Listener Feedback: Alternative Medicine

A topic sure to get under the skin of many of its often vocal proponents is alternative medicine. Believers in unproven treatments and opponents of commercialized medicine can often take their beliefs very seriously, almost to the level of religion, and sometimes react with great hostility whenever their beliefs are questioned. So this subject always results in some fiery feedback. Let's read a few.

Immune System Boosting

The Skeptoid episode addressing the claims of products that say they can boost your immune system was especially inflammatory — pun somewhat intended. Many marketers claim that drinking their special juice or taking their special supplements will strengthen your immune system with their unique blend of nutrients. In fact, this is not at all the way the immune system works, but many customers of such products were outraged at the suggestion. Jacob from Melbourne, FL wrote in and said:

I'm sure we all know someone who gets sick more often than other people. It's often someone who is in the same places as you (like a dorm room in college, or an office building), and they seem to catch EVERY cold that comes around. And no I'm not talking about the people that play hookie. I very rarely get sick, so when I compare myself to those other people, I am led to believe that my immune system is superior to theirs in some way. According to your analysis, if I'm not catching their colds, then my body's immune system must be attacking my healthy cells, in some sort of low-level auto immune disease-like function.

No, not catching every cold doesn't mean that you have an auto-immune disease, and that was not my conclusion in the episode. More likely you're in a different risk group. There are many different risk groups for catching colds. New schoolchildren, for example, are young and haven't been exposed to many colds before, but suddenly they're exposed to many at school, so a lot of them get sick. They bring them home to young parents, who catch them too. Older parents, school teachers, and experienced family doctors have already been exposed to virtually every cold on the planet and are more likely than non-parents to have the antibodies to any given cold. People who shake a lot of hands in their job are likely to catch a lot of colds, but if they've been doing it for decades they may have already caught a lot of the colds. Once your adaptive immune system is challenged with a new pathogen, your body retains resistance to that particular pathogen for years, decades, often even for life.

Don't confuse your adaptive immune system — the part consisting of antibodies created as responses to exposure to pathogens through disease or vaccination — with the innate immune system, systems like the skin and saliva and all the immune responses that produce the familiar symptoms of inflammation, fever, running nose. When that person at your office comes in with the full-blown cold symptoms, you're seeing their immune system in action and doing its job. It makes no sense to conclude that your own immune system is somehow "boosted" because it's not currently reacting to anything.

Drugs and Natural Compounds

Alan from Los Angeles raised a common straw-man argument against approved drugs, that we claim herbal medicines don't do anything:

For those of you who say alternative medicines don't work, you will agree with me that herbal medicines count as alternative right? Will you say then that salicylic acid, digitoxin, paclitaxel, colchicine, vinblastine, cocaine, morphine, caffeine, nicotine, and countless other NATURAL compounds derived from plants used in traditional medicine have NO effect on the human body?

No, you're confusing the two terms, alternative medicine and herbal medicine. As you note, the vast majority of drugs on the market are derived from compounds found in nature. The whole science of ethnobotany is about discovering useful compounds in nature, not just herbs but insects, roots, fungi, algae, just about anything. Every pharmaceutical company has research stations in jungles, oceans, everywhere. Remember, every herb is a chemical, and many of them can be pharmacologically active. The development stage is where we isolate, refine, and possibly synthesize the active molecules, determine proper dosages, and so on. Then we test them clinically to be sure they work as intended before putting them on the market.

Alternative medicine, on the other hand, refers specifically to treatments that are either not yet proven to work, or proven not to work. They're often those that have been abandoned during the research stage for failing to yield anything useful. Thus they're not allowed to be sold with claims that they treat any disease, thus they're classified as "alternative".

Note that some of the herbal alternative medicines available over the counter are pharmacologically active: St. John's Wort, for one; which if you've ever been in surgery, is one that the anesthesiologist might ask you if you've taken recently. The reason I'd recommend against using any over-the-counter herbal compounds is that they have not gone through the drug development stage required for FDA approval, and you're getting an unknown dosage of unknown purity.

Magical Jewelry

Our episode on magic jewelry assessed the claims made by many marketers of jewelry products that claim to produce healthful effects or improved sports performance, usually with the contention that ions, magnetic fields, vibrations, or some other such nonsense are involved. But one listener, Astrid from San Francisco, made a suggestion that I hadn't heard before; that wearing special therapeutic jewelry is simply a topical application of a mineral supplement:

Actually, copper is an essential mineral of the body. The skin absorbs things topically. You can see this realization now in the modern pharmacutical industry, they now produce many topical medicines. Wearing a bracelet may not be a cracked up as people are inflamed to believe. Also, many different people have many different healing needs. Everyone's body is different. A bracelet may help some people and not others. It depends on the need. No need to get inflamed and freaked out over people who experience healing by less chemical means.

Astrid's assertion that taking metallic elements into your body is a "less chemical means" is difficult to defend, as metals are (quite obviously) among the most familiar of chemicals. Her main point is that copper jewelry constitutes copper supplementation. There is some truth to this. An adult normally needs 1.5-3mg of copper per day to maintain the body's total burden of some 100-150mg, and in testing, copper bracelets worn around the wrist have been found to lose about 1.8mg/day. Metallic copper is slightly soluble in human sweat, and the copper has been found to be perfused into the skin.

The point to be cognizant of is that nearly all such research has sought to determine whether such copper supplementation is an effective treatment for arthritis, and that result has been a resounding no. So really, all that wearing a copper bracelet might be useful for is if you have some highly unusual diet that, for some reason, doesn't provide the same amount of copper as a normal diet, and you're suffering from a deficiency acute enough to justify the expense.

Detox Scams

The episode on detoxification has continued to produce lots of feedback, even years afterward. The pitch that we all live in a toxic modern environment is compelling to many people and easy to sell. Isabelle from Victoria, BC conflated these alleged environmental toxins with prescription drugs, suggesting that they are equally toxic:

Oh my, Looks like the skeptoid is not aware that the 2nd cause of death in America is prescriptions correctly prescribed by their doctors. That is a fact! Total Health can only be acheive by natural means (except for emergencies). We are overloaded by toxins and detoxing on a regular basis can extend one's life significantly. The examples are so stupid to discard the whole industry like that. How lame

It is a fact that most people who die in the United States are under medical care at the time. Cardiovascular diseases as a whole are the leading killer, including heart attacks, strokes, and so on; followed by all the many cancers; followed by respiratory infections, car accidents, etc. Depending on how you group them into categories and break down the categories you can make just about anything rise to the top of the list. But clearly, a majority of deaths are of people treating chronic illness with medical care. You can say that it's the medical care that killed them, but it's not as true as saying it was the disease that the care was attempting to treat. Contrary to popular belief, medicine is not magic, and we simply can't cure everything despite our best tries. Thus, most people die under medical care.

Doctors Treating Symptoms vs. Diseases

This episode also produced a lot of non-specific anti-pharmaceutical feedback, which is ironic since all the detoxification products I'm aware of are themselves pharmaceuticals; just unapproved and unproven. Nevertheless, the episode prompted Tove from Varberg to repeat one of the most familiar arguments against science-based medicine:

I've had a lot of healthproblems and I found most doctors didn't bother to even try to find what was causing them, they just wrote a bunch of prescriptions for meds to treat the symptoms, they made my problems worse, always.

The idea that medical science treats just symptoms while only alternative practitioners treat the cause of disease is simply wrong. Doctors who have addressed this claim, like Steven Novella and Harriet Hall, have pointed out numerous times that — with the exception of chronic pain management — there's really not a single example of a medical treatment that does not attempt to treat the cause. Antibiotics are to kill bacteria infections. Trauma management and critical care attempt to repair injuries. Oncology focuses on killing the cancer cells. Other than when we're trying to make a terminal patient comfortable, the entirety of medical science is directed at finding and treating the cause of disease.

Reflexology

The episode on reflexology generated a lot of straw-man feedback. Reflexology is the idea that certain points on the soles of the feet and palms of the hand correspond to all bodily organs, despite the glaring fact that no anatomy connects them. For example, if you have stomach cancer, massage the spot on the sole of the foot that allegedly corresponds to the stomach, and you can cure the cancer. It's pure pseudoscience, but its proponents adhere to it religiously. Dee from Canada wrote:

I have been teaching reflexology for some years now. Here is the definition "Reflexology is the pressure point massage on the feet, hands and ears to relax athe body so that the body can heal itself" There is NO mysticism involved. Science proves that there are over 7200 nerve endings in the feet alone. If we can relax the body by massaging the feet - what a concept. Does it work? After a foot massage are you relaxed? Well that answers that.

This is by far the most common feedback I get pertaining to reflexology. Of course foot massages feel great and are relaxing, and yes, relaxation does reduce stress and that can impact general health and wellbeing. Science doesn't deny that at all; in fact, therapeutic massage is often doctor-recommended. But massage is not reflexology. A reflexologist gives a foot massage — along with all the real benefits it confers — but then makes a further claim that the massage is treating a specific disease or condition in some specific part of the anatomy. If they don't, it's not reflexology; it's massage. I've no doubt that the majority of reflexologists are talented masseuses whose foot massages produce true relaxation and stress reduction. That's what massage therapy is. It's not what reflexology is.

The requirements to get a massage therapy license are pretty onerous in most states, usually requiring hundreds or even thousands of hours of work as a trainee. But reflexology is not a board certified medical profession; any Joe Blow can legally hang out a shingle and call himself a reflexologist with no training whatsoever, even though any of the various self-certifying reflexology authorities may not like it. This type of loophole tends to draw people who want to shortcut the system. Probably most reflexologists are honest practitioners with no such desire to game the system, but any reflexologists who claim that it's identical to ordinary massage therapy either don't understand their own profession or are lying.

Listeners, keep that feedback coming. I can't answer all your feedback, but I will answer those that best represent the common reactions to established science. How we know what we know is even more important than what we know, and open dialog is the best way to spread it around.

By Brian Dunning
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