Monthly Archives: October 2011

Time for Blackmores to pull that evidence out of a hat

Posted in Alternative "medicine" scams, Big Placebo, Health by

Where are all the people dying in the street from complementary medicines?

Marcus Blackmore – September 2011

Although a seemingly innocuous if not arrogant turn of a logical fallacy called Begging The Question (and a few others as well) I was surprised at how gullible Blackmore may actually take Australians for. Four deaths in two years and 40 serious adverse reactions reported. But, not in the street to my knowledge. Forget the lead, mercury and arsenic poisoning from imported Chinese herbs.

In this case he’s trying to dismiss the vast vacuum of evidence for efficacy of Blackmores hanky panky, by confusing no medicine (or placebo) with a bad medicine. Confusing no effect with malignant effect. It’s also an inconsistent non-sequitur in that he’s applying the logic we would apply to real drugs (or consumer products under fire) to propose the absence of an outcome that by definition, cannot follow. Regardless of how you see this nonsense, it’s a pearler. It encapsulates so much of what’s wrong with regulation of alternative medicine today, in just a dozen words.

Fortunately for consumers it makes Blackmore look quite the villain. It has zero to do with the problem at hand. Namely the current Pharmacy Guild deal done during an evolving awareness of unsustainable claims and corresponding outrage. Although he hasn’t said this in response to recent criticism, he has been scathing of sound criticism, using this phrase before. More to the point it’s a taunting, if rather melodramatic version of What’s the harm? which to skeptics is a huge clanger. Professor Alastair MacLennan head of obstetrics and gynaecology at Adelaide University, cites “four harms of ‘harmless’ therapy”.

In the recent Trick or Treat article by Gary Tippet, MacLennan is summed up:

Probably most important is delay in seeking effective therapy, if there is one; increasing evidence of side effects and drug interactions, which are under-reported; a placebo effect that wears off within months and sees people ”becoming disappointed, disillusioned and depressed as they move along the health food shop counter seeking placebo after placebo”; and a multibillion-dollar industry that is a waste of the scarce health dollar, if they’re not doing any real good.

Interestingly, Marcus Blackmore’s Dirty Dozen words resonates more or less with each of those points. But back to the fallacy. Just because something isn’t doing harm doesn’t mean it’s doing good. Nor can potential benefits (such as supplements suitable for malnutrition) justify wide scale use or the – quite frankly – astonishing prices of Blackmores’ concoctions. Had he asked the question, “Where are all the people wasting money on complementary medicines?”, one could just steer him toward customer exit of any large store.

Fairfax Poll Today

Chemist Warehouse have made their position plain. But don’t abandon your trusted pharmacy/pharmacist. These guys are about slicing trade from competitors. Including (in my suburb) with the 30 plus metre aisle of junk potions bulging with Blackmores’ goods.

Their grab for the “integrity dollar” was written up today in The Age. The Life and Style section included a poll. Of note, the article continued:

However, in a sign the guild is backing away from the deal, it wrote in its latest newsletter that the Blackmores’ prompts in its computer system were a pilot only, which would be reviewed.
”Contrary to some media reports, there is no compulsion whatsoever on pharmacists to sell these products, nor is there any direct incentive to any pharmacist to sell them,” the guild’s newsletter said.

Fortunately the lack of evidence is now evident. In a great interview recently on ABC is Professor Paul Glaziou of Bond University from the Centre for Research in Evidence based practice. He went looking for and couldn’t find the evidence one would expect from Blackmores. He’s asked for them to make it available. He shouldn’t have to – nobody should be left looking for evidence here.

Or download here.

The clash of reality catching up with an industry that survives on social psychological trends such as the need to take control of ones health, distrust of pharmaceutical companies and a prevailing zeitgeist of choosing something – anything – natural in an environment we are erroneously told is highly toxic is getting louder. Marketers of this junk know this and they’ve been fighting a semantic battle against the growing doubts of efficacy, trying to head off reality at the pass.

We’ve gone from “natural”, to “alternative”, to “complementary” and now we’re getting scammed with Integrative. As though this cockypop mix of potion and ritual actually has a place waiting for it within the current model of evidence based medicine. Purveyors of naturopathy, vitamin therapy, supplemental, acupuncture, reiki, massage, kinesiology, meditation, homeopathy, chiropractic (the one stop shop for self-health sabotage) have delighted in maligning “allopathy” for years.

The paucity of evidence to defend the need for unproven products is summed up well by Dr Wendy Morrow, chief executive of the Complementary Healthcare Council:

Quite frankly, if complementary medicines didn’t work it would have been a fad that was here and gone in the blink of an eye. Their increasing use shows they’re not a fad, they do work if used appropriately, and I don’t see that people are going to stop using them.

Which could also be said about any of the useless rituals above which also come bundled with attacks on vaccination, antibiotic therapy, medication in general and ample conspiracies about “allopathy”. However, late on Friday Blackmores did publish a research summary. Bear in mind however that claims made in advertising are subject to the Therapeutic Goods Advertising Code which is something I wish to look into shortly.

Pharmacy news items reported on Monday October 3rd:

Blackmores reports that while there is evidence to suggest that some medications can affect how the body uses nutrients, this is ‘unrecognised or overlooked by many healthcare practitioners’. Blackmores says that the evidence was compiled in line with the TGA’s Levels of Evidence Guidelines for Listed products and demonstrates that ‘some prescription medicines diminish nutrients and that supplementation can improve nutritional status’, adding that the evidence for its Companion range was reviewed in consultation with ‘leading [unnamed] pharmacists’.

NPS have published Examining The Evidence and looked into each of the four “companion medicines”. They find evidence was “absent” except for the probiotic option, which was “limited”. To summarise each area:

  • Supporting evidence for using Co-enzyme Q10 with statins (none)

Evidence does not support the use of Co-enzyme Q10 to prevent myalgia (muscle pain) during treatment with a statin. No trials have shown that taking a Co-enzyme Q10 supplement with a statin prevents myalgia.

Randomised controlled trials of Co-enzyme Q10 to manage statin-associated myalgia have conflicting results and do not support routine use with statin therapy.

  • Supporting evidence for using magnesium supplements with PPI therapy (none)

Magnesium deficiency or ‘hypomagnesaemia’ has been associated with long-term use of proton pump inhibitors (PPIs). Case reports indicate that stopping the PPI is the best way to normalise magnesium levels. Taking a magnesium supplement with the PPI may not be enough to correct the magnesium deficiency.

No studies have investigated the use of a magnesium supplement to prevent magnesium deficiency during PPI therapy. A magnesium supplement should only be considered if a PPI has caused a deficiency in magnesium that requires treatment. Evidence for using a supplement with a PPI to treat magnesium deficiency is based on case reports.

  • Supporting evidence for using zinc supplements with antihypertensives (none)

Routine use of zinc supplements is unnecessary for people taking blood pressure lowering medicines (or ‘antihypertensives’). There is evidence that long-term treatment with certain types of antihypertensives may reduce zinc levels, but it is unclear how often this causes zinc deficiency.

  • Supporting evidence for using probiotics to alleviate antibiotic-associated diarrhoea (some)

There is some evidence from trials that probiotics may prevent antibiotic-associated diarrhoea in some adults and children. But limitations with the trials mean that the true effect of probiotics is uncertain, as is the most effective product or dose.

58 million prescriptions per year. Coke and fries. 90% non-compliance with regulation. No regulatory enforcement because it’s not “cost effective”. A recent audit finding the TGA has failed for decades to counter deceptive, false and misleading advertisements. If compound X is today found to be unable to make claim Y proper policing applies only to new products coming onto the market. Products already on the Australian Register of Therapeutic Goods cannot be edited.

Given what’s been leaking out about the industry and the paper tiger apathy of the TGA, it shouldn’t be surprising Blackmores’ “Coke and Fries” is geared for consumers money, not health benefits.

Floreani, Golden and the myth of homeopathic immunisation

Posted in Alternative "medicine" scams, Anti-Vaccination Lobby, Chiropractic, Denialism, Health, Scam, Science by

For a mob that officially professes “no position” on vaccination the Chiroprctors’ Association of Australia disseminate ample false, misleading and quite dangerous antivaccination hanky panky.

Take CAA NSW branch vice president, Nimrod Weiner. The Weiner from Newtown Community Chiropractic whose Nimroddery was pegged as a “rant on vaccines” by The Australian. Although he feverishly ran for cover after outraging real doctors, not-a-real-doctor Weiner’s “rant” bibliography can be found here. A hodge podge of dusty conspiracy twaddle and outright lies, much from the Australian Vaccination Network it alone refutes Weiner’s claim:

I’m good at knowing how to read a research aritcle, and knowing whether it’s viable or not. I’m also good at collecting a lot of research. This vaccine topic I update every single week. So what we’re looking at is new as of yesterday morning.

He didn’t write that, but announced this to attendees of his seminar Vaccinations: An informed choice, in what can quite justifiably be called a lie. There’s more on the entire debacle along with a Radio National segment here. At times we’ve met other crackpots from the CAA. Jason Parkes and Rob Hutchings, both of whom approach their profession like a religious fundamentalist approaches taking up arms. Warren Sipser who believes vaccines cause harm yet chiropractic “repairs DNA”. Genevieve Keating is another pleasant sounding predator who specialises in convincing parents chiropractic builds super human kids. They lean toward the weird beliefs of founder Daniel David Palmer and his views on “God given energy flows”.

Sipser was the subject of an article in The Australian headed The Chiro Kids which brought home just how ludicrous (and scurrilous) the new brand of Mystical Chiropractors really are. Thanks to Dr. Rachael Dunlop we can read the CAA’s Media Release warning CAA members of that article. It’s disturbing stuff given these quacks are subsidised by our government (Medicare foots the bill for five sessions per year) and health insurers. Written by CAA national president Simon Floreani, it is a straight out attempt at damage control, obfuscation and dodging questions.

Floreani himself has run antivaccination clinics and is a member of the Australian Vaccination Network. He describes Dorey’s little fraudulent scheme as a valuable resource for patients. Simon is married to Jennifer Floreani, famous for writing an article supposedly describing (Update – as noted below the bogus article has been removed but can be found here pp. 348-349) her newborn’s battle with pertussis, picked up from an older sibling. Given the outcome and treatment the article is almost certainly fraudulent, but if perchance the diagnosis is correct then at best it is reckless neglect and at worst simple child abuse.
She writes (bold hers):

This experience did indeed test our resolve and we were forced to draw on our support network of healthcare providers. We performed chiropractic checks on our baby daily and utilised a whooping cough homeopathic. I dosed myself with an array of vitamins to boost his immunity via breast milk and kept him hydrated with constant breastfeeding.

Whooping cough is often slow to develop and may respond well to conservative management, including chiropractic, osteopathy, homeopathy, herbs, acupuncture or acupressure. Within two days, the severity of our baby’s symptoms cleared and within a two week period, each of our boys had a complete resolution of their symptoms.

Fortunately for the Floreani’s this little tale is just that – a tale and a comical one too. Every type of “conservative management” is absolutely non efficacious. Babies with pertussis gag, choke and may have profound difficulty breathing making this nonsense of super fortified breast milk as a realistic option seem laughable. More so, there’s no evidence an increase of maternal vitamin intake when breastfeeding will do anything but produce expensive maternal urine. Even more farcical is the notion of “boosting immunity” with vitamins. Either way, if their baby did have pertussis there’d be no magic recovery after two days but admission to intensive care many days later as the insanity of their hokery pokery gradually sank in. Yet, that’s not really the point.

The dangerous, deluded and unconscionable message pushed on parents here is that using your breasts, vitamins and witch doctor spells, you can clear up a potentially fatal disease within two days. It’s outrageous and a bald faced lie that I cannot even begin to comprehend the motivation for. What’s infuriating is that chiropractors exploit the confirmation bias in parents and the Floreani’s are prime examples.

Parents who believe these nonsense manipulations cure everything report that yes treatment keeps children healthy. They also report inaccurately that lapses in treatment lead to poor health. Knowing this, chiropractors are famous for setting treatment frequencies, with some even insisting on treatment contracts. That the locus lies with parental bias has been shown splendidly in trials on colic.

As we know, chiropractors claim they can “successfully treat” colic or – in their lingo – Irritable Baby Syndrome. Trials show that if parents believed their baby received chiropractic care, whether they did or did not, they reported improvement. If they believed that no chiropractic care was applied – even when it was – they reported a worsening of colic. You can catch up with Simon Floreani admitting no proper trials exist here on Lateline back in July 2009.

He’s caught out claiming injuries from neck manipulation are one in 5.85 million cases when in fact they are gauged at 1.3-5 per 100,000 manipulations, by insurer Kaiser Permanente, who refuse to cover the practice. In short Floreani is claiming instance of vertebral injury is 60 – 300 times less than it is.

On August 21st this year, a video entitled “Homeopathy evidence and research” filmed by Simon Floreani and featuring homeopath and fraud Isaac Golden, appeared on YouTube. The video below looks initially at the rise of the Mystical Chiropractors and then picks through Golden’s claims of Cuban “homeopathic immunisation” and his own so-called PhD on “homeopathic immunisation”.

When used to defend against a complaint to the TGA about homeoprophylaxis, Golden’s PhD actually helped uphold the CRP decision of misleading claims by fellow crook, Fran Sheffield. This is because even Golden admits in his thesis text that his sample was flawed in size and there was no chance of contracting infection. In short he showed nothing.

Enjoy…