About this Author
Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases.
To contact Derek email him directly: derekb.lowe@gmail.com
Twitter: Dereklowe
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Category Archives
March 23, 2012
Posted by Derek
Longtime readers will remember the interaction I had with Nativis Pharmaceuticals. That's the outfit that claims to be working with "drug signatures" instead of the drug molecules themselves. I found it interesting to see a company with all the outward trappings of a biotech startup that was spending its time (and its investors' money) on what sounded to me like the next thing to homeopathy. "Unique photon fields" of drug molecules? "Photon payloads" from "imprinted coherence domains"? You don't run across this sort of thing every day - well, not where I work.
When I said so, though, I got to hear from the company's chief legal counsel, and we ended up trading helpful advice. (Well, I thought my advice to him was helpful, at any rate). We have not crossed paths since.
But readers are reporting that the company's San Diego site appears to be emptied out, so I decided to check up on them. As it happens, they do not seem to be out of business: they're just moving to Seattle. Now, why the company seems to have pulled back its presence on its own web site, and on LinkedIn, etc., I don't know. And whatever happened to the publications that they were planning, and to their IND, I don't know, either. But at least as of last fall, they were a going concern. If any readers up the Northwest hear some news, please pass it on!
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+ TrackBacks (0) | Category: Snake Oil
December 14, 2011
Posted by Derek
Here, courtesy of Science-Based Medicine, is a comprehensive look at the Burzynski cancer clinic's methods. If you have any interest at all in cancer quackery or semi-quackery, or especially if you know of anyone desperate enough to approach the Burzynski people themselves, here's everything you need to know from a med-chem point of view.
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+ TrackBacks (0) | Category: Cancer | Snake Oil
November 29, 2011
Posted by Derek
There seems to have been a recent surge in interest in the Burzynski cancer therapy in the UK. A family publicly raised a good deal of money to have their daughter flown over to Texas for the treatment, and this seems to have raised the profile of the clinic quite a bit over there.
But Dr. Burzynski and his therapy have been around for decades, and not everyone has been pleased with their results. Orac over at Respectful Insolence has (as you'd expect!) taken up this topic before, and for background I definitely suggest reading his piece. Quackwatch also has background. Put together, it seems that no one has been able to replicate Burzynski's results, despite many attempts. This does not appear to have slowed down his acceptance of patients, nor his billing of them.
Perhaps the best single reference I can give for Burzynski and his associates, though, is this blog from Wales. Rhys Morgan, a high school student, wrote earlier this year about his misgivings about all the UK publicity and fund-raising to send patients to the clinic, and for his pains he was treated to some good old-fashioned legal scare tactics. I'm glad to see that he's standing up to these, and it appears to me as if he's been giving good legal advice in doing so. From his post, it seems that the same law firm is sending out such letters to other people who've written unfavorably about the Burzynski Clinic, and has this ever been a good sign?
It would appear that Dr. Burzynski has had a good deal of time, and numerous opportunities, to provide convincing data to back up his claims. Instead, he seems to have spent his efforts at expanding the definition of the phrase "clinical trial" in response to a court order - and in sending lawyers after people who point such things out. Personally, in my review of the literature, I have seen no reason to disagree with the American Cancer Society's opinion that the value, if any, of the Burzynski therapy has not been established, and I would add that this is still the state of affairs 35 years after his initial publications.
If anyone has anything that might change my mind about that - and I'd prefer data, not legal threats - I'd be glad to review it. But you'd think that the convincing evidence would already be out there by now. 1976!
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+ TrackBacks (0) | Category: Cancer | Snake Oil
November 14, 2011
Posted by Derek
And Google Translate is no help at all for this sort of thing. A reader who attended the recent TEDMED conference sent along a quote transcribed from one of the speakers, a high-ranking Pfizer executive:
"We’ve moved from a [two-dimensional] to a [three-dimensional] approach. [Now,] we need to work all dimensions of the problems that face us, including the fourth dimension … time. Let’s call it “metacollaboration” — an approach that links knowledge and assets in a productive way to problem solve in every dimension."
Let's call it something else, shall we?
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October 31, 2011
Posted by Derek
I occasionally cover odd attempts at alternative - very alternative - energy sources here, because there's a chemistry angle to many of them. The various cold fusion claims have always gotten a slightly less frosty reception among professional chemists than among professional physicists, on average. And yes, there are two good explanations of that, which are not mutually exclusive: (1) that the chemists are willing to be a bit more open-minded since (among other things) they have less invested in the state of physics as it is, and (2) that the chemists are willing to be more open-minded because they know less about physics.
So far, the track record on these things has been pretty close to 100% hardtack disappointment, dry as dust and crunchy as hell. But as Tyler Cowen put it over at Marginal Revolution, the expected value of such things is so high that a small amount of attention is worthwhile. The latest headline-grabber is a mysterious thingie from Italy called the E-Cat, which I mentioned briefly here back in July.
The inventors apparently concluded a larger-scale demonstration over the weekend, as reported here, at the request of an unnamed client from the US. The problem, as that article shows, is that we really don't have a lot more to go on: this "client" could plausibly be DARPA, or that could (also plausibly) just be what the device's backers would like for everyone to think, the better to fleece the unwary in the next round.
So for now, I'm just noting this with cautious interest. I certainly hope that the people behind this are operating in good faith, in which case I will in good faith wish them well. But we'll see what happens next, if anything. For now, the "snake oil" tag stays on.
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+ TrackBacks (0) | Category: General Scientific News | Snake Oil
August 11, 2011
Posted by Derek
Well, we could use some comedy around here these days, and here's someone from the Napa Valley wine business to help us out. Let's work up to this one slowly: do you drink wine? If you do, do you swirl it around in the glass at any point? Do you think it matters, for the taste, which direction you swirl it?
Didn't see that one coming, did you? But never fear, answers are at hand. (Thanks to LeighJKBoerner on Twitter, via Chemjobber.
. . .When you swirl your wine to the left (counter clockwise) the scent you pick up is from the barrels over the grapes, what we call the spice shelf. When you swirl the wines to the right (clockwise) you pick up more flavors from the fruit. . .The question comes up, why is that? Now, as a master herbalist and aroma-therapist, and as someone who has lectured extensively on natural health, anatomy and physiology I know a thing or two about plants, and how people perceive them. So, based upon what I know about how living cells function, these are my insights.
Let's pause a moment, because I want to make sure that everyone's braced for those insights. Make sure that you're ready to keep up with a master aromatherapist and natural health lecturer, because it's going to get pretty, um, technical at this point:
Like all living things wine cells have a magnetic polarity, just like humans and the Earth. The positive pole is more highly charged, just like the North Pole of the Earth, which is why there are Northern Lights in the Arctic Circle, but not Southern Lights in the Antarctic. (Link added for clarity, and because I just couldn't resist - DBL) This polarity tends to keep wine cells generally upright, spinning on their axis when they are being swirled. This magnetic action within a liquid is commonly demonstrated in laboratories. Because plant molecules are mostly liquid, when they form they are also subject to the electromagnetic forces that are a component of the rotation of the Earth. As a result, the pores on the surface of the molecules develop based on that rotation, like the shingles on a roof.
He probably lost you at "wine cells" - see, I told you it was going to be hard to keep up. Note that a follow-up to this adjusts that language, saying that "The proper term would be molecule or even atom", which is surely pretty much roughly the same thing as a cell, right? When you're talking about wine? That second article is worth reading all by itself, by the way, for the kind of check-out-my-credentials display that would do well for a bird of paradise during mating season. But let's get back to the science:
". . .when you swirl the wine clockwise the pressure of the surrounding fluid forces the fruit flavors out through the pores. It also pushes any flavors concentrated on the surface down onto the skin of the molecule. . .
. . .Everything has a polarity right down to the atomic level, and when put into suspension in a liquid it rotates in relation to that pole. Because we are on a planet that has both a polar system and a consistent rotation, everything forms with a pole and a circular patterning. Wind it one way and it tightens and wind it the other and it unwinds.
Honestly this is just basic physics related to molecular science and plant chemistry, something which herbalists and herbal researchers deal with all the time. A pretty sober group of people. . .
So there you have it! Those herbal researchers, they must be right up there on the edge of knowledge if they deal with this kind of stuff all the time. All of this, and it's all half-understood second-hand gibberish, of course, reminds me of the biodynamic wine movement, which from what I can tell is stuffed just as full as it can be with, well, let's just call it half-understood second-hand gibberish.
Check out "Preparation 501", a key part of the process: "Ground quartz is buried in cow horns in the soil over summer. The horn is then dug up, its contents (called horn silica or '501') are then stirred in water and sprayed over the vines at daybreak." You don't need much, though - it's reputed to be very powerful stuff. But honestly, I think I'd rather deal with the mystical-life-force cow horn buriers than with people who try to tell me that it's all just simple physics, all the while yammering about magnetic fields and the skins of molecules. Or atoms. Whatever.
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June 30, 2011
Posted by Derek
I couldn't resist mentioning this one: the Archives of Internal Medicine was set to publish a paper showing a benefit for transcendental meditation in heart attack and stroke. Word was already out in the press - in the UK, the Telegraph had already published a story, with a quote from one of the paper's lead authors (from, ahem, the Maharishi University of Management) that the effect seen was as great or greater than any pharmaceutical intervention.
I don't have a link up to that particular newspaper report; its URL is no longer valid. That's because twelve minutes before the paper was set to be published online, the journal pulled it. (Other sources still have their stories up). We still don't know quite what the problem was. Nature got this statement:
“It became apparent that there was additional data not included in the manuscript that was about to be published, and the editor of Archives thought that the information was significant enough that it needed to be included as part of the paper, and then re-analyzed and verified, so she made the last-minute decision not to publish it. . .It’s an unusual situation, but the bottom line is that our journal wants to make sure that the information we put out is as accurate as can be.”
I'm glad to hear it. Larry Husten at Forbes has the data from the paper, and has a lot of questions. We'll see how things look when (and if) it ever appears. But for now, if you're looking for the latest anyone has ever pulled a paper before publication, we may well have the record.
Update: here's an excellent report on this at Retraction Watch.
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+ TrackBacks (0) | Category: Snake Oil | The Scientific Literature
June 21, 2011
Posted by Derek
Now, I try to help discover drugs for a living. And boy, do we not discover all that many of them. But you'd get a different impression if you listen to the radio here in the US. So many drugs! So many wonderful things that they can do! Improve your memory, boost your immune system, clean your liver, give you energy, grow hair on your head and flush those toxins out of you like a firehose.
Ah, but these aren't drugs, of course. They are nutritional supplements, silly people, and they are "not intended to treat, cure, or modify any disease". But they say that part low and fast, while the exciting parts are enunciated clearly, con brio, and at least three times. Drugs are foreign chemicals that you put in your body to make it do things, while nutritional supplements, why they're these all-natural. . .things. . .made out of, made out of. . .stuff. . .that you put in your body to make it do things. Anyway, they're different.
And here's the man who says so: Orrin Hatch, to whom (along with Henry Waxman) we owe the Hatch-Waxman legislation that made the supplement industry flourish like the green bay tree. $25 billion a year isn't bad, especially when you consider that the expenses of the supplement companies are just a tiny bit lower than those of the drug companies. Not having to do any preclinical research at all helps, of course, and not having to run any clinical trials at all (nothing for efficacy, nothing for safety) helps, and not having to be reviewed by the FDA helps, too. And then on the other side of the ledger, being able to say any damn thing that comes into your head helps the most of all.
And as you'll see from that article, not only has Senator Hatch himself benefited greatly from his nutritional ties, but so has his family, immediate and extended. And his friends, and his former business partners - pretty much everyone within range, it seems. Each sides regards the other as the gift that keeps on giving. And why shouldn't they?
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June 15, 2011
Posted by Derek
I was going to take a shot at this article myself, a piece in The Atlantic called "The Triumph of New Age Medicine". But Matthew Herper at Forbes has done the job for me. The original article advances the thesis that modern medicine isn't doing much for chronic diseases, which is why people are turning to acupuncture, et al. Says Herper:
. . .that’s all horse microbiome. Let’s take those one by one. Saying we’re not making strides against heart disease and cancer is just, well, wrong. Look at the below chart of mortality from both, courtesy of the Centers for Disease Control and Prevention. Notice something? They’re both going down. . .Yes, the battle against heart disease and cancer is slow, grinding trench warfare, but that’s because these our diseases written by evolution into our genetic code. And we’re still winning.
He goes on to demolish one of the article's other sweeping claims - that alternative medicine focuses on prevention, but mainstream medicine doesn't. And he's got an interesting reason (which may have occurred to you before) for why most "alternative" therapies have such ardent fans. Hint: there really is a secret ingredient, which has been gradually removed from a lot of modern medical practice. . .
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+ TrackBacks (0) | Category: Press Coverage | Snake Oil
March 23, 2011
Posted by Derek
I managed to do a whole post on medical/pharma cranks without mentioning one of the biggest factors of all. As many people pointed out in the comments, look out for any therapy that makes a big point of being "all-natural".
There are several interesting mental attitudes behind the success of that marketing ploy. One of them is the appeal to primitivism. I'm reading Jacques Barzun's From Dawn to Decadence , and that's one of the persistent philosophical currents he identified in Western culture. Back to the basics! Shed the corrupting influences of modern life! In medical terms, this shows up as a constellation of beliefs: that people were truly healthier back in the good old days, that, correspondingly, there's something about modern civilization that's making us all sick, and that remedies for such ills are not to be found not among the fruits of that industrial civilization. Why would they? It's like a drunk reaching for an eye-opener to cure a hangover, right? No, you want to go back to the simple, natural remedies, because only those can cancel out what's been done to you.
I should mention up front that these beliefs are not totally insane. One of the things that I took away from an earlier book that I recommended here, A Farewell to Alms , is that life expectancies and general human health actually took a bit of a dive as cities began to grow in importance. Dietary and sanitary standards were lower for the mass of people in London, say, than they were for the farmers in the countryside, and it showed. And even today, some of the less-developed countries are in even worse shape than they were before the modern world ran into them.
But those aren't the customers for pricey natural remedy come-ons, are they? No, those go to well-off first-worlders with disposable income and high life expectancies. Industrial and urban civilization, although it got off to a pretty dirty start, has in fact led to a great upsurge in human health and productivity. And that's given people the time and wherewithal to respond to ads on their large flat-screen TVs or their satellite radios, and to pay money for shaken vials of distilled water or ground-up plants shipped from the other side of the planet.
Speaking of those ground-up plants reminds me of one more mental attitude. Among people who are big herbal medicine believers, there can be a sort of teleology, a view of the world as if it were more rationally constructed than I think it is. I've seen people asking questions like "I have Condition Y, what's the herb for that?" This every-disease-has-a-plant-for-it view is quite odd to me, because I don't see any reason why it should possibly be true. Plants make medicinally active substances for reasons of their own, and they only overlap with our needs once in a while. And for that matter, most of the really active compounds found in nature are things that will mess you up, rather than help you, just like most of the really active compounds made by humans. There are simply more ways for our biochemistries to be interfered with than for them to be improved.
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March 22, 2011
Posted by Derek
I get probably more than my share of come-ons for various wonder-healing potions. For some reason, people see that I talk about drug discovery and think that I'm sure to be interested in homeopathic wonder water, magnetic healotronic belt buckles, or what have you. I am not. Well, at least not in the usual way that they're presented, as Great New Discoveries that I can order right now, first month's supply is free, and so on.
I also get to hear about many of these things at second hand, from people who write to me about them wondering if there's anything to them. And while I delete the press releases and advertisements, I respond to genuinely curious individuals, and I try to do so civilly. I tell them that no, according to what I know about chemistry, medicine, biology, and such, this things that they're describing won't (or shouldn't) work. I ask what kind of data might be available to back things up, and point out that in my own line of work we have to generate huge amounts of it before we believe we're on to something, and so on. I also try to get across how hard drug discovery really is, and how unlikely it is that there's going to be a Big Honking Breakthrough! every year or so, no matter what the ads on the radio say.
There are repeated themes in these things, and I'm by no means the first to notice them. Anything that promises to "boost your immune system", for example, is automatically suspect. Given what the immune system's capable of when cranked up a bit, I'd rather keep mine at its current setting, thanks. Of course, "detoxifying" is an instant red flag. As crank-watchers know, the conviction that we'd all be in perfect health if it weren't for insidious toxins is a widely held one, and a widely played-upon one. A corollary belief is that these toxins are piled up somewhere in your body, waiting for the right hand on the flush valve to clear them out and restore you to health.
Anything involving the word "energy" when applied to general medical concerns is worth a suspicious look. It's not an invariable sign of hand-waving, but it's common enough. This sort of language runs from the vague "gives you more energy" promises at one end to the mystical-life-forces stuff at the other. And related to that last part, appeals to Ancient Wisdom That We Have Forsaken are almost instant grounds for disqualification. Displacing the burden of proof in time (centuries ago!) or in space (the Mystic East) does not inspire confidence.
Naturally, as in any field, intimations of conspiracy are instant red flags. My friends, the Powers That Be don't want you to learn these wonderful things (but for $39.95, as it happens, you can hear about them until you're dizzy). Appeals to things that most people know of but don't understand well are worth scrutiny (most anything involving magnets, e.g.), as are attempts to make everything seem incredibly simple (Vinegar! The wonder-working key to health!)
In fact, what seems to be missing from most crank medical come-ons is, oddly enough, humility. There are no package inserts detailing side effects or symptoms to watch out for. There are no thoughts that any new data might sweep the latest discovery aside, and rarely any nods to others who have come before. No, this latest therapy is presented like a religious revelation - here it is, what you've been waiting for, and you'll never need anything else. Those of us who are trying to be on the other side should remember this, and try as much as we can not to sound like the people we can't stand. . .
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January 25, 2011
Posted by Derek
Several people have asked me about this recent press conference, where two Italian researchers (Andrea Rossi and Sergio Focardi) say that they have demonstrated anomalous nuclear reactions with nickel and copper, on a scale sufficient to produce electrical power. (To be technical, it's probably not fusion per se, but is it anything, and if so, what)?
I hope that they're right, naturally. But there are a lot of things to wonder about. They chose to announce this at a press conference, and to "publish" in a journal that actually doesn't exist. Rossi himself seems to have had some criminal problems with the Italian authorities in the past. All this does not inspire confidence (says the blogger in a scrupulously neutral tone of voice). And this whole area is absolutely saturated with cranks, sharp operators, self-deceivers, paranoids, and loose cannons of every description. I continue to think that these phenomena (if there are phenomena there at all) are worthy of study, but man, the signal-to-noise ratio in this field just could not be worse. The legitimate scientists working in it (and there are some) have my sympathy.
For what it's worth, this latest work seems to follow up on some earlier reports from another Italian physicist, Francesco Piantelli. That link, a blog written by a sceptical enthusiast, will probably tell you more than you want to know about the story, and a look through its other posts will tell you plenty about the state of the whole field. I'm going to take the same course of action that I have with all purported new energy breakthroughs in the last twenty years: wish the participants good luck, hope that they've actually found something worthwhile, and sit back to watch. If anyone does make a breakthrough, it's going to be abundantly clear. If, on the other hand, the people involved are still flopping around and issuing press releases year after year, then they're probably still having to pay their own electric bills.
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Posted by Derek
Well, no sooner do I speculate about whether Luc Montagnier has lost it then he makes headlines with a "water memory" story about teleporting DNA. There are, of course, umpteen reasons for this not to be a real result. We'll start with contamination of vials, which in a system like PCR can be disastrous, and work from there. The other major problem I have with this is one of the major problems I have with homeopathy: if incredibly small dilutions of things have such an effect, then why aren't we seeing it happen all the time? There are tiny amounts of DNA everywhere: how come all our experiments aren't turning into fuzzy blurs of results from all the small but oh-so-powerful fragments and traces in every sample?
Well, Montagnier himself says that he thinks that this experiment will be replicated by others, so I'll hold my fire until that's tried out. Until then, I note that this experiment has apparently made Deepak Chopra's day. It's hard for me to imagine that anything that has inspired such a fuzzy-brained column from such a fuzzy-brained man could lead to any good. But perhaps we'll all be surprised.
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January 10, 2011
Posted by Derek
I truly don't know what to make of this one. Virologist Luc Montagnier has announced that he's heading off to Shanghai, to found an institute and investigate. . .mysterious electromagnetic signals from extremely diluted pathogens.
What we have found is that DNA produces structural changes in water, which persist at very high dilutions, and which lead to resonant electromagnetic signals that we can measure. Not all DNA produces signals that we can detect with our device. The high-intensity signals come from bacterial and viral DNA. . .
. . .I can't say that homeopathy is right in everything. What I can say now is that the high dilutions are right. High dilutions of something are not nothing. They are water structures which mimic the original molecules. We find that with DNA, we cannot work at the extremely high dilutions used in homeopathy; we cannot go further than a 10 to the minus 18th dilution, or we lose the signal. But even at 10 to the minus 18th, you can calculate that there is not a single molecule of DNA left. And yet we detect a signal. . .
Well, Montagnier believes that he's chasing something real, and all I can do is wish him luck as he tries to chase it down. I'd be extremely interested to see something reproducible come out of such ideas, not least because it would open up whole new areas of science. But at the same time, I'm not going to hold my breath waiting on success.
That's because this whole homeopathy/high dilution/water signature business isn't just another wild new idea that might or might not pan out. Even if it were that, this would be tricky stuff - any of the edge-of-detection phenomena are. But this area is a known swamp full of quicksand (and inhabited by various strange swamp creatures) which has claimed careers before. There are huge sunken deposits of quackery and self-delusion to be found out there, and before you announce you're digging up something valuable, you'll have to be very sure that you're not just dedging up more of the same swampy stuff.
Montagnier, as a famous researcher past retirement age in his own country, might be (from one perspective) just the sort of person who can investigate such things. But there have been a lot of eccentric dead ends pursued by famous researchers past retirement age, too. Bring us back some numbers, I say, and some reproducible experiments. Then we'll have some serious talks indeed.
Blog housekeeping note - I'm provisionally assigning this to the "Snake Oil" category, since many other discussions of this sort of thing can be found there.
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January 6, 2011
Posted by Derek
The 1998 paper that linked MMR vaccination with autism has had a long way to fall. It made, of course, a huge media sensation, and energized the whole vaccination/autism controversy that still (in spite of evidence) goes on. But it didn't look very robust from the start, scientifically. And over the years it's gone from "Really needs shoring up" to "hasn't been reproduced" to "looks like there's something wrong with it" to "main conclusions retracted" to the final, lowest level: outright fraud.
Here's a good history of the whole affair in the BMJ. And here's the first part of a series of articles by Brian Deer, the journalist who dug into the study and found how fraudulent it really was. Not one of the 12 cases in Wakefield's original study hold up; the data were manipulated in every single one to make it fit his hypothesis. His hypothesis that he was getting grant money for. His hypothesis that he was already planning lawsuits around, before the study even started.
His hypothesis, I might add, that has led to completely unnecessary suffering among the unvaccinated children this scare has produced over the years, and has diverted enormous amounts of time, energy, and money away from useful study of autism. This sort of deliberate action is really hard to contemplate, as a reasonable human being - it's like some sort of massive campaign to persuade people to throw bricks through the windows of ambulances.
In a better world, we'd be getting expressions of sorrow and contrition from all the celebrities and others who've profited from this business. But that's not going to happen, is it?
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+ TrackBacks (0) | Category: Autism | Snake Oil | The Dark Side
December 3, 2010
Posted by Derek
Well, as those of you who searched for the phrases found, the person responsible for the nonsense quoted here is none other than Ray Kurzweil, who with his co-author Terry Grossman published Fantastic Voyage: Live Long Enough to Live Forever in 2004.
Kurzweil is, of course, a widely quoted futurist. He's also an extremely accomplished inventor and a very intelligent man; there's really no doubt about either of those statements. But his techno-optimism, which I broadly share, still leaves me sounding like H. L. Mencken with a head cold. I think that all kinds of wonderful things are possible, and so does Kurzweil - but he thinks that they're not only possible, but that they're happening right now.
I've had occasion to look over Kurzweil's predictions before. What worries me about his futurism is that whenever he starts talking about a field that I know well, he suddenly sounds to me as if he's gone off the rails. And when that happens, well, you have to wonder about the rest of it.
These latest thoughts were prompted by an article by John Rennie, an acidic look at Kurzweil's prediction record in the areas that he should know best (computing, engineering, etc.) His record in medicine is no improvement. And seeing stuff like this alkaline-water nonsense (which I really didn't know he was into) makes me reluctantly mark him even further down. Honestly, if you go for that stuff, you've lowered your defenses against dumpster-loads of hoo-hah. It's very, very hard for me to take seriously anyone who pushes the health benefits of "alkalinized water". But people do.
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December 2, 2010
Posted by Derek
OK, let's try a game of "Identify the Author". No fair Googling - that'll call it right up. No, see if you can figure out on your own who believes this:
"Animal cells survive best in an alkaline environment with a blood pH of 7.35 to 7.45. Plant cells are the opposite; they prefer an acidic environment. As our bodies become increasingly acidic, some cells adapt through an internal evolutionary process and become more like plant cells. These abnormal plantlike cells have a high tendency to become cancer cells, which thrive in an acidic environment. So an important strategy for preventing or treating cancer is to maintain an alkaline environment in the body."
No, it's not our old friend Kevin Trudeau, although it sure does sound like him and the other "pH is destiny" people. The guy I'm writing about does indeed sell nutritional supplements, though, and has sold a device to make "alkaline water" at home. About that:
"Another issue concerns the infrastructure of water. Magnetic resonance imaging reveals that most tap water is organized into microclusters of about 12 water molecules each. In alkalinized water, the microclusters are reduced in size to only six molecules per cluster. This enhances the permability, solubility, and absorption of the water, thereby boosting its detoxification effects."
Great stuff! I'll bet you've never seen anything that enhances the solubility of water before. There are a lot of water hucksters out there, for sure, and these claims could be slapped on any of a thousand shady web sites and fit right in.
But that's not where I got them. This guy doesn't have any late-night infomercials, or at least not yet. I'll leave this post up for a while, then update it with the real source, and a few more comments. . .
Update: Here's the source, with more comments.
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July 9, 2010
Posted by Derek
A reader in the UK sent along this item from the BBC, and those of us in the drug industry will enjoy it very much. An EU regulation is forcing health food and supplement companies to. . .wait for it. . .actually provide evidence that their advertising claims are true.
For those of us living in Orrin Hatch's world here in the US, this will certainly be a change of pace. US readers know how it works - listen to the ads, with the first two sentences delivered as a low-decibel mutter: "Sold as a nutritional supplement only. Not intended to treat, cure, or modify any disease. But the hell with that! It'll grow hair, regenerate your liver, detoxify your colon, improve your memory, and boost your immune system! You'll lose weight, have more energy, sleep better, and you'll have to fight off the attentions of the opposite sex with whatever weapons come to hand! And it's all-natural! Call now for a free thirty-day supply!"
No, the EU isn't letting this stuff pass. Want to claim that your cranberry drink reduces the risk of urinary tract infection? Show us your clinical data - and no, not from someone else's study. From yours, with your product. Glucosamine for arthritis? Got some data to back that up? Green tea for cholesterol, or as an antioxidant? Show them some numbers, or go home. The marketers aren't too happy:
Ioannis Misopoulos, director general of the International Probiotics Association (IPA), is openly hostile.
"It can take three years to get these kinds of human studies together but in the meantime the claims are going to be wiped away," he said. "The regulation is killing this industry and the job losses are already being felt."
Cry me a procreating river, dude. Or come over here to where you can't get near the market without going through the clinic first - and for a lot longer than three years, I might add. And where every claim you make for your product is hammered out with the regulatory authorities, and if they catch you stretching out past them you can get fined out the wazoo. So they won't even let you keep running the ads while you go fetch some evidence, eh? Well, it gets worse:
Not surprisingly, the process has left many manufacturers here in the UK angry. Some say EFSA is demanding the same kind of clinical evidence which prescription medicines would require.
"EFSA is rejecting most of the proposed food supplement claims," says Jenny Baillie of the York-based health foods company Power Health, "even established claims like cranberry for urinary tract health, which will mean that there will be no information on packs for the consumer to assess what the product is supposed to do."
She believes the regulation may even drive consumers into buying from less reputable sources.
To which I am tempted to reply: Mundus vult decipi, ergo decipiatur. Except in the EU.
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July 1, 2010
Posted by Derek
I wanted to call attention to some legal action that appears to be underway - no, not against me. This is Quackwatch being sued by an outfit called "Doctor's Data" (no link from me).
These people perform urine tests for toxic metals, and seem to cater to all sorts of alternative practitioners, many of whom I'd regard as misled at best and fraudulent at worst (see the list of medical board actions and lawsuits near the end of that link). The biggest issue seems to be that the test is administered under "provoked" conditions (after infusing some sort of chelating agent), but the reference values are for normal conditions. People are then told that they have high levels of toxic metals, need lots of therapy, and so on. . .
It looks to me like Quackwatch's Stephen Barrett has performed a real service by detailing this problem and bringing together a lot of widely scattered information about it. But Doctor's Data is suing him for defamation and seeking to have him remove all such material from his site (and not to post any such anywhere else in the future). I've donated to his legal defense fund and would ask that others consider doing the same.
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June 10, 2010
Posted by Derek
I've received a letter from John Kingma, the Chief Financial Officer of Nativis. I reproduce it below word-for-word (Here's the PDF of the original, in case anyone would like to check):
Dear Dr. Lowe,
The scientific nature of your blog seems to have taken a turn for the worse with the negative personal attacks on John and Lisa Butters and othe rmatters related to Nativis. The comments have gone far beyond reasoned scientific debate, skepticism and criticism. In fact, the overall tone seems to have degenerated into something resembling the Internet bulletin boards of old, with personal attacks, sexual comments and statements that may well amount to libel and defamation of character.
It appears to us that that the same person, using multiple names, is responsible for many of the negative personal comments (indications are that this is a person who bears a personal grudge against John Butters, and who now seems intent on ruining his reputation and that of Nativis). It seems clear to us that you have permitted unprofessional, bizarre, and even potentially activity prohibited by law to be conducted by this commenter and others on your blog site, activity that clearly overrides the scientific debate.
No one in the Nativis family has experienced anything so outrageous and unprofessional as the content of your blog site. I don't know if the current non-scientific banter is what you intended for your blog - essentially now a forum for personal attacks. Not only have you allowed theses attacks to be posted, you have also been selective in posting (screening out) information that would be more favorable to Nativis, such as the positive pre-clinical research data that John Butters provided you, showing how drug signal therapy reduced tumors in mouse models.
Moreover, apart from personal attack comments, your blog also contains comments from a person who announced his attempts to gain access to Nativis's facility. In fact, he visited Nativis's site, posing as a representative of your blog, The Pathfinder. When he was turned away by security, he reportedly took photographs or videos through office windows. His actions were reported and encouraged on your site. His actions may well have been illegal.
We have asked counsel to take a look at what is happening on your blog and the activities by commenters promoted there, and to recommend a course of action. But everyone at Nativis would rather get past this unfortunate situation and spend 100 percent of our time advancing our technology.
In that regard, may we suggest that in the best interest of all parties that you moderate your blog, focus on the scientific debate, delete all personal attacks and prevent personal attacks from occurring in the future? That would seem fair and reasonable, while also keeping the scientific debate going.
Thank you, in advance, for the consideration. I look forward to your response.
Sincerely,
John E. Kingma
Chief Financial Officer
Well. I suppose that the rest of this post should begin with "Dear Mr. Kingma:"
I am, as you see, in receipt of your letter of June 9. Allow me to comment on it, so that we may understand each other.
Your first objection is that the tone of some of the comments to my two posts on Nativis have "gone far beyond reasoned scientific debate". A less charitable observer might say that the claims that Nativis makes for its technology have long since occupied that territory. But I've actually tried to be charitable. Until your letter arrived, most of the criticism I'd received from readers and colleagues in the industry was that I'd been far too tolerant in my discussion of your company.
Your CEO, in addition to sending me papers on such disparate subjects as the Mossbauer effect (and offering generously to send along a large book on quantum electrodynamics), did indeed provide a graph of what is said to be the effect of your most advanced. . .well, let's call it a "therapeutic agent" in a mouse model. This does not help me as much as you seem to believe it does. Imagine some other company claiming that they can show effects in a mouse xenograft model though the intervention of invisible pink unicorns - and providing a dose-response curve as proof. Extraordinary claims, which yours surely are, require extraordinary evidence, and I don't see how you can possibly provide enough in a blog forum to convince your critics. Besides, this would be a waste of your time. You will surely be generating a tremendous amount of data in preparation for your company's IND application, and I certainly can't ask you to share all of it. Convince the FDA, and you'll have gone a long way to convincing everyone else.
Now, to your observations about my blog's comment section: I do not actively moderate it, except to occasionally remove duplicate posts. No real moderation has been needed: the tone of discussion around here is unusually civil, for the most part. It's especially so compared to the rest of the blog world and the Internet as a whole - not just "of old", but every day of the week. If no one in the "Nativis family" has ever experienced anything so outrageous as the contents of this blog, permit me to observe that you appear to have led sheltered lives.
Believe me, you will hear worse from other people as you go on developing your company's approach to drug therapy. I mean this in the best possible way, but the material that Nativis uses to explain and promote its technology does not inspire confidence in trained observers. I assume that you're well aware of this; if you're not, you should be. And that's fine - huge breakthroughs in the sciences often have that effect on people. But the problem is, nonsense has the same effect. If I may quote the late Carl Sagan on this very problem, "They laughed at Galileo. They laughed at Einstein. But they also laughed at Bozo the Clown."
Your company's claims are so startling, and so far beyond what most scientists would assume to be possible, that you truly have no alternative but to fall into one of those two categories. A red nose, a fuzzy wig, and floppy shoes are waiting for anyone who makes such claims. Your job is avoid being fitted for them. To that end, you do not have to convince me, or any random bunch of people on the internet. You have to convince the patent offices, the journal editors, and the regulatory authorities. My advice is to devote your time and effort to that task, and to stop worrying about what people say about you on blogs.
Worse things have been said on this site about other (far larger) companies; worse things are said all over the internet a thousand times a second. I certainly do not endorse the making of defamatory comments about people, but I fear that some of the very comments you might object to might not be seen that way by every observer. If I start taking down every comment that offends anyone who writes to me, there will be no end to it.
If you read my posts, you will see that I have not encouraged anyone to engage in illegal conduct. That goes for the entire 8-year archives of the blog, for that matter. I did not encourage anyone to visit your site in any way, and did not comment when someone reported that they did so. I live and work on the other side of the country from you, and my readers are responsible for their own actions. By the way, if the person you speak of did identify themselves as a representative of "The Pathfinder", as you state, then their connection to a blog called "In the Pipeline" is unclear.
As to whether some individual is engaging in a campaign of defamation against your company and your CEO, I can see no evidence of that in my blog's records. The uncomplimentary comments seem, from what I can tell, to have come in from a wide variety of separate sources - you truly have brought people together. On the other hand, some of the glowing endorsements and defenses of your company have come in under different names from the exact same IP addresses. Make of that what you will.
Mr. Kingma, you (and John Butters, and all the other officers and employees at Nativis) should be out there working to revolutionize the entire drug industry. If you can do what you say you can, that's exactly what will happen. Any scientist on the trail of something this wonderful, this huge - and potentially this profitable - would not allow anything to deter them from claiming their place in history. Go do that. I'll be overjoyed if you manage to pull it off. But having heard, after only two blog posts, from both the CEO and the CFO of your company makes me wonder about how you choose to use your time.
Sincerely,
Derek Lowe
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June 4, 2010
Posted by Derek
I've been hearing a lot about Nativis since my post the other day, much of it from their CEO, who's sent along quite a bit of information. Two themes that reoccur are that the company is planning to publish on their technologies within the next few months, and that they're planning to file for an IND on their taxane-derived work.
Rather than continue to speculate on what the heck is going on with them, then, I'm going to wait until one or both these events happen. Either of them will provide a lot more data to work with, and either one will require convincing other observers that there's something worthwhile going on. Based on what I've seen, I remain skeptical, but there are always things that I haven't seen. We'll take up the topic again.
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June 2, 2010
Posted by Derek
A longtime reader sends me word of a new company out in La Jolla, Nativis Pharmaceuticals, whose technology is most certainly eyebrow-raising. I think that the only way that I can do it justice is to quote directly from their web site; I wouldn't want to get anything wrong:
Nativis has developed and patented a breakthrough technology that captures the unique photon field (signal) of active pharmaceutical ingredients (API), or drugs. . .Every drug molecule in a solution is surrounded by a photon field that contains information unique to the molecule. With Nativis’ technology, the photon field, or “drug signal” can be recorded and then replicated for medical treatment. Nativis has proven in preliminary trials that the drug signal – or photonic signature – mimics the original chemical molecule and can unlock the same biological processes as the original to treat diseases, such as brain tumors. With the technology, the drug signal can be reproduced rapidly and flawlessly, each time containing all relevant biochemical information encoded into the new therapeutic signal to drive a biologic reaction. . .
There now, tell me that your eyebrows didn't get some exercise when you read that. I'm baffled. According to this story from the North County Times, Nativis has investors and advisors who are neither scam artists nor saffron-robed gurus, and unfortunately, the only other appropriate category I can think of is "victim". Am I wrong?
I say that because there have been ripoffs beyond number that claim to use some sort of strangely energized or structured water, which is what seems to be going on here (see below). Honestly, you could easily fill a 500-page book with them, in fine print, and there are more every day. And if the Nativis folks don't want to be taken for another member of that crowd, then they should do more to differentiate themselves from the scam artists (and no, linking to videos of Feynman explaining the basics of quantum electrodynamics is not enough). Here's why I say that - this is the company's explanation of their process:
MIDS (Molecular Interrogation and Data Systems) captures the photon field surrounding the solvation shell of a molecule in solution.
Captured photons are then imprinted into Coherence Domains in dipole (water-based) solution for delivery to patients; following administration, the photon payload chemically activates a non-water molecule for therapeutic effect.
The questions come tumbling out: what, exactly, is a "photon field"? And how do you capture one? Isn't a solvation shell a rather dynamic thing, which depends on (among other things) concentration, ionic strength, and pH? How do you imprint captured photons into something? And "Coherence Domains?" That sounds like optical coherence tomography or the like, but only vaguely. How do you imprint into one? And this creates a "photon payload"? How does that, whatever it is, not dissipate?
And that "chemically activates a non-water molecule", does it? By that, I presume that they mean a drug target. But my understanding of how a drug works on its target is that the drug has to be physically present, because it's interacting, on an atom-by-atom basis, with said target. Drugs engage in a complex dance of attraction and repulsion with their binding sites (with attraction winning out!), and this process is affected by electron density (charge), hydrogen bonding, van der Waals forces, and more besides. The drug molecule physically occupies that binding site, which forces the rest of its target into a different shape. And in many cases, it physically displaces water molecules while doing so, and while it's there, it keeps other molecules from coming in.
I don't see how a "photon payload" can do these things. If it's some real assembly of water molecules, I don't see how it holds together at room temperature. Besides, the water solvation shell of a drug molecule isn't what comes in and binds to a target; it's the molecule itself. Shedding those waters is a key energetic part of the whole process. And if it's not a real, physical assembly of water molecules, then what the heck is it? And here's another objection: either way, it sound as if they're taking this "drug signal" while the original drug is out there in solution. But the shape that most drugs have in solution isn't the one that most drug have when they bind to their targets; adopting that new shape is another key process.
No, I have a weakness for wild ideas, but not this wild. Nativis has a lot to prove: can they take the "drug signal" from a fluoroquinolone antibiotic and kill bacteria with it? Can they use the signal from a receptor agonist and see calcium or cAMP changes in a cell assay? Will the "drug signal" displace a reference compound in a radioligand binding assay? Can you do Michaelis-Menten kinetics with one of an enzyme inhibitor? Will it affect a protein's NMR spectrum? Can you determine its on- and off-rates in an SPR assay? Can you see a thermodynamic signature in a calorimeter?
And most importantly, will it help anyone who's sick? Well. . .Nativis says that they've shown efficacy in a mouse model of glioblastoma with the "drug signal" of taxol. They say that they hope to file an IND later this year, and to publish more details in the literature within the next few months. I cannot wait. If they really have data sufficient for an IND, then I will enjoy, most thoroughly, being proved wrong. And if this stuff works, we can all take the opportunity to learn some physics while glory, prizes, and huge amounts of money rain down on the Nativis folks, to a backdrop of cheering cancer patients.
I am, as this post shows, intensely skeptical. But these are issues that can be answered, completely answered, by experiment. Bring on the data, guys. I'm sticking with the blog category shown until then.
Update: John Butters, CEO of Nativis, has sent along some more information about his company's technology. Much of it seems to be based on work by del Giudice and Preparata on the properties of water. Those names rang a faint bell for me - turns out that their work pops up in all sorts of discussions of odd water effects: cold fusion, homeopathy, theories on the origins of life and of consciousness, and so very much on. I must confess that much of the physics is beyond my competence.
However, this all reminds me very much of homeopathy, and of the Benveniste affair and its aftermath, with many phrases ("digital biology") in common. I have to conclude, for now, that this is what's going on. In which case, I wish everyone involved - particularly the investors - the best of luck, because I have grave doubts that anything useful will come out of it. I will be delighted and amazed if I am proven wrong.
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March 25, 2010
Posted by Derek
Nature has a review of a new book on the anti-aging field, Eternity Soup by Greg Critser, and I found this part very instructive. The same things apply to several other therapeutic areas where people see fast money to be made:
Critser's methodical portrayal of a host of anti-ageing practitioners reveals some fascinating people who seek to convince others that they can purchase longer and healthier lives like any other commodity. He makes clear that many anti-ageing treatments are based more on faith healing than on science, and that the industry defends them and presents them to the public with evangelical zeal. Scientific gerontologists who point out the lack of empirical evidence behind the claims are shouted down, sued for libel or made fun of as lab technicians or statisticians with no experience in treating patients.
Critser became aware during his research of why the ridiculed scientific gerontologists find the anti-ageing industry so aggravating. The industry closely monitors the field for any advances, and when it spots something that might be turned into a commercial enterprise, the product is repackaged, branded and sold to the public as the next great breakthrough of its own invention. . .
It's interesting, though, that the cancer-cure quacks tend not to ride so much on the current research. A lot of that stuff seems just to be completely made up, without even a connection to something in the scientific literature. Perhaps that's because there are occasional spontaneous remissions from cancer, but none from old age. . .
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March 17, 2010
Posted by Derek
I'm a complete sucker for dense but well-presented information, and this one isn't bad at all: here's a chart of nutritional supplements by the strength of the evidence for them in human trials. I haven't cross-checked the data, but the authors appear to have done some homework in PubMed, at least, and haven't included any non-human or in vitro data. The interactive version at the link is particularly fun to mess around with. (Thanks to a reader and commenter here who put me on to this).
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January 14, 2010
Posted by Derek
Or nocebo, in this case, since people were sure that they were being harmed. Residents of a Johannesburg suburb detailed their reactions to a new cell phone tower in the area: rashes, headaches, nausea, disrupted sleep, and more. Electromagnetic poison, for sure. (Clearly they haven't heard that they might be at less risk for Alzheimer's).
What they didn't know was that the tower had been switched off for six weeks before the hearing. Descriptions of symptoms disappearing when the beleagured locals managed to sleep somewhere else for a night, only to reoccur when they came back to their homes, are thus a bit hard to reconcile. . .
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January 13, 2010
Posted by Derek
I'd like to take the time this morning to deal with two conspiracy theorists, and I'll take them in order of increasing foil-hat thickness. First up is Joe Collier, an emeritus professor who writes a blog for the British Medical Journal. He notes the recent study that suggested that cell phone emissions could have a beneficial effect in rodent models of Alzheimer's. I didn't give that any play on this blog - too many other things going on, and I don't find any rodent models of Alzheimer's particularly trustworthy to start with. But the study also showed (apparently beneficial) effects on normal rodents, and is certainly worth following up on.
But Collier takes this result and runs with it:
So what happens next? Faced with the prospect, albeit remote, of losing a lucrative market, I predict that the industry will want to quash the electromagnetic treatment theory as soon as possible. To this end, I would expect that the industry propaganda machine will go into overdrive in an attempt to undermine the credibility and findings of Arendash, and to overwhelm the decision makers (ultimately the funders) so that the use of drugs is maintained. The power of industry as an information generator and distributor is unmatched, and industry will use all its persuasive skills. . .
And so on, and so on. The problem (well, one problem) with this line of reasoning is that it could also be extended to other new drugs for Alzheimer's. If the industry wanted to keep selling the existing Alzheimer's drugs at all cost, why would we go to the trouble of trying to develop better ones? We are, you know - I have no idea how much money has vanished down that particular pipe, but it sure has been a lot, and I've helped flush some of it through myself. But we're not the monolithic "drug industry" over here. We're a bunch of companies climbing all over each other trying to make money, take each others' market share, and get to the clinic faster than the other guys down the road. That's what keeps things moving - everyone who's done industrial drug discovery has read a new press release or seen a new patent filing and heard the footsteps coming up from behind.
So I have a counterprediction for Collier. The South Florida study will, in fact, be followed up on. It's interesting enough. And if there's something to it, someone will find a way to optimize the effect and make money off it. And the drug industry will not mobilize to squash it, either - honestly, we have enough to do trying to get our own stuff to work. I haven't seen a single statement from a drug company about this study so far myself, and if Joe Collier has, I'd invite him to produce it.
Next! OK, now we move on to something that seems to be getting some more headlines in the past week or two, and that people have been e-mailing me about. One Wolfgang Wodarg, a German doctor and SPD politician, has been telling everyone that the handling of the H1N1 flu epidemic should be investigated because, he says, it's all a "fake pandemic" whipped up by the drug companies. (You can get all the Wodarg you need, and more, at his web site). Stories in the more excitable press make him sound like the head of all the health agencies of Europe, but people are confusing the Council of Europe (where Wodarg heads a subcommittee) with the EU, among other things they're mixing up.
The World Health Organization is now fielding questions about whether they oversold the epidemic, but it's a sure bet that (if it taken off more drastically) they'd be fielding even more about why they weren't prepared for it. At any rate, if you think that the Monolithic Drug Industry can simultaneously push around the WHO, the CDC, and the public health agencies of every other country in the world, I invite you to think again. If we could do all that, we'd at least be in good enough financial shape that we wouldn't be laying thousands of people off and doing ridiculous mergers out of desperation.
Wodarg, for his part, seems to have been sounding all kinds of alarms for a long time now. Back in the fall, he was telling everyone that the vaccine was going to give them cancer, for example. In case anyone's wondering, I treat his suggestions with the contempt that they appear to richly deserve.
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+ TrackBacks (0) | Category: Alzheimer's Disease | Infectious Diseases | Snake Oil | Why Everyone Loves Us
July 6, 2009
Posted by Derek
There's been a raging battle going on in the comments to this post wherein I disparaged homeopathic medicine. I've been staying out of it, but I had to excerpt this comment, make by a persistent advocate for the miracle water:
In the meantime, homeopathy is practiced openly by learned men in Europe. Why is that? Are they THAT ‘superstitious’? That ‘stupid’? Or that ‘corrupt’. Seriously. Is Great Britain RULED by a bunch of superstitious idiots? The Royal family retains homeopaths as part of their medical staff.
I'll be glad to field that one. Why yes, since you ask, if the royal family pays homeopaths, then "superstitious idiots" seems to be a perfectly appropriate phrase. And anyone who believes that any member of a hereditary monarchy (or of any other rich family) has to be more intelligent because of their position. . .well, there are phrases to describe a person like that, too. Hey, we can even be thrifty and reuse "superstitious idiot". This is an old enough logical fallacy to have a Latin name; see above.
If you'd like to see someone else berate the House of Windsor for just these same failings, you can see Richard Dawkins do a first-class job of it here.
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June 26, 2009
Posted by Derek
I missed commenting on this earlier, but many readers may have noticed the recent scandal caused by Zicam. This is a cold remedy which was sold as a homeopathic medicine, but its makers committed the unforgivable sin of actually having something in its formula besides well-shaken distilled water.
A lot of people are convinced that zinc is good for colds - I'm agnostic, having not seen much convincing evidence - so if that's the case, why not snort zinc up your nose? That, at any rate, seems to be the condensed version of the Zicam pitch, although I don't believe that they used that exact wording in their ads. (A gift for advertising copy might not be one of my more robust talents. . .) At any rate, snorting zinc salts has actually been known, for some time now, to injure the sense of smell in some people. So it's proved with Zicam, with several hundred victims.
The moral? If you're going to sell homeopathic medicine - and boy, is it a lucrative business - make sure that you don't put anything in there except sterile water. That'll cut down on your expenses, too, since most ingredients cost more than water, anyway. Stick with that strategy, and you can be absolutely sure that nothing bad will happen to your customers. Nothing good will happen to them either, but they won't know that. When their cold/headache/whatever goes away of its own accord, they'll ascribe it to your miracle product. Sit back and profit! Be sure to thank Senator Hatch while you count your money, though - it's only proper.
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May 27, 2009
Posted by Derek
I came across this tonight, and had to put up a link. The Guardian newspaper has started a "You Ask, They Answer" feature in its environmental section, and this week a British chain of homeopathic remedies (Neal's Yard) stepped up to the podium. Unfortunately, they weren't prepared for an onslaught of Ben Goldacre fans, who picked up on the opportunity quickly.
About twenty-four hours later, the newspaper had to close down the comments section. The Neal's Yard people had backed out, utterly, refusing to grapple with questions like: "Have you ever been offered a natural remedy that was so obviously without any merit that you refused to bottle it and sell it to your gullible customers, or does pretty much anything go?". But the whole thread is up for your reading pleasure here, even if the ball never does get hit back across the net.
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May 20, 2009
Posted by Derek
Well, we can all study biochemical mechanisms in tumor cells every day of the week. And we can crank out tens of thousands of potential clinical candidates to hit them, run the assays, and then turn around and do it again. We can send things through all sorts of tox testing, take them to the clinic, try them against all sorts of terrible cancers, and amass enough data to make it through the FDA. Then we can let the oncologists continue to try variations, combinations, and regimens in the continuing search for something that works.
And every so often, we actually succeed. Childhood Hodgkin's lymphoma has one of the highest cure rates of all cancers. We can actually do something about that one (as opposed to, say, pancreatic cancer, which we can't do much about at all). Children who would otherwise die - and die slowly - now get a chance to live, to grow up.
But we can't, apparently, convince everyone of this. Many readers will have heard over the last few days of the case of Daniel Hauser of Minnesota, a 13-year-old diagnosed with Hodgkin's a few months ago. Instead of going in for rounds of chemotherapy, the boy (who has said that he doesn't believe that he's sick) and his family have opted for "Native American alternative therapy", and have fled from a court order. The boy's mother, who apparently does believe that he's sick, has said that she's treating him with "herbal supplements, vitamins, and ionized water".
These will, almost certainly, allow the lymphoma to kill him. Chemotherapy and radiation, on the other hand, will very likely allow him to live. If someone is bleeding to death from an arterial wound, anyone trying to heal them by invoking spiritual powers or alternative therapies would (and should) be shoved aside by any onlooker with a tourniquet. Daniel Hauser is bleeding to death as well: just more slowly, and in front of many more onlookers.
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January 14, 2009
Posted by Derek
I’ve been hearing from all sides since I took my swipe at Deepak Chopra et al. the other day. The biggest subgroup with a grievance have been the people who weren’t happy with my comments about Qi Gong.
Part of the problem is that “Qi Gong” means different things to different people, ranging from “Chinese-derived low-impact exercise program” to “manipulation of universal healing energies”. That’s a lot of ground to cover, but I obviously have no problem with the first of those. Exercise is clearly beneficial in a number of different ways. I go to a gym myself, and emerge with sore muscles and a glow of self-righteousness.
But it’s hard to get away from that second definition. Different practitioners put different amounts of woo into it (as Orac puts it), but if you just go grab pages off the web or brochures from a local class, odds are very good that you’re going to start hearing about energy fields and such. And that’s where I get off. I have yet to see any convincing evidence for any such “energy lines” or “concentrations of the life force” (whatever that is) that show up in a lot of (semi-)mystical exercise programs.
If the people boosting Qi Gong and the like stick to claiming that exercise is good, and that these are good ways to get people to exercise, then fine. If they want to claim that Qi Gong is more effective than other sorts of exercise programs, then that’s fine, too, because we can subject that to empirical tests: blood pressure, muscle strength, joint flexibility, per cent body fat, resting heart rate, fasting glucose and triglyceride levels. So far, I haven’t seen anything that convinces me that it is – many of the studies that claim this seem to me to be very small and poorly controlled. The ones that address these issues tend to be a wash, or to show the reverse. But post some literature references and we’ll talk.
But claiming greater effectiveness gets tricky, because many of the people who do that aren’t just saying that Qi Gong (or what have you) is more effective for physical reasons. It’s a quick slide into the syrup from here, and in no time we’re aligning our energies and tapping into ancient wisdom. (I’m not that good a customer for ancient wisdom, myself. I don’t think that people were any wiser or more virtuous in the past, however misty and distant, and given the mixed-up course of history, I think that anything really ancient that’s survived has probably done so by accident as much as anything else. But that’s another subject).
And any of these comparisons will have to deal with the placebo effect, which is what I was getting at with my proposal for the Don Ki Kong protocol. There are, no doubt, patients that will show more benefit from an exercise program that they believe comes from the Ancient Orient than they would from a very similar set of moves that just got marketed in Santa Barbara. Some other patients may well show the reverse, depending on their attitudes. If you’re going to claim specific benefits for Qi Gong (or any other such system), you’re going to have to show that it isn’t due to such effects. Is it something that still works whether you believe in it or not? If belief is important, do the details of what you believe matter or not, or is it just a general placebo effect that depends on thinking that something beneficial is underway?
We have enough confusion with placebo effects already with our supposedly mechanistically targeted drugs. It varies, though – for depression, it’s a relatively huge effect in clinical trials. For post-surgical bleeding, not so much. For an exercise and lifestyle program, especially if we’re going to be measuring things like mood and outlook, I’d think that placebo effects would be quite meaningful. Blood pressure will show up there, too, and a number of other things that are tied in to cortisol and other stress responses.
And if you can improve those, fine. Just don’t try to convince me, unless you have good evidence, that it needs to be these particular Chinese gestures, because I’ll ask you what would happen if you did all of them in reverse instead (would your blood pressure go up?) And especially don’t try to convince me that the effects are due to fuzzily defined life energies that Iron Age shamans are tuned in to, but which we somehow can’t detect.
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January 12, 2009
Posted by Derek
Update: a follow-up post is here, for those who want more on Qi Gong, placebo effects and the like.
Well, we don’t even know who the new FDA commissioner is going to be under the Obama administration, but people are already making their bid for a change in direction. In Friday’s Wall Street Journal, you can find Deepak Chopra, Rustum Roy, and Andrew Weil with an op-ed titled “Alternative Medicine is Mainstream”. I think you can go ahead and silently append “. . .And Deserves Serious Mainstream Funding”.
My hopes for this piece were not high – Deepak Chopra, for one, I consider to be an absolute firehose of nonsense. Both he and Andrew Weil should be whacked with sticks every time they say the word "quantum". But they manage to avoid that one here - the op-ed turns out to be a marbled blend of things that I can agree with and things that make me raise both eyebrows. Its general thrust is:
1. Chronic diseases related to lifestyle (diet, physical habits, etc.) account for a large percentage of health care costs. These could be ameliorated or downright prevented through changes that don’t involve medical procedures.
2. “Integrative medicine” (by which the authors mean, among other things, plant-based diets, yoga, meditation, acupuncture and herbal therapies, have been shown (they claim) to help with such lifestyle changes, and with less expense. The definition of integrative medicine is not provided, nor is the boundary line between it and "regular" (disintegrative?) medicine drawn.
3. Therefore, the incoming administration should make these a big part of the health care system as soon as possible. Did we mention the funding?
Now, I can’t argue with that first point. Cardiovascular disease and Type II diabetes could both be much smaller problems if people in the industrialized nations would just eat less food (and better food) and exercise more. The editorial makes it sound as if no one believes this or has ever heard of such a thing, but come on. No one’s heard anything else for decades. However, it seems equally clear that jawboning people about this issue does not do nearly as much good as one might hope.
Whether “integrative medicine” is any more effective is something that I would very much like to see someone prove. The authors seem to be familiar with a bunch of well-controlled studies that I haven’t heard about, and I invite them to trot out some data. But some of the statements in the op-ed make me think that my cardiovascular health won’t be able to stand it if I hold my breath while waiting for that. For example, we have:
”Chronic pain is one of the major sources of worker’s compensation claims costs, yet studies show that it is often susceptible to acupuncture and Qi Gong. Herbs usually have far fewer side effects than pharmaceuticals”.
Studies show, do they? Is there really a believable study that shows that Qi-freaking-Gong, of all things, is good for chronic pain? Ancient hokum about “energy fields” and “life force” does the trick, does it? My idea of a good trial of Qi Gong would involve one group of patients getting the full hand-waving treatment according to the best practitioners of the art. The other cohort gets random hand motions from a system I will gladly invent on request, and which I will have to be forcibly restrained from naming Don Ki Kong. It’ll be full of talk about holistic energies and connections to the universal flow, don’t you doubt it, and I’ll round up some impressive-looking worthies to administer the laying on of hands. Their passes and taps will be carefully screened by the Qi Gongers beforehand to make sure that none of them, according to their system, have any chance of actually having any effects on the Qi (assuming that any of them can agree). We call that a controlled trial to investigate placebo effects.
And I hardly know where to start with those beneficial herbs. The literature I’ve been reading has been showing that many of the herbal treatments show no effects when they’re looked at closely – St. John’s Wort, Echinacea, and so on. The larger and more well-run the trial, the smaller the effects go, in too many cases. But I have no problem with the idea that plants and plant extracts can have medicinal effects, of course: they’re full of chemicals. My whole career is predicated on the idea that taking chemicals of various sorts can alter one’s health. Where I jump off the parade float is at the nature’s-bounty-of-beneficial-herbs stuff, the idea that things are somehow more benign because they come from natural sources. Vitalism, they used to call that. It’s hooey. Strychnine. Ricin. Come on.
The editorial is full of fountains of happy talk like this one:
Joy, pleasure and freedom are sustainable, deprivation and austerity are not. When you eat a healthier diet, quit smoking, exercise, meditate and have more love in your life, then your brain receives more blood and oxygen, so you think more clearly, have more energy, need less sleep. Your brain may grow so many new neurons that it could get measurably bigger in only a few months. Your face gets more blood flow, so your skin glows more and wrinkles less. Your heart gets more blood flow, so you have more stamina and can even begin to reverse heart disease. Your sexual organs receive more blood flow, so you may become more potent -- similar to the way that circulation-increasing drugs like Viagra work.
Calling Dr. Love! All I have to do is change one letter in my last name, and I'm in business, expanding brains and other useful body parts. Unfortunately, that first sentence typifies a lot of thinking in this area. It's one of those "isn't it pretty to think so" statements. As far as I can see, deprivation and austerity have been the norm for most people throughout most of human history, even though they were eating natural foods and getting lots of exercise and fresh air. And one of the big reasons that people put on weight is that they have the freedom to experience the joy of tasty food a bit too often. No, this is noble-sounding stuff, but there's nothing behind it.
Update: Orac's take, with more on those "studies".
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September 15, 2008
Posted by Derek
I need some cheering up this morning – one of my favorite writers, David Foster Wallace, has died most unexpectedly. Perhaps, in looking back over his best work, it wasn’t as unexpected as all that, but you still never see these things coming.
So I’m glad to report, by contrast, that Dr. Matthias Rath has some problems of his own. Rath, some of you may recall, is one of those people who usually has “controversial” somewhere in front of his name in news articles. I’ve never thought of him that way myself: he’s always seemed just a particularly brazen and heartless con artist. He’s made large sums of money by telling HIV-infected patients that antiretroviral drugs are killing them, and that they should instead cure themselves with vitamin supplements purchased from, yes, Dr. Rath. His rants about the pharmaceutical industry are contemptible – Rath claims, naturally, that we’re a gang of evil poisoners, which is at least a field that he knows something about. He’s one of those people that you’re ashamed to share DNA homology with.
To be scrupulously fair, Rath appears to have distributed his supplements for free to the poorest patients in places like South Africa, which has surely brought down his average profit-per-suffering-death. But he’s been happy to tell wealthier customers in the US and Europe that he can not only cure HIV infection, but various cancers and other fatal ailments, with no convincing data of any kind to back up such claims.
Ben Goldacre, the estimable Bad Science columnist for the Guardian newspaper, ran a column in early 2007 on Rath and his work in South Africa, and followed that up with two more containing disparaging references. Not caring for this sort of publicity, the Dr. Rath Foundation sued for libel. (Goldacre is no stranger to threats of legal action, it seems). I am happy to report that the suit has now been dropped, and that Rath has been ordered to pay legal costs, which are gratifyingly extensive.
It now seems that the Dr. Rath Foundation is moving on to the profitable Russian market – with plenty of bad health and plenty of money sloshing around, it would seem a natural feeding ground for a creature of his type. I hope that the Guardian is able to collect its money in short order, and that Ben Goldacre gets a cut.
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December 11, 2006
Posted by Derek
Since I've been getting some more less-than-friendly email from Kevin Trudeau fans recently, I thought I'd take a minute to point out something that may not have been generally appreciated. What does the complete failure of a drug like Pfizer's torcetrapib say about the evil-pharma conspiracy theories that Trudeau and his type like to spin?
I mean, think it through: Pfizer spends hundreds of millions of dollars, only to find that their drug has unexpected toxicity. Not the horrible, chemical-weapon toxicity that the conspiracy mongers talk about, mind you: 11 deaths per thousand versus 6 deaths per thousand. But development stops immediately, as it should, the very day that Pfizer's executives get the news. Two days after trumpeting the compound as the biggest thing in their pipeline, they pull it and walk away from the billions of dollars that could have been.
How, exactly, does this fit the Evil Conspiracy worldview? Isn't this, according to Trudeau, exactly the same as all the other drugs already on the market? Why would a company walk away from all that cash just because of a measly little figure like 5 excess patient deaths per thousand? If you believe Kevin Trudeau, everyone who takes anything is being poisoned already.
I know I'm going to regret making this offer, but here goes: I'd be interested in hearing a Trudeau-ite explain this one to me. If you buy into his story, why any drug ever fails in the clinic must be a real head-scratcher, since you'd think that the Evil Pharma Overlords would be able to hocus the data enough to make any sort of toxic junk look good. And this one must seem especially weird.
So tell me, you folks who are convinced that I and all my colleagues in the drug industry are poisoning the world: why did torcetrapib fail? Ground rules: you have to know what torcetrapib is, and you have to have some basic understanding of what it was (in theory) supposed to do. ("Improve cholesterol to try to prevent heart attacks" is enough of an answer for that one - there's a free one for you). And you have to be able to spell Pfizer, and to have read at least one news story about the drug's demise. Have at it in the comments section.
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August 15, 2006
Posted by Derek
I've taken a few good swings at Kevin Trudeau around here, naturally enough, since he's going around telling everyone that my industry is poisoning them. I get some Google traffic from people searching for information about him, which makes me happy, since what they read here might possibly prevent them from giving this sleazy scam artist their money.
But I've noticed some odd search phrases turning up, things like "How old is Kevin Trudeau" and "Kevin Trudeau real age". Some looking around confirmed my fears. Yes, it seems that Trudeau is going around telling people that he only looks like he's in his forties - when, according to him, he's actually seventy years old. This statement seems to be confined to his personal appearances, because it's hard to track down in print. But it's out there. And it's a lie, as numerous legal records (such as his convictions for credit card fraud) will verify. This shows a combination of greed and contempt for his own audience that you don't come across very often. I'd want to get my clothes dry-cleaned if I brushed up against him by mistake, but you have to admit, he's quite a specimen.
So, for anyone who comes across this page by a Google search, here's the short answer: Kevin Trudeau is not seventy years old. This is an outrageous lie, being told to your face by an equally outrageous excuse for a human being. Trudeau is telling you this whopper for one reason: because he wants your money. Don't give it to him. Too many people have already.
Meanwhile, the marketing practices I spoke about last year continue - he's still slamming phone customers for his book with unwanted subscriptions to his $71 newsletter, for example. Here's one of the many folks who've found that getting Kevin Trudeau's hands off your credit card is next to impossible - and here's another. That applies to the poor suckers who pay $100 each to see him live, too - refunds are mighty slow in coming. And it appears that at least one of his front companies, Media Planet, has officially "gone out of business" in an effort to strand as many people as possible.
Naturally, he has another book out. And naturally, it's accompanied by a mudslide of lies and arrogant nonsense, such as the repeated claims that the FTC "censored" his first book, and that this one has all the good stuff in it that was cut out. (His real interactions with the FTC are considerably more complicated). This is merely a ploy to extract more money from his audience, even the ones who felt ripped off when they paid for his first book only to find it virtually content-free. This one is, naturally, full of the same vacuous gibberish as the first one. Naturally, it's $29.95.
Reputable publishers, though, are looking at the stacks of money that Trudeau is hauling away and wondering how to get some of that health-conspiracy mongering action. And what is this benefactor of humanity doing with some of the cash? Why, bankrolling a professional pool tournament. Where? Las Vegas. Naturally.
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March 30, 2006
Posted by Derek
I get emails every so often from people who are looking for more information about treatments for cancer or other diseases. More often than not, they've come across some Keven Trudeau-like "now the truth can be told" stuff and want to know what I think about it. I should note that almost all of these are non-hostile messages - they're just questions from people who haven't had a chance to learn much chemistry or biology, and want to hear some opinions from someone who has. I answer all of them as best I can.
A common theme in the miracle-cure claims is that such-and-such herb/supplement/device/mystic vibrational ripsnorter "boosts the immune system". If I had a dime for every time that claim is made, I'd be writing this from the conservatory of my mansion, right next to the orchid-hybridizing greenhouse and the frog pond. Who doesn't wish that their immune system worked better, tuned up to where it zapped every virus and cancer cell?
But, as Abel Pharmboy of Terra Sigillata pointed out, you should think twice about asking for that boost:
"Even if such a remedy existed, the immune system is far too complex to regulate with a single, myopic approach due to its multiple checks and balances, feedback loops, and other regulatory process that normally keep us from attacking our own tissue while recognizing and mounting responses against invading organisms. Even the most clever cancer immunologists have only made incremental headway in harnessing immune responses to treat cancer."
He goes on to mention that the notorious TGN1412 antibody was nothing if not an immune booster extraordinaire, and look what happened to the people that were exposed to it. My guess is that most people aren't aware that the immune system can attack a person's own tissues - they figure that there's an infallible friend-or-foe decoder built in or something. No such luck, though, when you consider the number of autoimmune diseases (and the number that might eventually be added to that list).
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March 1, 2006
Posted by Derek
I recently had an opportunity to look into some self-described autism treatments on behalf of a friend. There are huge numbers of desperate and hopeful parents out there, and there are some desperate and hopeful people selling things to them, too. The stuff I looked at was not, as far as I could tell, a cold-hearted scam, and considering the things you find in such disease areas, that's saying something. I think that the person involved believes, and wants to believe, that he's doing good in the world, and I'm sure his customers want to believe the same things.
At the same time, unfortunately, I don' t think much good is being done, but I can't get as enraged about it as I can some other situations. Take vitamin fraudster Matthia Rath, for example. He has recently withdrawn his lawsuits against a number of people and organizations in South Africa, in a sudden and unexpected move. Among them are the Health-e News Service, the group that broke the story of how some of Rath's alleged anti-HIV success stories involved patients who were taking antiretroviral drugs the whole time. Also off the hook is Dr. Eric Goemare of Medicines sans Frontieres, sued for defamation after characterizing Rath as a liar and a killer (which descriptions I find perfectly fitting, myself).
Says Goemare: "We are pleased that this phenomenal waste of time has ended." Dr. Rath is, of course, an expert at wasting things: people's time, their money, their hopes, their lives. I'd extend that list to include the oxygen he consumes by continuing to walk among us, but perhaps that's just me.
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November 21, 2005
Posted by Derek
This Volokh post (via Instapundit) about a former gang member who's been "nominated for a Nobel Prize" prompted me to leave a comment there, which I'll expand over here. It would seem that many people don't realize where Nobel Prizes come from.
The Peace and Literature prizes have a comparatively open nomination process, which makes for what I'm sure is a pretty poor signal/noise for whoever handles their mail. (Of course, the signal/noise of the list of eventual winners for those two isn't so great, either). But the science prizes are run in a tighter fashion. Here's the nominating committee for the Physiology/Medicine prize, for example, and it's very similar for the Physics and Chemistry Prizes.
The various Scandinavian professors involved are notoriously quiet about their choices, as are most prior laureates. The committees never say who these "other scientists from whom the Academy may see fit to invite proposals" might be, and I'm sure that identifying oneself would be a sure way to be dropped from the list. That's not to say that there are no controversies, just that we don't get to hear about them in detail for fifty years or so. That link will let you search older Medcine prizes. It's interesting that the corresponding database searches for Physics and Chemistry aren't even available.
What this means in practice is that no scientist, in theory, is able to be identified as a "Nobel Prize nominee." That doesn't keep it from happening, though. In fact, that link will take you to the story of someone who is claimed to have been nominated five times. A Google search for "five-time Nobel Prize nominee" turns the same person up all over the place. It's almost as if he hasn't done anything to discourage the practice.
One of most notorious recent examples was a neurologist, William Hammesfahr, who was all over the media during the Terri Schiavo case. He was invariably referred to by his supporters as a Nobel prize nominee, but this was another whopper. At least he only claimed to be nominated one time, but anyone who claims to be nominated at all should be under suspicion.
Searching for "N-time Nobel Prize nominee" for various values of N will net you all kinds of stuff. Excluding the Literature and Peace candidates, you find Nigerian crank physicists (more here, medical quacks, and Dr. Johanna Budwig herself, the current record holder in this doofus category. She's usually described by her acolytes as a "seven-time Nobel Prize nominee", which wouldn't be good news even if it were true, wouldn't you think? I note with amusement that in she was being called merely a six-time nominee back in 2002. Things have clearly advanced since those days, which is remarkable since I don't believe that Dr. Budwig is actually still with us.
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October 16, 2005
Posted by Derek
It's been a little while since we checked in on Dr. Matthias Rath, vitamin entrepreneur and scourge of my chosen field of work. But there have been some wonderful developments that I'd like to share with everyone. A note from a reader brought him to mind:
"Your education may not be serving you in a changing world. From some of what I have read you remind me of the physics professor who is still teaching the Bohr atom, sure that the quantum madness will go away. I highly recommend, before uttering another "sure" word on medical cures, you find and interview 10 patients whose HIV has been arrested by alternative treatment and 10 cancer patients who were diagnosed terminally ill and whose condition was reversed under Dr Rath's methodologies. I have followed them, in awe, watching as they were liberated from the naivete of the modern medicine you hold high. . ."
As I pointed out in a reply, it would do Doctor Rath a world of good for him to humiliate the medical establishment in a clinical trial showdown. You'd think that that we should be able to get the World Health Organization or some other worthy organization to referee, and if Rath's treatments are that good, he'd have nothing to fear. Think of it - the drug companies would have to eat dirt and Dr. Rath would be an instant hero for his amazing medical advances. No more nasty comments from snide onlookers like me, no more threats of arrest. . .why doesn't he come and settle our hash already?
I think we already know the answer to that question, don't we? But in case you've any doubt, take a look at the latest news from South Africa, where Dr. Rath has been parading patients who he claims have been fighting off HIV infection by taking his vitamins. As it turns out, they seem to have been supplementing the supplements:
Two HIV-positive women presented to the media in June by the Dr Rath Health Foundation as examples of how its vitamins can reverse Aids have admitted that they were on antiretroviral (ARVs) drugs all along. A third woman, a high profile Rath Foundation agent who has been promoting the vitamins in Gugulethu, died a few months after rejecting ARVs. . ."
Well, that's one way to do it. Dr. Rath, once again, is on the cutting edge of clinical practice. Think of the power of this technique! You could probably show that chocolate ice cream is an effective cholesterol-lowering agent, as long as you dosed people with a statin on the sly. Imagine how much proprietary-recipe chocolate ice cream you could move that way. . .and at twenty dollars a bowl, most likely. Oh, I'm in the wrong business, I tell you. If I could just cut every bit of human conscience out of my psyche, to the point that I could deceive terminally ill people into forsaking their only chance of survival and spending the last of their money on my worthless crap instead - I could be down there with Dr. Rath, wallowing around in the hundred-dollar bills like a pig in a trough. Doesn't he look happy, though. . .
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August 29, 2005
Posted by Derek
One of the things that came up in regard to that last post was the idea about blood being acidic or alkaline. I don't think that most people outside the medical sciences realize how much effort the human body expends on these matters. Those of us who keep up with these topics could do some good by letting people know how robust this stuff is.
To listen to most quack nutritionists, your body is in perpetual danger of flying apart. This thing is out of balance, that thing over there is running low, all these other things are set totally wrong. You need. . .herbal supplements! Of the kind that I happen to sell! Fix you right up! Of course, if you stop taking them, your physiology might well just start wobbling around again, so you'd better play it safe. . .and it so happens that we offer discounts on a yearly supply. . .
Now, it's not like things can never get out of whack, but a lot of metabolic energy goes into keeping that from happening. Biologists, MDs, and medicinal chemists are always getting surprised at just what sorts of abuse a living system is capable of absorbing without breaking down. Homeostasis is what I'm talking about. That concept applies to a huge number of living processes, but we'll stick with one dear to Kevin Trudeau's alleged heart: acidity and alkalinity.
The pH of the blood is held steady around pH 7.4 by several systems, not all of them well characterized, but all acting at the same time. The amount of carbon dioxide that the lungs exhale (or retain), the actions of the kidneys, and the circulating blood proteins are all involved. (Buy why it's pH 7.4 and not some other value is one of those very good questions that no one has a very good answer for.)
One of the main places that your body can go acidic is in muscle tissue during exercise. That's due largely to the buildup of lactic acid from anaerobic metabolism, and can send the interstitial fluid between muscle cells down to pH 7, much lower than blood gets under the same conditions. (There seems to be something about the capillary wall that excludes the excess acid, which is yet another control mechanism.)
Going alkaline is usually a sign that something's off with your breathing or with your kidneys. (You'd better hope that it's the former, because you can stop hyperventilating a lot easier than you can stop kidney trouble.) In either case, it takes a lot to overload the various pH controls, and if you do manage to - in either direction - you can be headed for serious trouble and even death.
This should illustrate why the "alkalinity causes cancer" theories from the likes of Kevin Trudeau are nonsense. The blood of people who get cancer is at pH 7.4, like everyone else, and that number (if it fluctuates at all) moves around according to whether or not that person just took the stairs, rather than whether they're drinking "coral calcium water" or whatever damn thing. pH changes in your stomach aren't reflected in the blood - if they were, we'd be dead as soon as we smelled lunch.
But all you have to do is Google any combination of "blood" "acid" and/or "alkaline", and you'll step off into a swamp of people who are trying to convince you otherwise. It's a simple, appealing theory, which if it were true it would explain a lot and immediately suggest ideas for treatment. But it's wrong, and it's been known to be wrong for a very long time. The only utility it has is as a prybar to separate people from their money.
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August 28, 2005
Posted by Derek
The time has come to take up the case of Kevin Trudeau. His pernicious book has hit the top of the New York Times best-seller list, a fact that the paper itself seems to find surprising. This 570-page doorstop is an ax job on my industry and my field of research, and accuses my peers and me of complicity in terrible amounts of human suffering. ("The drug industry does not want people to get healthy" is one of his favorite lines.)
How, you wonder, do people like me accomplish such awful things? Why, by denying consumers wonderful all-natural cures for just about everything that could possibly be wrong with them. And how do you find out about these wonders? By forking out for Trudeau's book, naturally. And when you find out that there's hardly a paragraph of specific information in the whole thing, then you can go pay him more money to get access to the untold amounts of crap on his web site. $499, according to the Times, will buy you a lifetime membership. This from a man who says "I changed my priority from making money to positively impacting people."
The medical rationales Trudeau offers are hardly worth even discussing, and make me feel like positively impacting the man with a spiked club. Readers who know some biochemistry might be forgiven if they haven't heard that "If your body is alkaline, you cannot get cancer. . .and if you have cancer, it goes away." I would be interested to hear what on earth he means by a person's body being alkaline - last I heard, my blood was at pH 7.4. But there's really no sense in arguing with the sort of person who can get things like this out with a straight face.
This is someone who spins tales of herbal clinics that cure cancer, every time. Of wonderful all-natural cures that will reverse type I diabetes. Of simple cures for multiple sclerosis, for heart disease. These are not harmless ideas - these are lies that can kill people, and given the number of books Trudeau has sold, they probably have. Perhaps his next book will detail the story of his consciencectomy. No doubt Kevin Trudeau moves around from mansion to mansion, but how he can sleep at night in any of them escapes me.
Update: Longtime reader Don Hertzog sends along this recent demolition of Trudeau in Salon (free registration required.) If you have some time on your hands, the Amazon review pages for the book are worth a look, too - there are over 800 reviews there, and most of them are from some pretty ticked-off customers.
Update 2: Ha!
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June 9, 2005
Posted by Derek
There's a doctor named Matthias Rath who for some years has been taking out big ads in the New York Times and the International Herald Tribune. Rath is a big proponent of megavitamin therapy for just about everything, and by some cosmic coincidence he also has a line of vitamins for sale. No doubt he has a web site and a half, but damned if I'll link to it.
His ads are thunderous, paranoid denunciations of the pharmaceutical industry, the likes of which I haven't seen since the Church of Scientology took off after Eli Lilly and Prozac in the early 1990s. If you want some Instant Rath, take those and add some Lyndon Larouche-level conspiracy theories (for a while there, Rath was all but blaming drug companies for 9/11), and mix well. Season to taste, but if you've really got a taste for this stuff stuff, there's no hope for you.
His latest manifestos have been targeted to South Africa, and they're just what that country doesn't need. Rath rants about antiretroviral drugs being sinister poisons, while apparently everyone could be cured of HIV if they'd just guzzle his multivitamins without pause. The South African activist groups demanding free retroviral drugs are, according to him, tools of the "international drug cartel" that exists in the fevered reaches of his head.
It's hard to know how to answer such otherworldly accusations. Try, for example, the idea of drug companies funding groups who are screaming for their patents to be abrogated and their profits confiscated. I'm having a hard time making the connection. All in all, I'd rather be stuck in an elevator for three days with a dozen Intelligent Design advocates than spend five minutes with Matthias Rath.
South Africa's attitudes and policies toward HIV are enough of a mess already, as those who remember former president Mbeki's handling of the epidemic know. According to an article in Nature Medicine, the South African Traditional Healer's Association has sided with Rath, and a recent press conference from health minister Manto Tshabalala-Msimang featured one of her many endorsements of garlic, lemon peel, and beets instead of antiretrovirals. Meanwhile Rath is lobbying South Africa's parliament directly, amid accusations that he's planning to set up a factory to sell his own vitamin pills.
And meanwhile, at least 20% of South Africa's adult population is infected with HIV. What could be a great nation is threatened with an ugly slide back into the third world, while wastes of good carbon like Matthias Rath spend their time fighting the only known treatments. It makes you wish you could just avert your eyes.
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October 3, 2002
Posted by Derek
Most of you have probably seen this link by now, but for those who haven't, here's Montana's blue Senate candidate. The picture would seem to do a reasonable job of rendering his color, but I suspect that he's more gray than blue. Still, no doubt the effect is quite striking in person.
Colloidal silver (very fine particles of the metal suspended in water) is to blame. Actually, let me rephrase that: this guy is to blame, because he drank hefty amounts of the stuff for an extended period. The silver just did what silver does; you can't blame an element for acting the way it has to act.
And why, one asks, did this man do all these silver shots? Well, if you go to Google and run the phrase "colloidal silver" through it, you'll be assaulted with come-ons for so much of the stuff that you could start your own currency. It's been around for a long time (turn of the century, at least) and was a common ingredient in nose drops up until the 1950s or so. Here's a rundown on it from Quackwatch.
While it does have antibiotic properties, it's not effective enough (and its side effects are too great) to be of much use. The only modern application of it that I know of is in some kinds of burn salves, where it's at least applied topically.
Unfortunately, it's not a metal that the body handles very well. Silver doesn't have any known endogenous use, and there aren't any clearance mechanisms for it. So it just tends to pile up, which is the general problem with ingested metals. And, for reasons that aren't well understood, many people end up depositing fine particles of the metal in their skin, eyes, fingernails, and so on. It wouldn't surprise me if the metal were present in a number of internal organs, too (I'd start with the liver.) The condition's called argyria, from the Latin.
It's there to stay, too. There is absolutely no way to get it out. Here's an unfortunate woman who was given the nose drops for a period in the 1950s and ended up with argyria for the rest of her life. She's in a rather testy mood about all the latter-day silver promoters, and who can blame her? I'll link to a particularly clueless (and poorly written) example to give you the flavor of the field.
Our metallized Montanan made the stuff at home with a similar kit (probably generously laced with silver salts, depending on what kind of water he used,) because he feared antibiotic shortages after Y2K. And the hucksters told him, you know, that if he took this wonderful silver that he wouldn't have to worry about that sort of thing. How was he to know?
By using his brain, perhaps? By doing a half-hour's research on the web or in any good library? Apparently not. Actually, I shouldn't be making fun of his Senate candidacy. Come to think of it, he'd fit right in.
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June 23, 2002
Posted by Derek
After going off on the Weekly Standardon the 11th about the ridiculous miracle-cancer-cure ad they accepted, I see that there's one nearly as stupid in the latest National Review.Fortunately, it's not a particularly dangerous one.
It's for a book that touts a zillion uses for hydrogen peroxide, that wonder chemical that apparently will do everything except housebreak your dog. The good part is that it doesn't actually say that you should drink the stuff to cure cancer, and that's enough for me to hold my fire. If someone gets ripped off because of curiosity about new ways to simultaneously clean their refrigerator and soak their feet, I won't lose much sleep over it.
Of course, there have been various oxygen-therapy yahoots promoting peroxide and worse for years, and many of them claim to cure cancer (and whatever else you've got, though they don't seem to do much for the Heartbreak of Gullibility.) I once saw a come-on that impressed me greatly, promoting some sort of superoxygenated water as a way to get rid of free radicals in your body. That's kind of like selling gasoline-filled fire extinguishers, chemically speaking.
There's not too much good you can do with household hydrogen peroxide, but (fortunately,) not much harm, either. But I worked in a lab once where we had fairly good quantities of the 90% stuff, back in the days when it was more widely available. Now that material could be a real agent for change in your life. We had a spiffy chain-mail glove set that we used to pick it up, and donning those tended to concentrate your mind on the task at hand. . .
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June 13, 2002
Posted by Derek
Here's more info on the "Dr. Burton" mentioned in the egregious Weekly Standard advertisement (see the Tuesday, 6/11 post below.) This is courtesy of the invaluable Quackwatch. This is surely the same person. As far as Burton's methods go, what the book that the advertisement is selling is supposed to do for you, other than tell you more stories about his miracle cures, is hard to imagine. It's not something you're going to whip up at home (although stuff you could whip up at home would do just as much good, it seems, and cost less, too.)
As for Johanna Budwig, a Google search of that name will give you hours of reading, if not of reading pleasure. Flax seed oil and cottage cheese seem to the the two constituents of her miracle diet - there, I've saved you the $19.95 that those slimeballs were charging for their book.
I've had opportunity to study the effects of various lipid constituents on biological targets in the body, and I'd certainly not deny that you can effect a lot of interesting biology by varying the lipid profile of your diet. But keep cancer from even happening? I think not.
No response from the Weekly Standard folks yet (I sent them the first article below.) I'll be quite interested to hear what they have to say, if anything.
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June 11, 2002
Posted by Derek
Today I wanted to cover a particular intersection of medicine, commerce, and politics in the June 10th issue of The Weekly Standard.I've read the magazine on and off since its inception, and enjoyed it. I often agree with its editorial stance, and when I don't, I can usually see what the writers are up to, and how a reasonable person would come to their conclusions.
What caught my attention this time was something I disagreed with most strongly, but it wasn't an article. It was an advertisement on page 15, titled "Black Listed Cancer Treatment Could Save Your Life." Well, I earn my living by trying to find treatments that could potentially save people's lives, so headlines like that catch my eye.
But not in a positive fashion: for many years, I've kept an eye on all sorts of medical quackery, of which there is an inexhaustible supply. I'm pretty sure that I've seen this ad before, actually. For all I know, I've seen it before in The Weekly Standard.But I'd had a long day at the lab when I picked up this issue, and I was in a mood to read the whole thing.
It repays inspection. I found that in 1966, the "senior oncologist at a prominent New York hospital" developed some miracle serum that "shrank cancer tumors in 45 minutes!" And after another 45 minutes, "they were gone." (How this was determined using 1966 technology is left as an exercise for the reader, I suppose.) Who is this wonder-worker, and at which hospital did he work? The ad glancingly refers to him as "Dr. Burton," but goes on to relate that he was shut down by the FDA and forced - yes, forced - to leave the country, "where others benefited from his discovery." After their checks cleared, presumably.
We then switch to one Dr. Johanna Budwig, a "six-time Nobel Award nominee." Now an instant sign of fakery, as if another one were really needed after that first paragraph. No one knows who's really up for the science Nobels; the Academy isn't telling. When someone brags about being nominated for a Nobel in one of the hard sciences, it's time to head for the exits. I might as well say that I'm a six-time nominee for the NBA slam-dunk championship - hey, if I'd sent them postcards every year asking to be included, then why not?
"Dr. Budwig's" story is similar to Dr. Burton's, only she found a miracle diet that prevents cancer from even occuring. But (and you knew this was coming) she was "blocked by manufacturers with heavy financial stakes!" Hey, did they check Dr. Burton out? Seems like he'd have a reason to keep this competitor off the market. . .
Well, the ad goes on and on, and if you've seen one of these, in some ways you've seen them all. The whole thing is selling a book called "How to Fight Cancer and Win." Natural healing, miracle cures, secret breakthroughs they don't want you to know, all backed up by testimonials from people with initials for last names. One "Molly G" says that the book "has information I've never heard about before," and I find that statement the most believable thing on the whole page.
It's just another cheesy scam, another rip-off aimed at people who are scared of getting cancer, people scared that they might have it. . .or at people who really do have it and are scared that they're going to die. A fine group of customers to remove cash from. The publisher gets the money and a live mailing address (well, for a while), to sell to every other quack who needs a fresh group of the desperate and frightened.
So, what I'd like to know is, what is the Weekly Standard doing profiting from this slimy business? Now, I know that opinion journals need ads, and they never have enough. There are 44 numbered pages in this issue of the Standard, and there are only five pages of advertisements. That's probably about enough to pay for the coated paper. But I also know, as does everyone else, where the money is coming from: Rupert Murdoch, who felt it worth the inevitable steady losses to promote political views he agrees with.
More power to him, I say. But how are those views advanced by their proximity to sleazy ads for amazing cancer cures? I'm sure the advertising manager for the Standard would rather fill the issue up with ads for BMWs and single-malt whiskey. Does the magazine really hit the miracle-cure demographic? And does it really want to look like that's the one it reaches? Does News Corp. need the money this badly?
There's the practical argument. The impractical one is that taking money in exchange for giving these snake-oil merchants space is very close to immoral. I'm well aware of the precedent set (for example) by David Horowitz, trying to get his anti-slavery reparations ad placed in college newspapers. As was pointed out at the time, though, a newspaper or magazine is free to accept or reject any advertisements it feels like. (And a rejected advertiser is free to say what he thinks about the refusal!)
But this sort of ad isn't selling an argument - it purports to be selling scientific facts that will save your life. And these "facts" are, as far as I'm concerned, life-threatening bullshit. Would the Standard take an ad from the Scientologists? Would it take an ad from a throw-away-your-crutches faith healer? After this one, why not?
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April 9, 2002
Posted by Derek
That Fitzgerald reference is, of course, the quote about the sign of a first-rate mind being the ability to hold two contradictory statements at the same time. Like several of his other quotes, that one has the germ of spectacular error in it - similar to his line about there being no second acts in American lives. That one gets trotted out with great regularity, as we prove that some lives are made up of nothing but second acts.
Anyway, I'd say that that ability is as often the sign of a third-rate mind or lower. Another example of these contradictions came to mind after I read my mail about the last couple of postings. One correspondent pointed out that we have people watching for every food additive that might be shown to cause cancer, but thanks to Hatch-Waxman we're also letting people swallow almost anything as long as it's labeled as a "nutritional supplement." Some of these are the same people, actually.
Tropical leaves that starving tapirs wouldn't touch, roots whose previous function was to sterilize unwary nematodes, seeds and kernals that would give a buzzard the trots. . .grind it up; it's all fine. You don't really have to test anything for safety, and you don't have to prove it does anything (costs money to do that, anyway.) Just be sure to say that it's "not intended to treat, cure, or affect any disease" and you're rolling.
The latest issue of the fine review journal Trends in Endocrinology and Metabolismhas an article detailing cases where imported traditional "herbal preparations" have turned out to be laced with actual pharmaceuticals. While that reminds me of is the story of W.C. Fields spitting out the contents of his on-set swigging flask, which he always maintained was full of pineapple juice. Someone put him to the test, and his shout was "Who put pineapple juice in my pineapple juice?"
Imagine a traditional preparation of herbal goodies that turns out to be cut with man-made antihistamines or sulfonylureas, rather than Nature's own bounty of alkaloids and cardiac glycosides. Here you are, expecting the usual gut-bomb of all-natural ephedrine, caffeine, or hepatotoxic enzyme inducers, and you get something scraped out of a vat instead. The nerve!
The problem is, it's not just that some fly-by-nighters are slipping pharmaceuticals in. The article also includes harrowing cases of preparations that contained whacking loads of mercury or arsenic, for reasons unknown. Why people swallow the ads for these things, much less swallow the pills, is a mystery to me.
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April 8, 2002
Posted by Derek
Not much time to post tonight, since our 22-month-old came down with a sudden fever. She's fine otherwise, though, in case anyone's wondering. I'm sure that, as a blog-baby, she'd play well with "Gnat" Lileks.
I've already had several e-mails about my snake-oil outburst in the previous post. No one's come out for the pro-snake-oil position yet; I guess that audience doesn't read me, which is something I can certainly live with.
It was probably the contrast between the ads I mentioned and what I know that medicine can accomplish (see 4/4 and 4/2 postings below.) I've noticed that Sydney Smith over at Medpundit takes issue with both the degree of my gloom and the degree of my optimism. He's got a point about some of the things we can do now (vaccinations are always a good example to adduce,) but I wonder about the popular perception of medical treatment. Large groups of people are worse than I am, in both directions.
There are two mutually exclusive wrong ideas that the general public has about medicine, I think. The first is that there's nothing useful out there, they're just going to mess around with you and waste your time and money, you're going to get what you're going to get, why fight it, etc.
Contrast that weltanschaungwith the second major group: the ones who feel entitled to have everything that goes wrong with them fixed. If one doctor doesn't give them the satisfaction they're after, they go to another. If one medication doesn't cut it, then there's another that will. Generally, there's a sense among this population that any condition can also be traced back to its cause, that person, action, or thing that made them sick. After all, the default setting is perfect health, so something must have happened!
There's a subset of people who manage to believe both of these things at once: these are the big-conspiracy types, who are sure that the doctors and the evil drug companies are ganged up against everyone. (It's an odd viewpoint, when you consider that those two groups - although they need each other - don't always get along very well.) I've had people seriously explain to me that "they" have cures for all these terrible diseases already lined up - "they're" just waiting until everyone's sick enough to make the market really huge.
I give those folks my standard answer to all conspiracy buffs: "Yeah. . .that's what they want you to think. . ."
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April 7, 2002
Posted by Derek
For Monday, I'm just going to send everyone to a wonderful article from the Washington Monthly. (I came across this one over at Arts and Letters Daily.)
It's a strongly worded look at the alternative/holistic medicine area, with particular emphasis on the recent attempts to subject these treatments to clinical proof. Many of the practicioners are simply ignoring the studies if they don't give them the answers they want to hear (which, as you can well imagine, they generally don't.)
I can tell you that my blood heats up when I hear the radio ads for potions - excuse me, dietary supplements - to "cleanse your liver" or "sharpen your memory." Not to mention all the miracle weight-loss or hair-growing pills. I feel like I've slipped through some wormhole and ended up in 1910.
Just look at the ancient shucks that are still in business: magnet therapy, iridology, reflexology...you can read all about this stuff in Martin Gardner's first "Fads and Fallacies" book, which is nearly 50 years old. The true and inescapable mark of a pseudoscience is that it doesn't learn a thing. It never changes; the theory is never overthrown; it just keeps on plugging away obliviously. Who cares about facts?
And while I'm on the subject of pedigreed nonsense: if I see another gaudy display of homeopathic dishwater near the checkout of a pharmacy again, I may do something quite reckless. I can only imagine what my medical colleague over at Medpundit thinks about that stuff; I know the herbal supplements really get on his nerves. As they should.
I'll come back later to the subject of the Hatch-Waxman Act, which is one of the things that got us into this fix. For now, check out that article link for a table-pounding good time.
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