/ Health

Your view: do pharmacists and homeopathy mix?

Homeopathy pills in bottles

Our snapshot investigation into pharmacies revealed that 13 out of 20 failed to explain that there’s no clinical evidence that homeopathy works. It proved to be a popular starting point for discussion…

‘As soon as you talk about homeopathy, it divides opinion’, said our senior health researcher, Joanna Pearl, in her introduction to our investigation into pharmacists and homeopathy last week.

How right she was! Chrisb1 dared to open up the discussion by putting forward his view on the safety of homeopathy vs prescription medicine:

‘We should ask ourselves why prescription drugs, taken as prescribed in hospitals, are the fourth leading cause of death in the US and Canada, after cancer, heart disease and strokes. They cause about 10,000 deaths a year in Canada and about 106,000 deaths a year, and over two million serious injuries in the US.’

These statistics, and this view, were widely challenged by other commenters, including Paulj:

‘This isn’t an argument for an alternative such has homeopathy that has dubious, highly questionable evidence. Let’s improve evidence-based medicine rather than flee to non-scientific medicines.’

Guy Chapman believes there’s a reason why we have the term ‘alternative’ medicine:

‘A treatment is alternative only because it cannot be shown to work, or more likely it can be shown with good confidence not to (as with homeopathy). If it can be proven to work, it is no longer alternative, it is medicine.’

Should pharmacists sell homeopathy?

Many commenters – like Sophie Gilbert – think our snapshot investigation indicates a bigger problem with pharmacists selling homeopathy

‘Homeopathy belongs to the same realm as astrology and should not be recommended by pharmacists any more that financial advisers should recommend consulting our horoscopes to see if our investments are going to perform well in future.’

David Colquhoun agrees:

‘It is horrifying that pharmacists give such bad advice. Pharmacists are constantly pushing for a greater role in primary care. Their education seems just not to be good enough to take on that role at the moment. I have known some who are very good, but it seems they are still in a minority. I hope they take these revelations very seriously indeed.’

We even had Dr Ben Goldacre (author of Bad Science and Bad Pharma) join the discussion on Twitter (@bengoldacre):

What do pharmacists have to say?

A few days earlier, we published another Convo outlining the wider research into pharmacists’ advice. Karen joined that debate and made a good point about counter staff:

‘It is very difficult to approach some customers regarding their medicines as they tend to see Counter Assistants as ‘shop girls’ and refuse to take any advice given. It is very rare you get a good response when refusing to sell something to someone.

‘We need to remember that it is the counter staff who spend the most time with our patients and as such should be subjected to the same scrutiny as our pharmacists and technicians.’

On Twitter, pharmacist Joseph Bush (@josephbush) went a step further with his suggestion:

New vs old

The discussion on homeopathy went on to question how both alternative and conventional medicines move with the times. Dieseltaylor thinks that conventional medicine often backtracks:

‘I think one of the bugbears I have is that “proper” medicine has quite a few incidents of “we know we are right” and then in the fullness of time we find that in fact the medical fraternity are quite quite wrong. All I wish for is a little less hubris.’

Ned doesn’t think this made homeopathy any more credible, however:

‘Yes, scientific medicine evolves to take account of new evidence. You can’t do that without changing your advice.

‘By contrast, homeopathy is rigidly based on the unsubstantiated theories of a 19th century crackpot. But it makes a lot of money for pharmacists with little risk of them being sued for actually harming patients, (as long as they don’t advise people against going to a doctor for an effective cure).’

So do you think pharmacists should only recommend remedies backed by scientific evidence? So far, voters in our poll are overwhelmingly in favour, with nearly 80% saying that they should. Cast your vote now if you haven’t already, and tell us what you think about homeopathy being sold in pharmacies in the comments below.

Should pharmacists only recommend remedies backed by scientific evidence?

Yes - pharmacists should only recommend remedies backed by science (68%, 715 Votes)

Maybe - as long as pharmacists make clear it's just their personal opinion (17%, 179 Votes)

No - pharmacists should be free to recommend any remedy, including homeopathy (15%, 158 Votes)

Total Voters: 1,052

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Comments

I suggest that practitioners of homeopathy enrol at Hogwarts and learn something new from Harry Potter’s potions master.

Robin says:
9 June 2013

So far the supporters of homeopathy have been unable or unwilling to provide evidence to explain the rationale of the tapping process and how any process, or processes, as we can read there appear to be different ones, were validated as optimum. This is the stage, we are told where the magic happens. Thanks to Maria we know research is at “at early stage”, after 200 years. That may surprise some, not others.

I will live in hope that we might get an explanation, supported by evidence, but also will move on.

The next step, once an ultra diluted solution of water/alcohol has been prepared, is often to make a pill. Let us take the case of a highly diluted preparation, one that cannot have a single molecule of the original material in it.

Are the pills all the same size, how much of the solution is added, over what period of time. Is the final dilution and/or the pills kept as a stock, or made freshly every time? If they are kept, what data is there on stability? Bear in mind “because it still works” is not a fair answer. If it does act as a placebo then a placebo would also “work”. I suppose to use the language of the homeopaths, we need to know how long the water retains the memory. When does it forget, if ever, and what factors might contribute to the retention or loss? These seem like important questions you would need to consider if making a medicine and there has been 200 years to attempt to address them. What evidence is there to address these questions about this stage of homeopathic preparations?

Alan Henness says:
9 June 2013

Robin

Those are tough questions for any homeopathist to answer. We’ve still not had any good answer to my questions about the number of bangs required, but is anyone up for the challenge to answer Robin’s?

Oh, but maybe you’re not aware that one UK manufacturer of homeopathic sugar pills was found to be not producing their product correctly. Their automated production line was squirting the water into the glass tubes of sugar pills but was missing one in six tubes and the water was running down the side. There are no records of any complaints from customer that the sugar pills had stopped working…

And don’t ask about the broken glass!

Robin says:
9 June 2013

Alan
Yes it was the FDA, not even a UK regulator who found it if I recall correctly? Shame it wasn’t the Swiss

Alan Henness says:
9 June 2013

Yes, I have the FDA report…makes for very interesting reading…

But if it had been the Swiss, it would have been biased because of all the vested interests of all those big Swiss pharmaceutical companies. Or something.

Robin says:
9 June 2013

Alan
Next you’ll be suggesting homeopathy is all a conspiracy of “Big Sugar” 🙂

Robin: “Bankers, Buyouts & Billionaires: Why Big Herba’s Research Deficit Isn’t About The Money”

http://www.skepticnorth.com/2011/02/bankers-buyouts-billionaires-why-big-herba%E2%80%99s-research-deficit-isn%E2%80%99t-about-the-money/

It would be churlish to use this as a stick with which to beat the homeopaths, as such fallacious games are clearly their preserve not ours.

@Alan (to Robin)

Do you have a link to the article you are referring to in this partial comment I have pasted below? You posted it on June 9 2013 at 12:25 p.m. If not, the comment should be deleted.

You said: “one UK manufacturer of homeopathic sugar pills was found to be not producing their product correctly. Their automated production line was squirting the water into the glass tubes of sugar pills but was missing one in six tubes and the water was running down the side. There are no records of any complaints from customer that the sugar pills had stopped working”.

SAHC: Google FDA Nelsons.

And here’s the link: http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2012/ucm314629.htm

a. During the inspection, the investigator observed glass fragments present during the manufacture of Kali Phos 30 c Clikpak, Batch #36659. Specifically, glass fragments were observed in the Clikpak Assembly (b)(4) enclosed area where open glass vials are inserted into the outer plastic Clikpak sheaths and move uncovered on the conveyance mechanism. Your firm failed to implement adequate measures to prevent glass contamination and had no documentation to demonstrate that appropriate line clearance and cleaning is conducted following occurrences of glass breakage, which has been a recurring problem.

b. The investigator also observed for Batch #36659 that one out of every six bottles did not receive the dose of active homeopathic drug solution due to the wobbling and vibration of the bottle assembly during filling of the active ingredient. The active ingredient was instead seen dripping down the outside of the vial assembly. Your firm lacked controls to ensure that the active ingredient is delivered to every bottle.

c. The dosing process has not been validated appropriately. Specifically, your surrogate validation study, “Medication of un-medicated pillules with (b)(4),” visually demonstrates the variability of the amount of (b)(4) for the pillules in one vial. Your firm lacks control of the variation for the amount of the active ingredient in the pillules.

It seems very clear that no amount of reasoning will help to convince anyone who believes in homeopathy. Let us hope that their children and other dependants are not deprived of medical care because of their beliefs.

How do we tackle the problem that homeopathic preparations are sold by some pharmacists? How do we stop the NHS wasting public money on homeopathy?

Robin says:
9 June 2013

Wavechange
I think it is the sad truth and the worry is there seems to be a trend towards pushing homepathy in the developing world. We have heard people on this forum say they believe it can cure cancer. In countries where the regulation and oversight is nowhere near as strong the risks are greater that people will be directed away from effective help. You don’t have to look far for examples of homeopathy being promoted for malaria and HIV (including sadly the BBC giving a forum to these beliefs without challenge). Acceptance of it in the UK and it being used in the NHS gives it a respectability the evidence all suggests it does not deserve, I have no doubt that is used as “evidence” when promoting it elsewhere.

I don’t have any easy answers, but supporting Which, and challenging these views at every opportunity, shedding light on the detail that is often glossed over with a pleasant sounding sales pitch, is a good start. I have suggested visiting pharmacies where you live. If I find one who doesn’t follow the RPS advice I will report them. One person doing it probably won’t make a lot of difference. Everyone doing it might.

I believe I read that the current Health Minister replied to one of his constituents indicating he believed in homeopathy. This is, of course, in direct contradiction of the advice from all the senior medical and scientific advisors to the government. Guy posted a very pertinent quote about this earlier. This is the same minister who on the recent TV series NHS in a day asked “is all chemotherapy an infusion” – I suppose at least he was trying to learn. It does not not bode well.

Education in critical thinking is another avenue that I think should be explored as a more long term option – and perhaps as a prerequisite for senior public office?

Thanks Robin. I agree that we should be chatting to pharmacists, though I suspect that some are pushed to sell homeopathic ‘remedies’ if they are working in large organisations that see an opportunity for profit.

While reading some of the criticism of Jeremy Hunt regarding his support for homeopathy. I saw a nice comment, on the Guardian website. Homeopathy. There’s nothing in it. That would be a great strapline for an honest practitioner of homeopathy.

Guy,
cut poison and burn, is synonymous with surgery, chemo’ and radiation: so cut poison and burn boils down to what it actually is: cut poison and burn.

Robin says:
9 June 2013

Chris
You might have to fit in a few more things to your sound bite.

A friend of mine recently found a small squamous cell carcinoma on his hand. Left untreated, or treated with sugar pills it would have eventually have killed him.

Instead he had a simple cryotherapy procedure and the cancer is cured, and after a few weeks there is barely a scar to be seen. So freezing might have to be added in there as well if you think these techniques have no value.

Many people are alive today as their early skin lesions were cut out. I do not want to head down another diversionary path but the evidence tells the story, not the propaganda.

Chris: Yes, I know that “cut, poison, burn” is an attempt at framing by quacks who hate medicine. You don’t need to tell me what it means.

Cancer: A collection of diseases sharing some common characteristics, primarily that they are characterised by the uncontrolled growth of abnormal cells. Cancers may be aggressive or indolent, and they may be solid or liquid. They may metastasize, or not. Sometimes they spontaneously disappear or stabilise, most times they do not. Cancer, as a single term, does not usefully describe any single disease.

Cut: Surgery. Also used to cure heart defects, trauma, appendicitis and other medical emergencies. One of the few areas of medicine where it is generally agreed that RCTs are not necessary, because it is impossible to come up with an ethical way of testing whether it is a good idea to remove cancers or not. Indolent cancers are given “watchful waiting”, monitoring in case they become aggressive or invasive, aggressive cancers are removed as promptly and as completely as possible. This is controversial in the same way that gravity is controversial.

Poison: A pejorative framing of chemotherapy. Chemo comes in many varieties and is used for at least two completely distinct reasons. In solid tumours, chemo may be used as an adjuvant therapy to reduce the chance of recurrence. In liquid disease chemo may be the primary therapy. Some chemotherapies are exceptionally effective, and directly target the tumour’s biological mechanisms. Some chemotherapies are just cytotoxic so kill all fast-dividing cells. Nobody particularly likes these and there is a lot of debate in medicine over whether they are necessary in cases where surgery and radiotherapy jointly provide a very high chance of cure, mainly in discrete solid tumours. The day someone comes up with a better way of managing disease, oncologists worldwide will dance in the streets. They hate what it does to patients and use it only because there is no alternative shown to provide better results.

Burn: A pejorative term applied to radiotherapy. Radiotherapy, like chemo, kills cells, but it can be directed very much more accurately. It is used in both malignant and benign tumours. It is often used to reduce tumours before surgery, to control pain or to target residual tumours or those which are not surgically accessible. Radiotherapy is a particular bogeyman for people who do not realise that life on earth is exists only because we are continually bombarded by radiation from a massive fusion reactor.

Missing from the unholy triumvirate are gene therapies and preventive therapies such as HPV vaccination. The latter is a particularly interesting case as all vaccinations are considered evil by most anti-medicine cranks so they are in the position of opposing both a treatment that provably reduces the risk of cancer, and any therapy which treats that cancer. These people are the ones most likely to accuse medicine of loving cancer and to propose completely ineffective alternatives.

So, that’s “cut, poison, burn” laid to rest. Any other anti-medicine tropes you’d like debunked while we’re about it?

[This comment has been edited for breaking our guidelines. Thanks, mods.]

Robin said: Instead he had a simple cryotherapy procedure and the cancer is cured, and after a few weeks there is barely a scar to be seen. So freezing might have to be added in there as well if you think these techniques have no value.

I say:
Just because the small squamous cell cancer on your friend’s hand is not visible to the naked eye does not mean it is not still present microscopically. Wait a few months or a year to pronounce an effective “cure.” Remissions and other squamous cell cancers may reappear. Removing something from the surface does not mean that the systemic condition causing the carcinoma in the first place has been eliminated. Unfortunately, this is the type of comment that is so misleading.

It is all too common for people who have no formal training in medicine to misunderstand the language of same.

Robin says:
9 June 2013

SAHC
Fair comment that we can’t be sure it is completely clear. I apologise for my incautious use of language.

However, the clinical experience with very small lesions shows for some specific types of cancer that any growth following treatment is very rare. SCCs of these size are not often found to have crossed the basement membrane and are hence local to the epidermis, which not having a blood supply means the tumour is in situ and can’t spread, and thus has a very high probability of being destroyed by the treatment. That is not the case for all types of lesion, melanoma being a prime example where far greater care is required.

And if we want to be pedantic without pathology we can’t be 100% sure it was an SCC, it was the opinion of the dermatologist based on his experience that the lesion was most likely to be an SCC rather than say a solar keratosis, and best removed while very small. SCC is not often invasive, but if left untreated for a long period the probability of doing so will most likely increase.

But that is an aside, my point was if he’d taken sugar pills instead he’d be highly likely to die if it were a tumour, spontaneous remission being the exception, and that the mantra of cut, poison burn doesn’t include all therapies, as Guy so eloquently expanded on.

Robin says:
9 June 2013

SAHC
and just to absolutely clear if the lesion was an SCC, had not crossed the basement membrane and the freezing killed all the SCC cells then it has gone. There is no underlying “systemic cause” remaining that we know of, UV exposure is the biggest risk factor.

What kind of systemic cause did you have in mind? (But I’d much rather stay on topic and have answers to the questions on homeopathic methodology answered.)

Robin said:

“But that is an aside, my point was if he’d taken sugar pills instead he’d be highly likely to die if it were a tumour,”

My reply:

That is an assumption on your part, not a fact.

Robin says:
9 June 2013

SAHC
Plenty of people who take sugar in their diet die of cancer.

I don’t want more to die of ignorance.

What is your point, what systemic causes, and of course no homeopath can claim to cure cancer without falling foul of the 1939 Cancer Act.

Robin says:
9 June 2013

SAHC I see you’ve moved on, but let me conclude this part of the discussion.

You don’t seem to have noticed that it was you who made an assumption, not I. Re -read what we both said.

I said if he’d taken no treatment other than sugar pills he would die.

either you think sugar pills cure cancer
or
you assumed I meant homeopathy when I said sugar pills, are you agreeing that homeopathy is just sugar pills? I’d happily be guilty of making an assumption if that were the case.

Guy,
you are being too simplistic making generalized sweeping inaccurate comments on how people like me, who use the term cut, poison and burn.
It is not stupid either, because those terms are used for what they are: barbarism and and futile efforts that attempt to treat the causes of cancer. The only saving grace is the surgery, but this does not resolve the issue of cancer returning or being inoperable, and where the others are merely barbarism at treating a disease, where the cause is unknown (according to Medical Science that is).

Typical of Medicine to place an array of names on what is a singular disease process: cancer. Other examples are anything ending in “itis” (inflammation) such as arthritis or bursitis, bronchitis and so on and so on, and meaning inflammation of that particular body part of group of organs.

Cut: Surgery. meaning only in the treatment of cancer Guy; the word is not used in other surgical interventions which may or may not be necessary, but can indeed be life-saving and a valuable part of Mainstream Medicine.

Poison: A pejorative framing of chemotherapy and Radiation.

Absolutely.

“The great success stories of chemotherapy were always in relatively obscure types of cancer. Childhood leukemia constitutes less than two percent of all cancers and many of chemotherapy’s other successes were in diseases so rare that many clinicians had never even seen a single case (Burkitt’s lymphoma, choriocarcinoma, etc.)”—Ralph Moss

“Two to 4% of cancers respond to chemotherapy….The bottom line is for a few kinds of cancer chemo is a life extending procedure—Hodgkin’s disease, Acute Lymphocytic Leukemia (ALL), Testicular cancer, and Choriocarcinoma.”—-Ralph Moss, Ph.D. 1995 Author of Questioning Chemotherapy.

“1.7% increase in terms of success rate a year, its nothing. By the time we get to the 24 century we might have effective treatments, Star Trek will be long gone by that time.” Ralph Moss.

The fact that breast irradiation increases the risk of heart disease is not a new finding. Starting in the late 1960s, it became known that, after receiving adjuvant radiation to prevent breast cancer recurrence, more women than expected were dying of heart disease, sometimes decades after their initial surgery. It took brilliant medical detective work to prove that this apparently successful use of radiation therapy was also the cause of many cardiac deaths (Fajardo 2001). So many women were dying of the long-term adverse effects, in fact, that it more or less counterbalanced any survival benefit from the treatment itself.
Radiation is a classic two-edged sword. It does substantially reduce the risk of recurrences of breast cancer in the irradiated field. But this comes at the price of an increased risk of damage to the heart, especially when the internal mammary lymph node chains are irradiated or when the patient is a smoker. Patients and their physicians need to carefully weigh benefits and risks before agreeing to this or any other potentially toxic treatment.[2007] Big Blow to Radiation Therapy for Breast Cancer by Ralph W. Moss, PhD
“If you can shrink the tumour 50% or more for 28 days you have got the FDA’s definition of an active drug. That is called a response rate, so you have a response..(but) when you look to see if there is any life prolongation from taking this treatment what you find is all kinds of hocus pocus and song and dance about the disease free survival, and this and that. In the end there is no proof that chemotherapy in the vast majority of cases actually extends life, and this is the GREAT LIE about chemotherapy, that somehow there is a correlation between shrinking a tumour and extending the life of the patient.”—Ralph Moss

“A study was done which shows the majority of oncologists who refer patients for chemotherapy for lung cancer would not themselves take chemotherapy for lung cancer. And in fact if the chemotherapy involved cis-platen, something like 75% of them said they wouldn’t take it. But what do these people do all day long? They’re sending people for cis-platen.”–Ralph Moss (www.ralphmoss.com

“The great success stories of chemotherapy were always in relatively obscure types of cancer. Childhood leukemia constitutes less than two percent of all cancers and many of chemotherapy’s other successes were in diseases so rare that many clinicians had never even seen a single case (Burkitt’s lymphoma, choriocarcinoma, etc.)”—Ralph Moss

“Kanematsu Sugiura…..took down lab books and showed me that in fact Laetrile is dramatically effective in stopping the spread of cancer. The animals were genetically programmed to get breast cancer and about 80 – 90% of them normally get spread of the cancer from the breast to the lungs which is a common route in humans, also for how people die of breast cancer, and instead when they gave the animals Laetrile by injection only 10-20% of them got lung metasteses. And these facts were verified by many people, including the pathology department.”—Ralph Moss

“It amazes me how much of what passes for knowledge in cancer therapy turns out to be incomplete, inadequate, and anecdotal.”—Ralph Moss, Ph.D.

So when I used the terms cut, poison and burn, that is essentially what they are, esp’ the poison and burn which do absolutely nothing to address the causes of cancer.

Chris: Once again you are citing cranks as authorities. Ralph Moss has a PhD in classics, he has no medical qualifications (although he once worked as a science writer for Memorial Sloan-Kettering, until he was sacked for accusing them of suppressing a quack cancer cure). He makes a lot of money promoting quack remedies, but there’s no evidence he has any expertise in cancer at all.

The relevance of your distractions to homeopathy, which is an alternative to medicine in the same way that magic carpets are an alternative to aeroplanes, remains unclear.

Robin,
as long as your friend realizes that just because the carcinoma has been successfully treated with cryotherapy, does not mean that his cancer is not still there, or do you really believe that cancer is only visible to the naked eye? or even spread elsewhere?
Cancers sometimes take years to develop from their origins on a cellular level and even then not detected microscopically for years after it begins to grow and spread.

Robin says:
9 June 2013

Early treatment of SCCs with cryotherapy is around the 95% or even higher level of successful, so yes there is a small percentage possibility based on follow up studies. However as I said if the conditions I stated are met, then it will be gone, completely and will not return.

Robin: Aye, squamous cell carcinomas are at particularly low risk of metastasis, if they are well differentiated the chance of a permanent cure with surgery is excellent.

Robin says:
9 June 2013

He was at lunch with a consultant dermatologist when he mentioned it, good lunch, quick diagnosis of a minuscule lesion, and treated the same day. Guaranteed good follow up. Regrettable I used the word cure but I was supposed to be cutting a hedge so posted in haste. And Chris thank you, I will take your comment as well meant in case he and I didn’t understand the risks. As it happens he and I have a good grasp of carcinogenesis, which make she slip all the sillier!

Guy,
just one question: why should anyone need a medical qualification to act as a whistle-blower concerning (in this case) what is going on in the cancer industry? And make no mistake it is an industry.
This means there must be thousands if not millions of cranks out there. I am in frequent conversation with them most of the time, while I am typing.

Ralph W. Moss Ph.D., has been a journalist in the field of cancer. From 1974 to 1977, he was science writer (later assistant director of public affairs) at Memorial Sloan-Kettering Cancer Center in New York. Since being fired for “WHISTLE BLOWING,” he has written ten books which have helped define the field of alternative medicine (Cancer Therapy, The Cancer Industry, Questioning Chemotherapy, Herbs Against Cancer, etc.). Many consider him one of the world’s leading authorities on alternative and complementary approaches to cancer. Famed physician and author Dr. Julian Whitaker has said that if he had cancer he would turn first to Dr. Moss.

Ralph Moss’ account of his involvement with cancer and the cancer industry (verbatim)…………..
http://www.whale.to/c/moss.html

[This comment has been edited for breaking our guidelines. Thanks, mods.]

Chris: The phrase “cancer industry” is yet another example of framing, a pejorative used by the worst kinds of charlatans in the world: cancer quacks. I have never heard the term “cancer industry” used by anyone who was not advocating quack remedies. Usually laetrile, but also Gerson, Hoxsey, homeopathy and vitamin megadoses. None of these things cure cancer. Vitamin megadoses actually increase the risk of cancer, probably by upsetting free radical homeostasis.

Ralph Moss is a crank. He didn’t “blow the whistle”, he made a palpably bogus claim against his employer. He accused a world-renowned cancer center of “suppressing” a “cure” when in fact their investigations led them to the conclusion that it was not a cure. It is a repeatable feature of cranks that they cannot accept that science is generally conducted in good faith, and cannot accept that when science conflicts with their belief, it is almost always their belief that is wrong.

The crank mindset permits of only two possibilities: either they are right and the science supports them or they are right and science is suppressing them.

Citing whale.to as a source again is a clear sign that you have failed to understand why your arguments are consistently unpersuasive. If you genuinely believe that the Protocols of the Elders of Zion is an accurate historical document of a Jewish conspiracy then I have nothing further to say to you. If you don’t, then stop citing whale.to.

Adding some information to this discussion. Can the defenders of “real drugs” defend these practices noted in the publications cited below? I think the supporters of homeopathy have done a remarkable job defending it. Time for the detractors to defend the drugs of mainstream “real medicine” for a change. Give it your best shot.

From the Live Science website: Title: Dark Side of Medical Research: Widespread Bias and Omissions

“For instance, drugs such as Tambocor (flecainide) prescribed in the 1980s to prevent irregular heartbeat may have cost thousands of lives, according to a national study conducted by the National Institutes of Health from 1987 to 1989. That tragedy occurred because early warning signs of dangerous side effects were not published.”

Source: http://www.livescience.com/8365-dark-side-medical-research-widespread-bias-omissions.html

************
Title: Systematic Review of the Empirical Evidence of Study Publication Bias and Outcome Reporting Bias

“Conclusion: Recent work provides direct empirical evidence for the existence of study publication bias and outcome reporting bias. There is strong evidence of an association between significant results and publication; studies that report positive or significant results are more likely to be published and outcomes that are statistically significant have higher odds of being fully reported. Publications have been found to be inconsistent with their protocols. Researchers need to be aware of the problems of both types of bias and efforts should be concentrated on improving the reporting of trials.”

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0003081

******************
Title: Outcome reporting bias in randomized trials funded by the Canadian Institutes of Health Research

“Prevalence of incompletely reported outcomes:

Incompletely reported efficacy and harm outcomes were found in 96% (46/48) and 81% (21/26) of the trials respectively. A median of 31% of efficacy outcomes per trial were incompletely reported, as compared with 59% of harm outcomes per trial (Table 1). Incompletely reported outcomes were common even when the total number of measured outcomes was low (Fig. 3). Primary outcomes were incompletely reported in 7 (16%) of 45 trials that defined such outcomes in their publications. The proportion of incompletely reported harm outcomes was lower among the trials published in general medical journals than among those published in specialty journals (Table 1).”

Source: http://www.cmaj.ca/content/171/7/735.full

**************
Title: “Review Reporting Bias in Medical Research”

Source: http://www.biomedcentral.com/content/pdf/1745-6215-11-37.pdf

*******************
Title: Reporting bias in medical research – a narrative review”

“The role of the pharmaceutical industry – An association has been shown between industry sponsorship or industry affiliation of authors and positive research outcomes and conclusions, both in publications of primary studies and in systematic reviews [49,54-63]. For example, in a systematic review of the scope and impact of financial conflicts of interest in biomedical research, an aggregation of the results of 8 analyses of the relation between industry sponsorship and outcomes showed a statistically significant association between industry sponsorship and pro-industry conclusions [55]. A comparison of the methodological quality and conclusions in Cochrane reviews with those in industry-supported meta-analyses found that the latter were less transparent, less critical of methodological limitations of the included trials, and drew more favourable conclusions [57]. In addition, publication constraints and active attempts to prevent publication have been identified in industry-sponsored research [55,64-68]. Other aspects of industry involvement, such as design bias, are beyond the scope of this paper.”

Source: http://www.trialsjournal.com/content/11/1/37

SAHC: Can you please clarify the relevance of the acknowledged problems with medicine, usually identified through the diligent exercise of science, to the use of a superstitious alternative treatment that lacks any plausible mechanism of operation and for which there is, unsurprisingly, no credible evidence of efficacy beyond placebo?

SAHC: In other words, why should we believe that science is always right when it finds a problem with medicine, and always wrong when it finds that homeopathy is bunk?

Guy said:

SAHC: Can you please clarify the relevance of the acknowledged problems with medicine, usually identified through the diligent exercise of science, to the use of a superstitious alternative treatment that lacks any plausible mechanism of operation and for which there is, unsurprisingly, no credible evidence of efficacy beyond placebo?

My reply: Why?

SAHC: Because the topic of this debate is the fact that pharmacists are going against the guidance of their professional association and selling people treatments with no credible evidential basis (and indeed no tangible connection to reality).

I can quite see why you wouldn’t want to talk about that, maybe you should ask Which? to run a piece on the AllTrials initiative and the need for transparency in medicine. They could interview the excellent Ben Goldacre and Simon Singh.

Just have to share this article for those of you who SUPPORT, homeopathy by Robin McKinley and titled: “Homeopathy. Yes. It works”. I especially like this comment:

“The two remedies I carry teeny-tiny bottles of in my pocket are Arnica and Aconite. Aconite is the go-to remedy for shock and fear, and one of the guidelines about using it is that if you’re in a situation where someone is freaked out enough for you to be giving it to them, you should probably take it too because fear is contagious. You’re first on the scene at a traffic accident? While you’re waiting for the ambulance, give anyone who’s injured Arnica***—but give everyone present Aconite.”

Source: http://robinmckinleysblog.com/2013/04/03/homepathy-yes-it-works/

SAHC: Whistling in the dark. The testimony of the faithful, bolstering the faith.

Guy said: SAHC: Whistling in the dark. The testimony of the faithful, bolstering the faith.

My reply: Can you flat out deny that you are not doing the same for Big Pharma? Spare me.

Actually, the people who are familiar with the two remedies and their indications (consult any one of your copies of the Materia Medicas with Repertories), the quote from the doctor’s article is very wise. Sorry you did not understand.

Oh, and for your knee problems you mentioned in a prior comment…instead of playing the part of a martyr who is “living with the pain” since it is not life threatening, why not consult your family homeopath? Touché !

Oh, forgot this helpful information on homeopathic remedies for guinea pigs… I’m sure it will force you to make some comments… :o).

http://aprillodge.co.uk/care/alternative-remedies-for-guinea-pigs/

SAHC: On September 27, 2012 I logged the first customer review of Bad Pharma on amazon.com. It was a 5* review. The idea that I am an uncritical fan of “big pharma” is your fantasy, and has no basis in truth.

The issue under discussion, however, is not the problems with medicine, however much you might prefer to talk about that. It is the fact that pharmacists are offering bogus treatments.

I was a bit unclear why I posted my last comment about the homeopathic remedies for guinea pigs…I should have prefaced it with remedies for your guinea pigs. Love the photos you have posted of them on your site.

SHAC: As to my knee problem, I will be consulting my holistic healer, as always. He is excellent. He trained alongside Andy Wakefield (impeccable credentials I am sure you’ll agree) and he diagnosed my coeliac disease with the help of a phlebomancer. It was confirmed by an expert who literally reached inside me to remove a sample of intestinal villi, obviously without actually touching my intestine, that would be silly. I then saw a remote viewer who looked straight through my bones and found evidence of osteoporosis and a nutritional expert who advised me to cut gluten from my diet.

All available on the NHS!

Link to my page talking about my holistic healer: http://www.chapmancentral.co.uk/blahg/2012/08/my-holistic-healer/

Guy,
I believe you mentioned you had osteoarthritis in your knee.

This is the most common type of arthritis, a degenerative arthritis usually associated with poor nutrition and aging. Its primary symptoms include knee, back and hip pain, which can lead to surgical replacements. The hands, wrists and shoulders are also commonly affected. Most people over 60 in this country have some symptoms of osteoarthritis. This type of arthritis occurs as a result of inflammation and weakening of the joint capsule and cartilage lining the joints.
Arthritis sufferers spend more than $1 billion annually on drug treatments. One million new cases are diagnosed every year, and the number is growing. Drugs and surgery are the standard treatments offered by the medical profession without attention to cause or nutrition. The Arthritis Foundation boldly declares in their literature that there is no special diet for arthritis and that food has nothing to do with causing it. Fortunately, there is solid evidence to refute this ill-informed and irresponsible opinion, including hundreds of scientific studies reported in medical journals.
http://www.drfuhrman.com/disease/arthritis.aspx

or better still……………..

“Although people with OA are best treated with an individualized homeopathic remedy chosen by a professional homeopath, several trials have found that some common homeopathic combinations may be at least as effective as conventional medications for OA. Potential remedies include:
A topical homeopathic gel containing comfrey (Symphytum officinale), poison ivy (Rhus toxicodendron), and marsh-tea (Ledum palustre)
A combination homeopathic preparation containing R. toxicodendron., Arnica montana (arnica), Solanum dulcamara (climbing nightshade), Sanguinarra canadensis (bloodroot), and Sulphur
A liquid homeopathic preparation containing R. toxicodendron, Causticum (potassium hydrate), and Lac vaccinum (cow’s milk)
Other Common Homeopathic Remedies for OA Include:

Calcarea carbonica (carbonate of lime or calcium carbonate)
Bryonia (wild hops)
Graphites
Guaiacum

Source: Osteoarthritis http://www.umm.edu/altmed/articles/osteoarthritis-000118.htm#ixzz2Vkxv5BLx
The University of Maryland Medical Center.

So you therefore have a choice of accepting medical advice and continue to live with a worsening degenerative condition and possible knee-replacement, or you can actually do something effective about it and even rid yourself of it.

Guy said to SAHC:

On September 27, 2012 I logged the first customer review of Bad Pharma on amazon.com. It was a 5* review. The idea that I am an uncritical fan of “big pharma” is your fantasy, and has no basis in truth.

The issue under discussion, however, is not the problems with medicine, however much you might prefer to talk about that. It is the fact that pharmacists are offering bogus treatments.

My reply:

Congratulations on your 5* review. To continue, I think the “issue under discussion” here went far astray the very first page when you started bashing homeopathy with your comment (4th one down) to wit:

“The problem is that homoeopathy is essentially a religion. It is not a rational belief system, so countering it with rational arguments only persuades those who are looking in from the outside. Once people are believers, their fellow religious will rapidly arm them with a series of rhetorical tools to avoid the cognitive dissonance generated by reality-based commentary.

Of course many Christians are not biblical literalists and don’t hold with young-earth creationism, or the literal virgin birth, but the evangelical types do and it’s they who tend to make new converts. The average Anglican shrugs and ignores this, as I guess the average casual shopper who pops Arnica when they have a bruise might discount the controversy, but the evangelists of homoeopathy spread dangerous disinformation in order to stir the faithful. They promote an anti-science, anti-vaccination, anti-rationalist agenda that is profoundly dangerous – for example, users of alternative medicines have worse cancer outcomes, because they typically present later, having tried woo first.

That’s why pharmacists and doctors should not touch homeopathy with a ten foot pole. It should be made entirely clear that this is nonsense, it has no validity, it has no parity with medicine. If people are still determined to find and use it then it’s their funeral but it should not be placed alongside medicine or event the largely harmless quackery of miracle diets, unnecessary supplements and the like.”

To continue my answer: Did you really think that no one who supports homeopathy would want to counter your attack on that first page? The first comment did not bash homeopathy, nor did the second. The third comment was a bashing comment with no answer to the question posed. You, however, chose to first bash homeopathy in two paragraphs, then answer the question in the third paragraph. You could have easily stopped bashing homeopathy after you answered the question and had made your point. But, but you chose to continue your unrelenting bashing instead. Why?

SAHC: the lack of any credible evidence of effect for homeopathy is directly relevant to the issue of pharmacists selling it, in a way that the known, documented and openly acknowledged issues with various medicines, is not.

It seems to me to be relevant that homeopathy is a religion – it has been called a cult by an ex-believer – because that explains so much about how believers approach debate.

Guy said:

SAHC: the lack of any credible evidence of effect for homeopathy is directly relevant to the issue of pharmacists selling it, in a way that the known, documented and openly acknowledged issues with various medicines, is not.

It seems to me to be relevant that homeopathy is a religion – it has been called a cult by an ex-believer – because that explains so much about how believers approach debate.

My reply:

But, you made your point on the first page and answered the question You then continued to bash homeopathy’s supporters instead of moving on to another article and/or discussion. Why?

I’m sure that I and other supporters of homeopathy will meet and challenge you again in the future. You and others post comments that intend to ridicule.

This forum is not the first encounter I have had to dodge the slings and arrows of similar ridicule and it will not be the last. The difference in my case, unlike others, is that I am not paid to comment. Could that be the driving force for the continued ridicule?

SAHC: as far as I can tell, the only thing you dodge is the facts.

When you find out who is supposedly paying skeptics to challenge nonsense, please let us know. The money would be welcome. At present the only people provably profiting in debates about homeopathy are the homeopaths who turn up.

Chris: Just as well you’re not my doctor. The osteoarthritis is the result of an injury sustained in a collision caused by the negligence of a car driver. I am nowhere near 60, fit, a regular cyclist, have an excellent diet slightly complicated by coeliac disease, and have no intention of undergoing surgery for it.

Your claim that it is “best treated with an individualised homeopathic remedy” I will file with the equally sincerely offered opinions that it is best treated by prayer, acupuncture, reiki, chiropractic and an number of other delusions, thanks all the same.

Guy said:

Link to my page talking about my holistic healer: http://www.chapmancentral.co.uk/blahg/2012/08/my-holistic-healer/

My reply

Your post was in August of 2012, 10 months ago. The link to your doctor showed an 404 error message, so I could not read that.

Can you report that you are better now with his recommended treatment or drugs? If not, you may want to consult a homeopath. Many homeopaths worldwide consult by Skype if you do not trust the homeopaths in the UK. The homeopaths in India are doing incredible work.

No one need “live” with many disease conditions and suffering when there are alternatives, including homeopathy. Difficult to lead a horse to water, much less expect him to drink. Sad.

Guy said to chris1 that your OA is

“slightly complicated by coeliac disease”

Pathologically speaking, coeliac disease could be the cause of improper nutrition.

Have you read the book “Wheat Belly” by William Davis, M.D. which addresses gluten and wheat intolerance which leads to coeliac disease?

Robin says:
10 June 2013

SAHC

That is a very strange attitude.

If I believe homeopathy is a delusion, why wouldn’t I continue to discuss the issue?

It is abundantly clear you feel homeopathy “works” so ask yourself the exact same question.Why continue to argue/discuss if you have made your point?

As for the outrageous accusation of payment, well that is just bizarre. It is not the first time that a supporter of homeopathy has played the conspiracy/victim card. Please provide evidence.

I will state categorically I am not rewarded in any way other than intellectually, by participating in this discussion at at times that is very tenuous.

There is a school of thought that if you don’t want to be ridiculed don’t say something ridiculous. You may not accept it but homeopathy is a minority opinion. From most people’s perspective it’s invoking magic or frankly nonsense. It can’t be pleasant but it isn’t surprising.

When Chris says “So you therefore have a choice of accepting medical advice and continue to live with a worsening degenerative condition and possible knee-replacement, or you can actually do something effective about it and even rid yourself of it”

A small prize for anyone who can show an objectively quantifiable difference between the above and “you have a choice of accepting that when you die you are gone, and continuing to live your life as if it’s the only one you get, or you can accept the Flying Spaghetti Monster as your saviour and have eternal meatballs”.

Guy,
“The issue under discussion, however, is not the problems with medicine, however much you might prefer to talk about that. It is the fact that pharmacists are offering bogus treatments”.

Actually, the original issue was to do with the conflicting and inconsistent “advice” given out by Pharmacists: “13 out of 20 Pharmacists “failed to explain” that there’s no clinical evidence that homeopathy works”.

This begs the question as to why Pharmacies sell Homeopathic remedies anyway, knowing as they do that (in their opinion) their is no clinical evidence that homeopathy works. Or in other words, mainstream drug-dealers selling placebos. Shame on you. Shame.

The discussion escalated into an attack on homeopathy, rather than a critique of the Pharmacists, misleading the public at large, where the latter should have been the case.

Further, the gang of five responsible for this critique and whitewashing of homeopathy, defend their untenable position from their premise that mainstream pharmaceuticals are in some way superior, and the hallmark of EBM, and and what they refer to as REAL medicine.
Joke.

The Skeptic movement, of which they are most definitely entwined is essentially anybody who questions vaccines, practices or endorses Alternative Medicine, suggests that the US/UK conventional medical model is flawed, is a parent of an Autistic child looking for solutions and so on. They are not yet known to be an organized group with AGM’s as such at a specific venue, but they do tend to congregate on WHICH forums such as this on homeopathy, and earlier on nutritional therapists, and of course on anything else remotely considered to be Alternative in the future. The same and identical participants, who have the agenda as described in the opening sentence of this paragraph.
Their role as skeptics is a misnomer because their stance does not question their own ingrained views of mainstream medicine, or even admit that there is much wrong with this practice of healthcare at all, except to grudgingly concede the role of biased pharmaceutical studies and follow the lead of Ben Goldacre.
It has been fairly obvious then from the outset, that the views of this group of people were predetermined, and therefore any hope of a rational or objective/impartial discussion/debate failed to materialize.

Chris: I agree that pharmacists should not sell homeopathic products. Your wilful misunderstanding of what skeptics believe and why is clear already so did not need restating.

SAHC: “Wheat belly” is unmitigated tripe. Coeliac is an autoimmune disorder affecting perhaps half a percent of the population, and it has specific diagnostic tests. The fundamental problem with the US population is not that they consume wheat, but that they consume too much, and much of it is of poor nutritional quality.

Guy,
“A small prize for anyone who can show an objectively quantifiable difference between the above and “you have a choice of accepting that when you die you are gone, and continuing to live your life as if it’s the only one you get, or you can accept the Flying Spaghetti Monster as your saviour and have eternal meatballs”.

In other more intelligible words: “gobbledygook”.

Guy………………..
“Chris: I agree that pharmacists should not sell homeopathic products. Your willful misunderstanding of what skeptics believe and why is clear already so did not need restating”.

Misunderstanding? I understand only too well Guy.

Scientific skepticism: an impartial attitude of the mind previous to investigation.
Skepticism is the process of applying reason and critical thinking to determine validity. It’s the process of finding a supported conclusion, not the justification of a preconceived conclusion.

You disqualify because of your “preconceived conclusions” with anything and everything Alternative or Complementary and despite the evidence which you have willfully ignored on anything alternative.

A more accurate description would be “Scientismist” or someone who has a “belief” (religion) in the universal applicability of the scientific method and approach, and the view that empirical science constitutes the most authoritative worldview or most valuable part of human learning (to the exclusion of all other viewpoints).

Guy,
“Your claim that it is “best treated with an individualized homeopathic remedy” I will file with the equally sincerely offered opinions that it is best treated by prayer, acupuncture, reiki, chiropractic and an number of other delusions, thanks all the same”.

Illustrates exactly what I been saying: your dogma and unreasonable prejudice against ANYTHING alternative, and despite the scientific evidence, so thank you for revealing the same.

Your starter for ten………..

The science of acupuncture……………..

http://www.the-scientist.com/?articles.view/articleNo/35301/title/The-Science-of-Stretch/
http://www.dnaindia.com/health/1823613/report-science-behind-acupuncture-revealed
http://www.news-medical.net/news/20130417/Science-behind-medical-acupuncture.aspx

“In what was hailed as “the largest, longest, and most rigorous study of acupuncture” ever conducted, acupuncture was found to reduce pain and improve function and movement among patients with osteoarthritis of the knee when used with other treatments”………………………..
http://www.webmd.com/pain-management/features/acupuncture-pain-killer

Chris: I have said several times what evidence I would consider compelling, such that I would change my mind. What would convince you that homeopathy is in fact bogus?

To reiterate: bring me a credible mechanism of action that accounts for the apparent inconsistency with current science, and a properly robust trial that shows a specific effect (e.g. three arm, selected remedy versus contraindicated remedy versus blank) and I will take it seriously enough to at least start looking at why anyone would think that provings are anything other than an exercise in self-delusion.

So, over to you. What would you consider clinching disconfirming evidence?

Chris: If you understand how skeptics view the world and what motivates us, why do you consistently assert that it is something else entirely? I was going with a charitable assumption of ignorance, the possibility that it’s deliberate falsehood on your part honestly didn’t occur to me.

Alan Henness says:
10 June 2013

chrisb1 said:

“The discussion escalated into an attack on homeopathy, rather than a critique of the Pharmacists, misleading the public at large, where the latter should have been the case.”

Well, when homeopathists come on telling us that homeopathy works, that has to be corrected lest readers were left with the erroneous impression that magic sugar pills actually worked and end up wasting the hard-earned money on it or end up relying on it instead of proper treatments.

“Further, the gang of five responsible for this critique and whitewashing of homeopathy, defend their untenable position from their premise that mainstream pharmaceuticals are in some way superior, and the hallmark of EBM, and and what they refer to as REAL medicine.
Joke.”

No. You need to re-read page 1. There are problems with the evidence base for *some* medicines, but, in general, there is compelling evidence for many of them. Perhaps you remember the 80% figure I quoted?

And, as has been said before and not refuted, just about anything trumps the zero % good evidence there is for homeopathy.

Robin says:
9 June 2013

Well no joy on the understanding of tapping, nor on water memory, pill making or stability.

Let’s try “provings”

I think it sounds like an oxymoron, but I will try and keep an open mind.

So we now have our homeopathic pill. In order to test it, from what I have read the pill is given to people and they are then asked what they experience. I think the people aren’t told what the supposed content of the pill, or its effects are, but it isn’t always crystal clear from my reading, so there may be a chance of suggestion playing a role in some cases.

The next part doesn’t seem to be consistent, sometimes it is diaries sometimes interviews, so again suggestion, leading questions, etc might play a role.

It certainly doesn’t seem to be ever controlled, for obvious reasons I hesitate to say placebo controlled. But the subjects are not ( at least that I have found) split and some given the same pill sans the homeopathic solution to test for such effects. Nor is there even a completely untreated group for comparison.

So the subjects know they are taking something, this is of course classical grounds for generating a placebo effect.

Here is one example
http://www.maryenglish.com/helvetia-proving.html
If anyone hasn’t seen this I highly recommend it. A homeopathic remedy is prepared from the wreck of a ship, honest.

I hope my description is at least reasonably close. If anyone can shed more light it would be helpful.
This example uses a very small sample, what sort of sample sizes are typical? Are all provings at best, single blinded, uncontrolled and the observer/investigators knows who is treated with what? Have there been any significant changes in the process since it was first performed in the time of Hahnemann? If so on what basis was this decided?

Alan Henness says:
9 June 2013

Ah, provings – the misnomer of misnomers!

But the interesting thing is whether they are actually clinical trials…

Alan: Clinical trials or comical tribulations? You decide…

Alan and Guy,
no one has yet answered my question as to whether RCT’s are your only acceptable form of evidence? and if not, which other types of “evidence” would you find acceptable for having any kind of therapeutic value.?

Robin says:
9 June 2013

Alan, Guy

Perhaps what this convo. needs is some homeopathic Berlin Wall ( I have some fragments I picked up as a guy was hammering it, so can vouch for its authenticity) I had a nerve jangling walk across a pipe over a river to get to it. But I will have to prepare my shed first…

I won’t cite the source as it delays posting but the text alone should guarantee a hit on a search if not I will post it later if anyone feels the need.

—-
There has even been a remedy made from a piece of the Berlin Wall. My homeopath had this remedy, and says it was so powerful she had to keep it away from her other remedies, out in the garden shed.

According to an editorial in the International Homeopathic Internet Journal, “Berlin Wall has many symptoms that fit the psychological aspects of that wall, a split between two worlds. The wall in Berlin seems to have been immersed with the psychological emotions and thoughts of humankind.”
—-

So if you you feel split between two worlds I can try and make a remedy for you, if I can work out the correct methodology, not doing so good so far.

Chris: There is a hierarchy of evidence. It starts with prior plausibility, in vitro tests, modelling and the like, then animal models, four or five phases of clinical trial depending on how you want to count it, then review studies and meta analysis. That’s more or less in ascending order of reliability and size.

But this is not the only way. Surgery, for example, can’t easily be subjected to RCT for ethical and practical reasons, but surgical interventions can be compared as can surgical v. pharmaceutical interventions. Diltiazem versus lateral sphincterotomy for anal fissure, for example. Diltiazem was already approved for another indication, and I really don’t want to know who thought of trying it for fissure, but it does work and does not have the known risks of sphincterotomy especially in female patients.

In every case the question to be answered remains the same: does this treatment provably deliver a specific clinical benefit, and is it acceptably safe. Specificity is important because non-specific effects are generally evidence of confounding.

Robin says:
9 June 2013

Chris

I empathise with your concern about people not answering questions. Perhaps take comfort they didn’t respond by posting something completely -and I know you love the word- tangential.

Robin says:
9 June 2013

Guy

NICE example, literally.

Don’t want to repeat early posts but NICE has issued guide documents about some drugs and their use off licence.

Robin, there’s no threading here so it’s awfully easy to miss a post. That’s no doubt why none of the homeopathists has addressed the points you note above.

Alan Henness says:
9 June 2013

chrisb1

You may have forgotten that I suggested we discuss evidence in my comment of 8 June 2013 at 10:32 am. I reiterated it in my comment of 8 June 2013 at 6:11 pm. That discussion got diverted onto something that was a complete red herring.

I had said:

“What constitutes evidence? What is good and poor evidence and why? Why is independent testing and verification important? What flaws and biases can creep in to studies and what can be done to eliminate or minimise them?

That might help explain why we are unwilling to accept anecdotes and why an odd study can sometimes come up with a positive result by random and why we must have a much higher threshold for accepting someone else’s evidence.”

I later said:

“Do you accept that, for example, what you heard someone say on the bus home last night about how they had been cured of disease X by treatment Y is not a suitable basis for anyone to make their healthcare decisions on? If so, why?”

I had missed your reply of 8 June 2013 at 8:25 pm and that got diverted again. However, you replied:

“I know where you are leading this, Alan, but in the hypothetical scenario that you describe I would inquire further and further. No evidence would be required if the cure had occurred as stated. If I suffered from the same disease/condition I would rely on that testimony.”

By inquiring further and further, do you mean asking more bus passengers?

But let’s assume it was me who claimed my disease/condition X was cured by treatment Y. I had it, I took the treatment and now I’m cured. No doubt about it. I give you categoric assurance the treatment cured me.

You have the condition X. What do you do?

Alan,
“By inquiring further and further, do you mean asking more bus passengers?

Being a just a teensy-weensy bit facetious now are we?

“But let’s assume it was me who claimed my disease/condition X was cured by treatment Y. I had it, I took the treatment and now I’m cured. No doubt about it. I give you categoric assurance the treatment cured me”.

I would seek out more testimonials, (logical) and if the weight and consensus of those testimonials were found to be effective in treating the condition, plus the historical anecdotal use of that product was found to be effective, (logical step) then have a guess as to what I would do?

Robin,
“So the subjects know they are taking something, this is of course classical grounds for generating a placebo effect”.

So how would you explain the positive homeopathic studies (they are not all flawed) where the results show a “significant therapeutic effect over and above a placebo”?

Robin says:
10 June 2013

That has been answered so many times….

Chris: As Robin says, you are revisiting old ground, but here it is again: http://xkcd.com/882/

Robin says:
10 June 2013

Guy, It also has no relevance to my post. Seems like another attempted diversion.

All the evidence I have found for provings, and the specific example I quote appear to be uncontrolled. So every person knows they are receiving treatment. With a methodology such as that ther is absolutely no way anyone can have any certainty I.e. no certainty at all, that the result is not a placebo effect to name but one possibility, the result is mere anecdote . The methodology is simply not capable of testing the hypothesis with any rigour.

Instead of addressing this inconvenient truth we are asked to explain again basic scientific methodology and concepts, that’s a bit of a worry.

Robin says:
10 June 2013

Guy
I prefer the homeopathic fertility treatment one but a point well made.

Alan Henness says:
10 June 2013

chrisb1 said:

“Alan,
“By inquiring further and further, do you mean asking more bus passengers?

Being a just a teensy-weensy bit facetious now are we?”

It was you who seemed to place some weight on the testimony of a bus passenger in the first place, so I wondered if you believed that yet more testimonies from the same source would increase that weight.

““But let’s assume it was me who claimed my disease/condition X was cured by treatment Y. I had it, I took the treatment and now I’m cured. No doubt about it. I give you categoric assurance the treatment cured me”.

I would seek out more testimonials, (logical) and if the weight and consensus of those testimonials were found to be effective in treating the condition, plus the historical anecdotal use of that product was found to be effective, (logical step) then have a guess as to what I would do?”

Do you see any problems in using these testimonies to add to your weight of evidence?

Alan,
“Do you see any problems in using these testimonies to add to your weight of evidence”?

No I don’t, not at all if the weight of the evidence was overwhelming, and it had a historical use (which you omitted to mention) as in anecdotal evidence from such therapies such as TCM.

Put it this way Alan, if I had relied exclusively on RCT’s for any evidence, I would have died over 30 years ago. In those circumstances which option would you have chosen?

Chris: So how would you discard bloodletting? Used for hundreds of years, doctors swore by it.

How does homeopathy discard remedies that turn out to be wrong?

Alan Henness says:
10 June 2013

chrisb1

You’re getting ahead of yourself again! There’ll be plenty of time to discuss RCT and such things later!

You said:

“No I don’t, not at all if the weight of the evidence was overwhelming, and it had a historical use (which you omitted to mention) as in anecdotal evidence from such therapies such as TCM.”

I was talking to a woman I met a few weeks ago who regularly used a decoction made from some (fairly) common herbs/plants (it doesn’t matter which ones and I can’t remember anyway) – she said it worked wonders for her PMS, which runs in her family and that many of her friends and her relatives have used it for at least two generations.

Is she correct or mistaken?

Robin says:
10 June 2013

Before I ask about the next stages of the homeopathic process, I’d like to make a side trip.

It seems to be a rarer variant but paper homeopathic remedies deserve a mention.

Obviously all that diluting, tapping and so on can be tedious, so an alternative is to just write down the treatment e.g.:-
______________
1. After you (or your child) is done a round of antibiotics, write the name of the antibiotics on a piece of paper with 30 C next to it (30 C is the homeopathic dosage). Put it under your pillow (or your child’s pillow) for 2 days. (I’ve been putting it in our pillow cases, so that the paper remedy isn’t lost during the night).
2. Repeat with 200 C for 3-5 days.
3. Repeat with 1M for 5-7 days.
The first time I heard of a paper remedy, even I thought it was kind of weird, but Juniper at Went to the Farmer’s Market has spoke about its effectiveness on a few occasions.
~~~~~~~~~~~~

In other cases the advice is to pin the paper to the person, or place a glass of water on top of the paper and then at a later point drink the water.

Obviously this theoretically has the potential to save the NHS a lot of money, and, bad news for pharmacists, we wouldn’t need so many of you. There would be a cost in retraining Doctors to write prescriptions in homeopathic form but the overall savings would be huge. Research into the efficacy of electronic delivery would probably be worthwhile in order to save trees.

What do the supporters of homeopathy think about this form of homeopathic treatment?
If you believe it can “work” can you explain how and why and provide evidence.
If you don’t can you please explain the thought process that led to you rejecting the concept?

Robin: The astonishing thing is that people will do this and the penny still doesn’t drop!

Alan Henness says:
10 June 2013

To get to the nub of the problem, we really need to ensure critical thinking skills and logical argumentation are taught alongside science in schools.

Alan: I disagree. They should be taught as part of the core curriculum as a subject in its own right. These skills are more important to those who are not scientifically literate or especially numerate. Spotting when you r being taken for a ride is more important than learning comparative religion, more important than design and technology, more important than music theory.

Alan Henness says:
11 June 2013

Agreed, but I think I was meaning that science should be taught to everyone at some level, whether they take it further – a class in science appreciation, perhaps? Science and the scientific method are so key to so many things today, yet we equip our children badly to understand what is going on around them. I would see critical thinking skills/philosophy as a parallel that has something for everyone.

Alan

I agree that science teaching provides the ideal opportunity for young people to develop critical thinking skills, but we have to cope with the fact that there are some who are not motivated by science. Perhaps there are opportunities to incorporate a scientific approach to money management, interpretation of advertising and many other aspects of daily life.

The ignorance of some adults is amazing. I once decided to have fun with a salesman who was pushing comprehensive insulation packages. He claimed that as much as 80% of the energy put into my home was lost in various ways, and confidently recited a long list. He was encouraged by my expression of horror, but when I questioned his figure he checked the script and insisted the heat loss was 80%. When I tried to get him to understand that 100% of heat is eventually lost, he mumbled something and made an excuse to leave promptly. That was over 30 years ago and I now try to help people rather than make fun of them. I find it very difficult to do this with those who reject scientific method.

Alan: Yes, we are fundamentally on the same page, I just don’t want it to cut into the already limited time science gets in the curriculum. And calling it science is likely to erect mental barriers, plus it’s not just science anyway. Actually basic statistics is arguably the most important element.

Wavechange,
your comment to ojeronimo……………………….

“What is the point of copying and pasting a list of 84 references instead of a link to the article”?

In the hope you read them I suppose. Links are easily dismissed.
I would have thought that was fairly obvious?

Apart from establishing that the list has been copied from an article that could have been cited, I have not read further. I have read enough homeopathetic claptrap already. 🙁

Someone has disagreed on my post concerning the scientific proof and links I have provided on Medical Acupuncture.

This means that this individual is refuting the science that they claim to endorse.

Absolutely incredible!!!!

Chris: Acupuncture is a separate issue. There is no credible evidence that acupuncture itself works (the meridians and acupuncture points do not relate to any relevant anatomical structures), though there is some evidence that needling may have an effect beyond placebo. This evidence is getting weaker as people become better able to control for the problem of blinding with needling.

Guy,
“Chris: Acupuncture is a separate issue. There is no credible evidence that acupuncture itself works”.

Just as a reminder Guy, it was you who brought up the mention of acupuncture not I, and in answer to the second part of your comment, you have ignored the medical evidence and credible science from the links I provided.
If you continue to ignore that evidence, then of course you will always hold to the opinion that acupuncture does not work.
Quite simple really.

Chris: I mentioned it in passing. You chose, as ever, to shoot off down the rabbit hole.

I have not ignored the evidence, merely disputed your presentation of it. The evidence for acupuncture (allowing the colloquial use and ignoring the now disproven claims for acupuncture points and meridians) is weak, and the evidence for specific effect is getting weaker over time.

I quote the 2011 editorial in Pain in respect of acupuncture:

““Is there really any need for more studies? Ernst et al. point out that the positive studies conclude that acupuncture relieves pain in some conditions but not in other very similar conditions. What would you think if a new pain pill was shown to relieve musculoskeletal pain in the arms but not in the legs? The most parsimonious explanation is that the positive studies are false positives. In his seminal article on why most published research findings are false, Ioannidis points out that when a popular but ineffective treatment is studied, false positive results are common for multiple reasons, including bias and low prior probability.””

This seems to me to be a very fair point.

Whether medicine works or not is still not a reason to support homeopathy. I do not refer to “homeopathic remedies” because they aren’t remedies for illnesses. They MAY reduce stress in people who believe in them, but homeopathy has been tested, in great detail, and shown beyond doubt to provide no biological benefits. Experimenters were not able to decide which of the solutions used were homeopathic and which were pure water. “The scientists were no better at deciding which samples were homeopathic than pure chance would have been”.
The video is probably still on youtube.

Should pharmacists offer homeopathic solutions to medical problems? Probably not, unless you also think that it would be reasonable for them to ask you to bring in eye of newt and toe of frog and they’d make up a potion for you. People expect pharmacists to offer something that, in their professional opinion, will treat the illness presented. If people go away with a little bottle of water that’s been proven to not work then they’ve been lied to.

And for any homeopaths out there, a fellow called James Randii offers you a million dollars if you can provide any proof at all that homeopathy works. That’s all you have to do to collect a million dollars! But be careful, you have to say what the result will be before you take the challenge, and then you have to do all that proving it nonsense.

You mean that James Randii wants real proof rather than the usual list of flawed investigations that is bandied about?

Just thinking . . . If something taken or applied works, that is it provides an efficacious treatment of the condition, it can be called a medicine or a remedy. If it doesn’t work it is not a medicine or a remedy. There is no such thing as an “alternative” medicine or a “homeopathic” remedy. In the phrase “conventional medicine”, the first word is otiose as medicine cannot be differentiated into categories.

John

The medicines that are prescribed by GPs undergo rigorous testing and every one is supplied with a concise summary of relevant information for the patient to read before use and refer to later. There is the yellow card system for reporting suspected problems and advice for patients is updated as our knowledge about drugs increases with use. I am not sure about the legal requirements regarding products sold by pharmacists or on open sale, but have seen very useful information included with these products. It is common knowledge that the efficacy of drugs varies considerably between individuals and that some must avoid certain drugs because of medical conditions, allergies, etc. It’s not perfect and human error is a real problem, but I believe the system works well.

What concerns me most is that homeopathic remedies could deny people urgently needed treatment with well established drugs.

Herbal remedies are an example of alternative medicine that can contain active ingredients. Some of these have been used as the basis of conventional medicines, offering the usual benefits including carefully controlled doses.

Yes I agree Wavechange. Purely from a semantic viewpoint, since I have no relevant scientific or clinical knowledge of the issue, I think it would be better if the word “remedy” was only used for things proven to work in most cases that show comparable symptoms. There are so many weasel words in the promotion and sale of well-being products; “essential oils” is another. Nowadays we associate “essential” with “vital” [i.e. the absence of which could be harmful, life-threatening even]. “Essential oils” are usually nothing of the sort, of course, merely derived from or containing essences. But I digress . . .

Everyone should be entitled to be able to trust medications to be efficacious and as safe as reasonably possible (a drug used for treatment of pain relief in terminal cancer should not be expected to be as safe as a headache pill).

This is a paragraph from the MHRA website: The product itself must have a licence called a ‘marketing authorisation’ (formerly called a ‘product licence’). In addition, the companies that are involved in all stages of the manufacture and distribution of the product need to have licences (manufacturer’s and wholesale dealer’s licences). New products which are still in development also need a licence before they can be tested on human subjects (clinical trial authorisations).

Perhaps the answer is to describe what John and I regard as medicines as LICENSED MEDICINES.

Wavechange: in the US, the supplement industry specifically drove legislation to prevent regulation of vitamins and supplements (the Proxmire amendment to the Food and Drug Act). The claim that big pharma controls health legislation is the exact opposite of the truth, it’s big herbs who had laws passed exempting supplements from the need to prove safety or efficacy.

Because, after all, what could be more natural than swallowing the equivalent of a box of oranges every day?

Good suggestion Wavechange. I like the idea of Licensed Medicine as a description. It would clearly indicate that anything not so described was unlicensed. That might assist people to make a more informed choice and possibly seek professional guidance [which, of course, should make it more likely that the pharmacist will give advice that conforms with RPS policy]. I would go so far as to say that, [a] in a self-service situation, unlicensed products should only be sold under that category label in a separate position from the licensed products, and [b] when the customer is buying at the counter, the unlicensed products should not only be displayed separately but also – since the sort of things you have to ask for are likely to be more complex or the conditions for which a remedy is sought are more problematical – the counter staff should point out that the requested product is unlicensed.

Guy – It’s funny how some people see the supplement industry in a very different light to the evil manufacturers of conventional medicines.

Wavechange: indeed. It’s a multi-billion-dollar industry where there are a a conservative estimate tens of thousands of serious adverse incidents a year, which in the US has been protected from even the most cursory scrutiny by legislators with massive vested financial interests in the industry.

If a drug has adverse reactions, there is a reporting scheme designed to pick them up, FDA alerts and mandatory product recalls. Aristolchia, used in a popular slimming aid, led to 100 cases of renal failure, 70 kidney transplants, an unknown number of deaths and the subsequent development of bladder cancers. This was not picked up during pre-marketing tests because, like strychnine, botulism, typhoid and bot fly, it is NATURAL so there are no tests.

The health freedom lobby was essentially begun by a vitamin pill multi-millionaire. Vitamin megadoses cause cancer and heart disease, and yet he had his customers demanding that Congress pass a law explicitly exempting them from testing by the FDA. And they succeeded.

The SCAM trope of big pharma pork barrel politics is a towering irony.

Guy,
“There was not even one death caused by a dietary supplement in 2009, according to the most recent information collected by the U.S. National Poison Data System.

The new 200-page annual report of the American Association of Poison Control Centers, published in the journal Clinical Toxicology, shows zero deaths from multiple vitamins; zero deaths from any of the B vitamins; zero deaths from vitamins A, C, D, or E; and zero deaths from any other vitamin.

Additionally, there were no deaths whatsoever from any amino acid, herb, or dietary mineral supplement.

Two people died from non-nutritional mineral poisoning, one from a sodium salt and one from an iron salt or iron. On page 1139, the AAPCC report specifically indicates that the iron fatality was not from a nutritional supplement. One other person is alleged to have died from an “Unknown Dietary Supplement or Homeopathic Agent.” This claim remains speculative, as no verification information was provided.

60 poison centers provide coast-to-coast data for the U.S. National Poison Data System, “one of the few real-time national surveillance systems in existence, providing a model public health surveillance system for all types of exposures, public health event identification, resilience response and situational awareness tracking.”

Over half of the U.S. population takes daily nutritional supplements. Even if each of those people took only one single tablet daily, that makes 155,000,000 individual doses per day, for a total of nearly 57 billion doses annually. Since many persons take more than just one vitamin or mineral tablet, actual consumption is considerably higher, and the safety of nutritional supplements is all the more remarkable.

If nutritional supplements are allegedly so “dangerous,” as the FDA and news media so often claim, then where are the bodies?

Reference:

Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Giffin SL. 2009 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 27th Annual Report. Clinical Toxicology (2010). 48, 979-1178. The full text article is available for free download at http://www.aapcc.org/annual-reports/

The data mentioned above are found in Table 22B, journal pages 1138-1148.

**********************************************************************************************

Dietary supplements cause 600 ‘adverse events in 2008……………………….

http://usatoday30.usatoday.com/news/health/2008-09-22-supplements-adverse-events_N.htm?loc=interstitialskip

“Adverse-event reporting has been required for prescription and some non-prescription drugs for years. The FDA took in 482,154 adverse-event reports for prescription drugs last year”.

The US Dietary Supplement Health and Education Act (DSHEA) (1994) is an “health-freedom” legislation. DSHEA defines supplements as foods…….not drugs and should therefore be protected as foods and not classified as drugs.

So who is this vitamin pill multimillionaire that started the health freedom lobby?

If you care to provide the evidence that Vitamin Megadoses cause cancer and heart disease please.

The supplement industry is not without fault as with any business, but they do provide valuable Nutraceuticals in the prevention and treatment of disease.

Chris: And this refutes the kidney failures due to aristolchia in what way? Oh, wait, it doesn’t.

The supplement industry has had laws passed in the US which specifically impede any attempt to collect meaningful data on adverse reactions. Why is that, do you think?

Hello everyone, I’m very happy that this Convo comment round-up has enjoyed so many comments. It’s our most popular of all time.

However, I am not happy about the continued infringements of our guidelines. Although I like to think that Which? Convo is about making comments as quickly as possible for a ‘live’ debate, my advice would be for you to step back and think about what you’re going to say before commenting.

If this thread is going to continue (I’m close to closing it) then please:

Be polite
Don’t make snide remarks or sarcastic comments
Do make your point, but don’t make it personal
Don’t paste huge swathes of text without credit. Preferably paste a few relevant paragraphs and include a link.
Do read these before making another comment: https://conversation.which.co.uk/commenting-guidelines

Patrick, I think it would help if you or someone you can contact who is not part of this debate, could summarise the positions of the “believers” and the “unbelievers” here, to refocus debate on the actual differences, because there is a terrible tendency to circular argument and also the argument tends to wander off into the long grass at times.

My suggestion is that Which? focuses on its own research plus the very limited input from pharmacists on this and the earlier Conversation. It is a pity we have not heard much from pharmacists but it is easy to see why they would not wish to join the heated debate.

A summary, as suggested by Guy, would be useful for future articles but with negligible chance of any agreement or respect for opposing views, homeopathy is not the best topic for an online discussion.

Patrick is thinking of closing this thread, and probably not before time.

In summary, the opposing factions of Homeopathy in this discussion have revealed their true character and falsehoods, by denying the latest scientific evidence that supports the use of Medical Acupuncture, as they would with anything else deemed to be alternative.
This of course speaks volumes for the bias and even the bigotry I have found here with anything to do with any alternative therapy.
As far as homeopathy is concerned, I give you this analogy: for how long do you suppose a dealership, which sells second hand and unreliable cars that were not fit for purpose, actually stay in business? Homeopathy has stood the test of over 200 years of therapeutic use, and is now recorded as being the second largest modality of healthcare in many parts of the World.

“Director general of Central Council for Research in homeopathy Dr R K Manchanda said, “Till now, the benefits of homeopathy were established through observational studies. Now we are validating homeopathy’s benefits through randomized controlled trials and fundamental research. Homeopathy is especially beneficial for arthritis, skin and respiratory diseases, gastric problems like irritable bowel syndrome and allergies. Homeopathy costs one fifth of an allopathic consultation in any government set up.”
According to the World Health Organization (WHO), homeopathy is the second largest system of medicine in the world”……………..
http://articles.timesofindia.indiatimes.com/2012-09-01/india/33534682_1_homeopathy-r-k-manchanda-second-largest-system
http://www.homeoprophylaxis.com.au/AboutHP/GlobalStatus/tabid/1060/Default.aspx
http://www.drbatras.co.uk/en/homeopathy/

Homeopathy would not have survived for this length of time, and would have disappeared from the face of the map if it were not efficacious in the treatment of many diseases.
The excuse of the placebo-effect does not bear scrutiny, and where the mechanism of action is actually the role of science to discover why, and not discount it because it is presently misunderstood and misrepresented.

The general theme here has been one of academic elitism and intellectual superiority over anything or anyone else.
These are not terms with which to have a sensible, open and rational discussion or debate of a subject that is looked upon with disdain by the majority here, and whose denialism has been allowed to dominate and run rampant over anything they believe does not fit into their own paradigm of what they refer to as “science”.

Alan Henness says:
10 June 2013

LOL!

chrisb

You ask us to be open-minded, yet you are not prepared to do this yourself. Ditto with denialism.

Since leaving school, I have studied science, done scientific research and taught science. I have revised my views based on new information and I would dare to suggest that scientists are amongst the most open-minded members of the community.

I have been critical regarding unattributed copy/paste, undoubtedly driven by the fact that this is frowned on in academia and more so in science, but my comments are made with the terms & conditions of this website in mind.

In our supposedly civilised society, many things have stood the test of time but that does not make them good. To give examples could be seen as provocative.

Chris: The editor of whale.to is John Scudamore. I believe I have his email address. Would you like me to ask him if he has any jobs going? If you work at it you can probably help him with his main business as well.

Wavechange,
“You ask us to be open-minded, yet you are not prepared to do this yourself. Ditto with denialism”.

That is simply not true Wavechange; I endeavour to accept anything on face value until it can be proven to be bogus or have no value at all. I totally accept most practices within Mainstream Medicine for example, unless it is unnecessary or worthless or even fraudulent practice, and I have highlighted some of these within these discussions. What on earth would we do without anesthesia or the skill of a surgeon or even diagnostics such as MRI’s and modern Ultrasounds. Modern medicine is of great value to us all.
However, I have encountered participants here who dismiss anything deemed to be alternative or CAM out of hand, and for the only reason that it is alternative and CAM, and for other reason alone. To illustrate: although a discussion concerning homeopathy, Medical acupuncture has been dismissed at least by one individual, even though I posted on the latest scientific research supporting its efficacy by no other than highly qualified Medical Doctors, rather than Acupuncturists.

Yes you have been critical re’ the use of copy/paste, and this may have broken the T&C here, but I fail to see how this can in any way be detrimental to the illustration of a debate, as long as the link is provided as to its source. The overlooked and most important part of this, is the actual message and the information contained within that message rather than the act of copy/paste itself.
I am guilty on that score.

Your comment on the test of time not making things necessarily good is probably true in some instances, but do you really suppose that a 200 year old therapy would last that long, and continue to increase in Global popularity because it is bad or even bogus? People are not as easily duped as you may think or believe.

Guy,
was this really necessary?………………..

“Chris: The editor of whale.to is John Scudamore. I believe I have his email address. Would you like me to ask him if he has any jobs going? If you work at it you can probably help him with his main business as well”.

Cynical sarcasm is not your strongest asset Guy, and I take offence to the above comment.

chrisb

I’m not sure how we can prove that homeopathy is bogus – after all, no-one has yet managed to provide a scientifically valid demonstration that it achieves anything beyond the placebo effect.

If you think I’m not open-minded, I accept that herbal products are effective, but the active components are better extracted and used as conventional medicines in known doses.

Religions have been on the go for more than 200 years. Without daring to criticise any one of them, it is fairly obvious that they cannot all be right.

I don’t know enough to comment on acupuncture.

Wavechange: Exactly. The inability to prove a negative, and the honest admission that this is so, is one of the things that homeopaths exploit. It is, of course, fallacious – the fallacy being reversal of the burden of proof.

Chris: My sarcasm underlies a serious point. The relative weight you give to cranks versus scholarly opinion is very badly out of line. You do not seem to realise that when you are rubbing shoulders with truthers, chemtrailers, new world order conspiracists and believers in the lizard men, you are in a place where reality is in short supply and where opinion will consistently trump fact.

Chris: Vitamin megadoses cause cancer an heart disease. The manufacturers got their customers to write to Congress to pass a law protecting them from scrutiny by the FDA. Vitamin megadoses are ever more popular based on the claims of manufacturers, which can be false because of their industry-friendly law, and because of celebrity endorsements and uncritical advertorial in the press. How many people are aware that high dose vitamins cause, not prevent, cancer?

Time and popularity have absolutely nothing to do with validity. Just as well or we’d never have got rid of bloodletting or purging.

Guy,
you have made some quite sweeping statements:

“Vitamin Megadoses cause cancer and heart disease”.

PROOF please only using the “scientific method” of course. Btw, no one advocates mega-dosing on Vitamin A or Iron for example. Please do not comment on Orthomolecular Medicine unless you actually know something about it.

AND……..
“manufacturers got their customers to write to Congress to pass a law protecting them from scrutiny by the FDA”

Fiddlesticks.

Is that so? So the general public of the United States were “forced” to write to Congress against their Will, just to support the manufacturers of dietary supplements?!!!! I suppose these manufacturers used the “half-nelson technique” on all of them, which can be very persuasive I can assure you.
More letters were actually written to Congress on DSHEA than on any other piece of legislation, leading then-President Bill Clinton to say that its passage “speaks to the diligence with which an unofficial army of nutritionally conscious people worked democratically to change the laws in an area deeply important to them.”
In point of fact: DSHEA preserved our rights to nutritional supplements by classifying them as foods. This ensured that supplements remained abundant and affordable, helping Americans to achieve good health naturally.
The DSHEA was actually an attempt to strike a balance between foods that are functional, in that they have some health benefits, and drugs that have clearly defined and approved health benefits.

AND………….
“For every Galileo there are uncounted thousands who were just wrong. The scientific method is how we tell the difference”.

You either have comprehension issues Guy, or you are just ignoring what has been written previously on the “scientific method” where it is doubtful and unreliable. Dr Milgrom also pointed this out to you.

AND,
“Time and popularity have absolutely nothing to do with validity. Just as well or we’d never have got rid of bloodletting or purging”.

Excuse me? Time and popularity have EVERYTHING to do with validity, and that is WHY we no longer have bloodletting or purging. That is not difficult to understand, or is it?

Guy,

For your information there are “cranks” on both sides of the health divide, and what you refer to as “cranks” are usually (although not always) highly qualified Medical and health professionals, so you are really “shooting yourself in the foot”.

Chris: Of course there are. But no, most cranks are not highly qualified medical professionals. A very large number of them have degrees from unaccredited “natural” medical schools. Chopra and Oz are rare exceptions.

Many doctors do not have much experience of research; in the UK the MD degree is a research doctorate, in other places it’s a professional doctorate awarded after a set amount of experience and in-service training. It is my understanding that most British doctors are not MDs.

Here’s the register from my local surgery. All excellent doctors, all highly qualified and recognised by their professional institutions, not an MD among them:

Dr Roderick Smith MA MB BCh (Cantab) DObstRCOG FRCGP
Dr Graham Paige MB BS DRCOG MRCGP
Dr Samantha Potter MB BS DRCOG MRCGP
Dr Helen Paige MB BS DRCOG MRCGP
Dr Andrew Brewster BSc BM MRCP DRCOG
Dr Jacqueline Payne BSc MB BS DCH DRCOG MRCGP
Dr Michael Kitching BSc MB BS MRCGP DFFP DRCOG D.Occ.Med
Dr Miriam Al-Kashi MB BS DCH DRCOG MRCGP
Dr Sarah Morton BsC MB ChB MRCP DRCOG DGM nMRCGP DFFP
Dr Ralph Smith GP Registrar

Chris: I think Lionel Milgrom’s main problem with the scientific method is that it doesn’t support his religion.

There is an important distinction between the scientific method, science as practiced by fallible humans, and the limits of science.

Science does not investigate the metaphysical. You may believe in God, science has nothing to say on that other than that there is no empirical evidence of deity. Some permit of the “non-overlapping magisteria” idea, others, such as Dawkins, do not. Science does investigate anything which is claimed to be an objective fact.

The problem for homeopathy is that it wants it both ways. It wants to claim metaphysics and “non-overlapping magisteria” (i.e. it refuses to countenance the idea that science is a proper way of testing its assumptions), while claiming to have real and tangible effects. It is in exactly the same place as faith healing, reiki and the like.

Guy,
your post which begins: “I think Lionel Milgrom’s main problem with the scientific method is that it doesn’t support his religion”.

It was as plain as the nose on your face; Dr Milgrom destroyed your arguments and points very ably and articulately. She won hands down, and you know deep down inside that that is the case.

I believe the saying goes something like this: “Game, set and match.”

Thanks all the same.

Chris: Milgrom destroyed my arguments in the same way that you refuted them – i.e. not at all.

For example, he cited a case where a news report mis-stated the weight of evidence, as if it validated homeopathy. That is wrong on many levels.

Do feel free to cite a single reliably reported case where homeopathy can be objectively shown to have cured a single case of a single illness.

Chris said: “Your comment on the test of time not making things necessarily good is probably true in some instances, but do you really suppose that a 200 year old therapy would last that long, and continue to increase in Global popularity because it is bad or even bogus? People are not as easily duped as you may think or believe.”

By this argument, every single religion in the world is right. All of them. Even though many of them explicitly state that some or all of the others are wrong.

Guy,
ok so pulling the “credentials card” now are we?

That’s quite an impressive list of Doctors I must say.

Is an MD in any way inferior? you will no doubt let me know.

Here are some of the “cranks” I endorse for your perusal………………..

Dr Al Sears MD.
Dr Joel Fuhrman MD
Dr Andrew Weil MD.
Dr Fred Pescatore MD
Prof’ Ian Brighthope, M.D. (Australia)
Ralph K. Campbell, M.D. (USA)
Carolyn Dean, M.D., N.D. (USA)
Damien Downing, M.D. (United Kingdom)
Dean Elledge, D.D.S., M.S. (USA)
Michael Ellis, M.D. (Australia)
Martin P. Gallagher, M.D., D.C. (USA)
Michael Gonzalez, D.Sc., Ph.D. (Puerto Rico)
William B. Grant, Ph.D. (USA)
Steve Hickey, Ph.D. (United Kingdom)
Michael Janson, M.D. (USA)
Robert E. Jenkins, D.C. (USA)
Bo H. Jonsson, M.D., Ph.D. (Sweden)
Peter H. Lauda, M.D. (Austria)
Thomas Levy, M.D., J.D. (USA)
Stuart Lindsey, Pharm.D. (USA)
Jorge R. Miranda-Massari, Pharm.D. (Puerto Rico)
Karin Munsterhjelm-Ahumada, M.D. (Finland)
Erik Paterson, M.D. (Canada)
W. Todd Penberthy, Ph.D. (USA)
Gert E. Schuitemaker, Ph.D. (Netherlands)
Robert G. Smith, Ph.D. (USA)
Jagan Nathan Vamanan, M.D. (India)
Atsuo Yanagisawa, M.D., Ph.D. (Japan)
Andrew W. Saul, Ph.D
John Cannell MD.
Dr Michael F. Holick, PhD, MD Professor of Medicine, Physiology and Biophysics
Director of the General Clinical Research Center
Director of the Vitamin D, Skin and Bone Research Laboratory
Director, Biologic Effects of Light Research Center
Boston University Medical Center.

Dr. Clint Comstock
Dr Carolyn Dean MD.
Prof’ T Colin Campbell
Dr John A McDougall
Dr Caldwell Esselstyn MD
Dean Ornish Clinical Professor of Medicine at the University of California, San Francisco.

I could go on I suppose but time…..you know.

Chris, as always you miss the point. Frankly I can’t even be bothered to point out where you went wrong this time.

wavechange commented, in part:

“Homeopathy is not the best topic for an online discussion.”

My reply:

I wholeheartedly agree.

It would be good to have the frequent contributors to these heated discussions come and join in on other Conversations. I’m sure there is plenty we can agree on. 🙂

That would be lovely Wave. Perhaps they’d be interested in our guest post from CASH on salt levels in biscuits: https://conversation.which.co.uk/consumer-rights/salt-sweet-biscuits-cash-asda-mcvities-labelling-health/

Patrick: My biscuits have zero salt. My wife bakes them. They are gluten free too. Shop biscuits are distinctly average by comparison, even if I could eat them any more (which I can’t).