (which could range from dangerous lies to beliefs that cannot at present be supported by unequivocal evidence). We need to tread a little carefully because many of our useful drugs have come from sources (e.g. plants) that have been treated with contempt in the past, though proper use of drugs means having products that have been thoroughly tested and available in a consistent formulation.

I would like to see supermarket shelves cleared of supplements and replaced by good food. Clearly there are people who do need supplements but I advocate that the NHS provides tests and prescribes them if required.

Member

Stuart,
you cite the example of Vitamin D or the steroid hormone precursor, and the dose makes the poison; in that respect you are quite right as Vitamin D is a fat-soluble Vitamin, and where excess is stored within the body, but that depends on what we mean by “excess”.
It is generally recognized that there is a worldwide deficiency in this Vitamin and that the RDI’s are considered by most Vitamin D-experts including Dr Michael Holick…………………….
http://www.pcna.net/images/ce_bios/Michael_Holick_bio.php
and Dr William B Grant…………
http://www.sunarc.org/wbgbackground.htm
to name but two………………………….
…………………………………..as set at too low a dose; food sources are scarce, and many people do not receive sufficient sunlight exposure (the best source) for one reason or another.
The risk of toxicity is generally considered to be to the magnitude of over 50,000ius per day, but no one is advocating that amount of supplemental use and the risk of Hypercalcemia.

It is true that (and something I have posted on previously) that water will kill you if taken in large enough quantities, but that does not negate our need for water; similarly sufficient dosages of Vitamin D are required for optimal health and as a prophylactic against many diseases.
So the issue here is not about toxicity, but the worldwide pandemic of insufficiency. An ounce of prevention as it were…………….
Sources………………………
http://lpi.oregonstate.edu/infocenter/vitamins/vitaminD/
http://www.vitamindcouncil.org/about-vitamin-d/what-is-vitamin-d/vitamin-d-toxicity/

However, water-soluble Vitamins taken in excess of bodily needs are firstly utilized by the body and where any excess is excreted. Take for example the case of Vitamin C where an excess intake results in what is known as the “bowel-tolerance-level” with no harm to the body
http://www.doctoryourself.com/cathcart_thirdface.html
http://www.livestrong.com/article/451616-do-all-excess-vitamins-get-excreted-from-the-body/

So what I am advocating here, and have done so since the beginning of this thread, is the vital role played by nutrition in preventing and even treating disease, but ignored by the Mainstream fraternity in favor of pharmaceuticals which even when properly prescribed can and do have horrendous side-effects and which are mostly absent from Nutraceuticals at a therapeutic dosage; and how one observational study on a small group of NT’s has in all probability turned the general populace away from Nutrition.
Therefore any impartiality and objectivity has been sacrificed and ignored.
I still maintain that this observational study was analogous to placing the fox in charge of the hen-house.

Member

Stuart,
I am sure that you are more than capable of doing your own research for the evidence in favor of IV Vitamin C Therapy so I’ll allow you to do the leg work.

In response to your comment…………………………..
“You refer to false hope to dying people and their families, whilst milking them of their savings”.

Perhaps you wouldn’t mind reading and comprehending the magnitude of this………………………

-Many doctors become so busy “practicing” medicine once they graduate from medical school that they no longer have time to study their art. They then rely on “trusted” sources to keep up to date. In fact, for most doctors, their sole source of information, once they start practicing, is the “party line” provided by the associations they belong to and the drug companies promoting their drugs or paying for “peer reviewed” studies that appear in their associations’ journals or, even worse, on the sensationalized reports of those studies in the media. The net result is that, over time, they become ill-informed or misinformed—merely parroting the party line.

Doctors, and people of your own particular persuasion in healthcare, complain that alternative healing is based on anecdotal evidence, not science like “real” medicine. Nevertheless, they remain blind to the fact that 85 percent of all medical procedures they rely on are also untested and based purely on anecdotal evidence. They’ve even developed a euphemism to describe the process: off-label use, the practice of prescribing drugs for a purpose outside the scope of the drug’s approved label. That’s right, once the FDA approves a drug for prescription use, there is no regulation as to what it’s used for, and so physicians can make decisions based on anecdotal evidence—or even their own best guess. In other words, large numbers of drugs are used for diseases for which their efficacy and safety have never been tested. And that’s called “science.”

Doctors say that many alternative healing procedures and herbal remedies are dangerous. In fact, fewer than five people die (theoretically) each year in the U.S. from complications resulting from overdosing on vitamins or an allergic reaction to herbal remedies. That matches up quite well with the 106,000 (conservatively) who die from the pharmaceuticals that doctors prescribe.

Doctors say that even when people aren’t being harmed by alternative health care, they’re being fleeced. “Millions of dollars are wasted each year on megadoses of vitamins that are peed down the toilet and on useless herbal concoctions.” Somehow, though, these same doctors don’t seem too concerned about the billions of dollars that have been spent (sorry, I meant “wasted”) on the “war on cancer,” only to see cancer rates soar to epidemic proportions, or about the $48 billion spent on useless angioplasties each year.

Fear – There is a saying in the medical community that goes, “It is better to die than to go against the faculty of medicine.” We’ve all seen prison movies—such as Cool Hand Luke, Papillon, and The Shawshank Redemption—where the evil warden keeps his prisoners in line by brutally and publicly punishing any who break any rules. Amazingly, these movies could just as easily have been stories about how the medical establishment keeps its ranks in line. Every doctor knows about the “renegade” doctors who have been harassed, raided, arrested, and driven from their practices for “going against the established order.” This tends to keep the rest in line. In 1979, for example, the Florida First District Court of Appeal reversed an order by the Florida Board of Medical Examiners placing Dr. Robert Rogers on probation, accusing him of “quackery under the guise of scientific medicine,” and directing him to stop using chelation therapy (a detoxification therapy for removing heavy metals). The district judges not only disagreed with the examiner’s ruling, but also declared that Dr. Rogers was a scientific and medical innovator comparable to Freud, Pasteur, and Copernicus. There are literally thousands of such stories—unfortunately, 99 percent of them end less than happily.

Member

Which? sent a letter to Anne Milton outlining our research and findings on Nutritional Therapists.

She has informed us that there is a bill going through parliament to change the remit of the current Council for Healthcare Regulatory Excellence (CHRE) to provide a quality assurance role for voluntary registers and unregulated health and social care workers. This bill will include nutritional therapists.

The CHRE will open a consultation in April 2012 on the standards and criteria for this new scheme. They are accepting comments on their website until that point for anybody who wants to make recommendations with regard to the development of these standards.

http://www.chre.org.uk/voluntaryregisters/

Member
Alan Henness says:
6 February 2012

Shefalee said:

“She has informed us that there is a bill going through parliament to change the remit of the current Council for Healthcare Regulatory Excellence (CHRE) to provide a quality assurance role for voluntary registers and unregulated health and social care workers. This bill will include nutritional therapists.”

As I understand it, the scheme is about how you run a register of members and your disciplinary procedures and it says nothing about what service it is the members provide. The ‘quality assurance’ has nothing to do with protecting the public from misleading claims for products or services.

Member
Katie says:
6 February 2012

Shefalee – where then does the CNHC (Complementary and Natural Healthcare Council) fit in set byPrinces Trust and funded by DoH.

Member
Alan Henness says:
6 February 2012

chrisb said:

“Nevertheless, they remain blind to the fact that 85 percent of all medical procedures they rely on are also untested and based purely on anecdotal evidence.”

I debunked that old canard the last time you mentioned it.

Member

Alan,
I’m afraid you didn’t debunk that old canard this time around with “anecdotal evidence” which is synonymous with “off label use”.

“Off-label” is also called “non-approved” or “unapproved” use of a drug.

The New England Journal of Medicine.
Although off-label prescribing — the prescription of a medication in a manner different from that approved by the FDA — is legal and common, it is often done in the absence of adequate supporting data………………………….
http://www.nejm.org/doi/full/10.1056/NEJMp0802107
And……………..
http://www.cbsnews.com/stories/2008/11/25/health/webmd/main4633004.shtml

Member
Alan Henness says:
6 February 2012

chrisb

You said:

“Nevertheless, [doctors] remain blind to the fact that 85 percent of all medical procedures they rely on are also untested and based purely on anecdotal evidence.”

Although you didn’t supply evidence to substantiate that figure, I debunked that: that only 85% of all medical procedures are untested and based purely on anecdotal evidence.

You then went on to say:

“They’ve even developed a euphemism to describe the process: off-label use, the practice of prescribing drugs for a purpose outside the scope of the drug’s approved label.”

Here, you state that ‘they’ had developed a euphemism (off-label use) to describe this process, but offered no supporting evidence and you’ve equivocated between talking about ‘medical procedures’ in the part I debunked and then moved on to ‘prescribing drugs’. Can you be clear what you are referring to?

In your last comment, you said:

““anecdotal evidence” which is synonymous with “off label use”.”

How do you see these as being synonymous?

Member
Alan Henness says:
6 February 2012

Katie said:

“Shefalee – where then does the CNHC (Complementary and Natural Healthcare Council) fit in set byPrinces Trust and funded by DoH.”

The CNHC was set up by Prince Charles’ Foundation for Integrated Health (which closed in 2010 amid arrests for fraud and money laundering), not the Princes Trust, but funded to the tune of around £900,000 of taxpayers’ money. There are some interesting details on the CNHC’s finances released today in response to a Freedom of Information Act request here.

The CNHC have expressed interest in the CHRE’s scheme and are presumably anxious to gain whatever credibility they can from it. The public will be further mislead by this false credibility since the scheme is just about having a register and says nothing about the efficacy or otherwise of any treatments given by those registered.

The CHRE is in the process of setting up this scheme because it’s in the Health and Social Care Bill, even though it is still in Parliament and it’s by no means certain it will become an Act. They seem to be assuming it will become law.

Member

Alan,
I assume that the ‘quality assurance’ has nothing to do with protecting the public from misleading claims for products or services, most likely means that there are many health modalities outside of Mainstream which do not need to “quality assured” as they are considered to be innocuous and of benefit to the patient.

Member
Alan Henness says:
6 February 2012

chrisb said:

“I assume that the ‘quality assurance’ has nothing to do with protecting the public from misleading claims for products or services, most likely means that there are many health modalities outside of Mainstream which do not need to “quality assured” as they are considered to be innocuous and of benefit to the patient.”

I don’t see how you can jump to that conclusion. The CHRE make no mention of anything the members of any future accredited registrar might be doing so it appears they are making no judgement about whether what they do is safe, efficacious, misleading or downright dangerous.

Member

Alan.
just pulling your leg re’ quality assurance.
Don’t worry.

Member

Alan.
by “anecdotal evidence” I meant information obtained from personal accounts, examples, and observations, and usually not considered “scientifically valid” but may indicate areas for further investigation and research” which tallies with “off label use” of a prescribed pharmaceutical, and not for the approved intention of the drugs usage.
I think you might be clutching at straws now.

Member
Alan Henness says:
6 February 2012

So, chrisb, what does the 85% figure you quoted refer to? And what’s your evidence for it?

Member

Spare a thought for the Which? team. Every message that includes a Web address has to be inspected before it we get to see it, and there are a lot on this Conversation.

There is bound to be an Internet forum for detailed discussion.

I propose that Which? was right to do their investigation and pass their findings on for more detailed study. Do I have a seconder?

Member
Alan Henness says:
6 February 2012

wavechange said:

“I propose that Which? was right to do their investigation and pass their findings on for more detailed study. Do I have a seconder?”

Seconded. (If they’ve not done it already.) I look forward to BANT and the CNHC publishing the results of their investigations.

Member

I can’t wait for the responses, Alan, and my comment was really a reminder for those who might not have seen the first half a dozen pages of this dialogue. Maybe BANT will let the public view its current ethics code at the same time.

Member
Alan Henness says:
6 February 2012

I hope you’re patient!

Member

NHS patient for preference. Mark my card ‘No unnecessary drugs or supplements please’.

Member

Alan,
the figure of 85% for off-label prescription drug use may have been a little high but whatever that figure is, it is very common: more than one in five outpatient prescriptions written in the U.S. are for off-label therapies.
Many people may be surprised to know that the FDA regulates drug approval, not drug prescribing, and … doctors are free to prescribe a drug for any [reason they think is medically appropriate],” says G. Caleb Alexander, MD, MS, a medical ethics advocate and assistant professor of medicine at the University of Chicago Medical Center. “Off-label use is so common, that virtually every drug is used off-label in some circumstances.”

Thats quite a lot of unapproved prescribing. In other words, large numbers of prescription drugs are used for diseases for which their efficacy and safety have never been tested. A practice that is unscientific, and which relies on anecdotal evidence for that prescription.

Member
Alan Henness says:
6 February 2012

chrisb

Thanks for the clarifying that the 85% figure you quoted referred to off-label prescribing of drugs in the US rather ’85 percent of all medical procedures’ as being ‘untested’ and ‘based purely on anecdotal evidence’ as you originally said (even though I don’t think it’s at all relevant and you’ve not supplied any evidence to back it up, even if it’s not as high as 85%).

Member

Alan,
I suppose the word “procedures” was a “typo” instead of prescription drugs.
Apologies for that.

Ah yes, the all-important “evidence”!!! I suppose that depends on what type of “evidence” you are looking for, and that you find acceptable.

Well here are some examples for your perusal…………………………
WebMD
http://www.webmd.com/a-to-z-guides/features/off-label-drug-use-what-you-need-to-know
ScienceDaily
http://www.sciencedaily.com/releases/2006/05/060513122427.htm
http://www.usatoday.com/news/health/2006-05-08-offlabel-drugs_x.htm

“Off-label medication use is common is out-patient care, and most occurs without scientific support. Efforts should be made to scrutinize under-evaluated off label prescribing that compromises patient safety or represents wasteful medication use.”
Arch Intern Med.2006:1021–1026.
http://archinte.ama-assn.org/cgi/reprint/166/9/1021.pdf

And so on and so on, but it would be acceptable to prescribe drugs “off label” without any scientific support, and based on anecdotal evidence, but NOT acceptable for anecdotal evidence to be used in Alternative Medicine.?
Last time I heard this was known as hypocrisy.

Member

I have followed with interest the recent posts on various pieces of supporting evidence on both sides of the current debate. It is normal that the burden of proof falls more heavily on those who are promoting a new technology compared to those defending the existing technology. Whether or not this is correct is itself debatable.
Now the big question. What is new? I mentioned in a previous post, a book I found recently entitled ‘Nutrition and health’ written in 1907. It appeared that the importance of diet was fairly well established 100 years ago and before that (eg Hippocrates). I also previously mentioned ‘macro Theories’ such as Gaia theory which are much harder to solve by reductionist science. Another more relevant ‘macro hypothesis’ is that presented in ‘The Blue Zones’ which seeks to correlate lifestyle differences and longevity. The book does not seek to ‘invent’ but only to ‘discover’ (I will come back to this later). The ‘experiments’ which were being studied in the book involved sample sizes which make most pharmaceutical trials look like a joke. Whole countries have been studied over periods of decades. Comparisons between countries allowed contributing factors to longevity to be determined with good levels of accuracy. One study alone involved looking at 97,000 Adventists who live only 60 miles from LA but have levels of health which are completely off scale compared to the surrounding populations.
This book and others seek to discuss an experiment which has been going on for hundreds of years involving millions of people. As long as you are not the kind of scientist who believes that ‘reductionist science is the only science’ then the evidence is overwhelming that diet and health are solidly linked.
Now back to NEW medicine (pharmaceutical medicine) the effects of which have only been studied on a much smaller number of people over a much shorter period of time. This is a discipline which to a much greater degree has sought to ‘invent’ rather than ‘discover’. Indeed the companies that have made the greatest number of inventions have usually also made the greatest levels of profit. However these patents are hugely lacking in their scientific content and only require the inventor to describe a method and the result. The ‘mechanism’ of the invention is not required, indeed patent agents will always remove any such hypotheses in case they turn out to be wrong and thus ‘teach away’ from the desired invention.
Thus the patenting process (which historically has worked quite well at rewarding innovation) has
utterly failed in creating a scientifically-led medical industry. Good quality publications have been replaced by poor quality patents (p.s. I would also use the word ‘poor’ to describe the 25 patents that I have written). Publications only appear later and are still totally lacking in providing a sound scientific basis for this ‘new’ medical method. While some papers might describe the way in which the drug is thought to interact with the body, I suspect that none have tested the effect the drug on every other one of the thousands of processes which go on in the body (please excuse my lack of med-speak). There is of course an added need to do this for synthetic chemicals which have never previously been in contact with humans (as opposed to foods and herbs which have been consumed for thousands of years).
Every so often, society gets really excited about how science will change our lives for ever. Back in the 70’s, Raymond Baxter would tell us on Tomorrows World how we would all be living in dome shaped houses and wearing disposable clothes by the year 2000. I would suspect that in a few decades time, the ‘pharmaceutical bubble’ will have passed and will to our grandchildren appear as silly as the Dutch Tulip bubble of 1637. In fact the ‘peak oil’ moment might have already arrived with another announcement of big lay-offs from big pharma (see http://www.bbc.co.uk/news/health-16851703 ). In the link, Prof David Philips of the RSC said ‘ It’s a fact that the easy targets, in the body, for the production of drugs have, essentially, all been used up’.

It is time for scientists to be a bit more humble and spend more time discovering and less time inventing. The answers are all around us already.