Hello everyoneHere is Grenoble it has been rainy for the past couple days which is a first because usually it is nice and sunny This weekend has been pretty quiet for me I went out with some friends on Friday night and on Saturday I went skating with some other exchange people which was fun. Courses are going well I have a midterm in my economics class in a couple of weeks so I will have to w
Biciklisticna odisejada po vzhodni obali
Danes je bil dan za bicikliranje. Tako sem odbiciklirala ze do zelezniske postaje da sem ob 10.02 sedla na lokalni vlak za Hualien. Ne mores ravno na vsak vlak z biciklom ampak jih je dovolj poleg tega je infrastruktura za moje pojme tukaj odlicna in je kar dober priblizek raja za kolesarje. Nasplosno je tole zelo bike frienldy drzava opazam saj lahko bicikel povsod vzames s seboj stegne so
Le dpart
Bon c39est le grand jour a fait des mois que je parle de mon dpart maintenant il faut y aller...Je me sens plutt bien mme si je n39ai pas dormi de la nuit Kamel et Julie sont avec moi pour aller jusqu39 l39aroport heureusement d39ailleurs car c39est vraiment grand paris et les aroports aussi...Bref je me fais enregistrer c39est le moment de passer la douane Kam
Cairns
Yesterday we spent our last day in the Blue Mountains. We acted like tourists and went to Scenic World where we took all of the trams and cable cars over the valley. The tram had a glass floor so you could see all the way down into the canyon and we went over the top of Katoomba Falls. Paul is a whiz driving on the left. We went to a park that is known for wild kangaroos but alas there were no
Moore River Nov 2011
I absolutly love Moore River. It is just over an hour 80km North of Perth and you feel like you are a million miles from anywhere. There is one shop at the caravan park and one shop at the petrol station no mobile phone coverage and absolutly nothing else to do but go to the beach play on the river play ball sports or hidey in the dark and RELAX I love it.So we39ve just had our annu
El Nido back to basics
Meanwhile at the Dallas Inn in Puerto Princesa in my best cartoon narrator voice I found my way into a van to El Nido which is a 57 hour ride through the same windy bumby dusty roads on route to Sabang. Something about travelling through the same road twice didnt appeal to me but as there is only the one road up north I sucked up my outrage and prepared for what I hoped would be a sleepy jo
Shinjuku by night
After a day out and about in Tokyo we went to Shinjuku for dinner and then to Kabukicho Tokyo39s redlight district. Lots of fun and flashing lights
Cairns Days 9 and 10
Friday November 4 2011 Day 9As you may have seen in the last blog entry there were pictures of the Great Barrier Reef. Jim was a little ahead on that one. We took a tour of the Reef on Sunlovers Cruises. We boarded a catamaran around 10 AM and set out for our adventure. When the crew went through the safety orientation at the beginning of the trip they showed how to put on the life jacket and
Centre du Vietnam
Avion jusqu39 Hu la ville impriale au centre du Vietnam.A l39aroport je rencontre Samy et Greg deux touristes de Ste tout juste partis pour un an dans cette rgion du monde. Nous passerons les prochaines journes a dcouvrir ensemble Hu puis Hoi An.A premire vue Hu semble tre une Gomorrhe en miniature si on en croit les nombreuses propositions dans la rue pour nous ve
…yep still here….Tennant Creek
.....all we can say is they better receive the correct trailer part tomorrow morning or we may just about go postal.Have checked out every attraction in town and surrounds over the last 3 days and are officially ready to move on. We seem to have mastered the management of the annoying biting ants that seem to be infesting everything in sight. The Patrol tyres sit inside 4 squares of Ant killer po
Journe Hong Hong
Arrive Hong Kong 7h du matin heure locale minuit heure franaise. Je n39ai pas dormi du voyage j39ai dcouvert qu39 moins d39tre vraiment mort il est juste impossible de dormir dans un avion les siges sont super inconfortable Bref me voil seule Hong Kong pour 17h je ne sais pas si j39ai le droit de sortir ou pas...Dbut de l39aventure...Mais avant
Sailing
So the full moon party saw my welcome return to alcohol and started. We started drinking in the Hostel at 1430 and made our way to the ferry with our boxes and bottles of goon cheap so called wine. In the party is one Dutch guy a Swedish Guy Fred 3 German girls as Australia is just full of Germans and me. We get to Magnetic Island at 1730 and went onto one of the local beaches near to whe
Days of rest
We have had the last two days doing very little. We have taken the time to do a little sunbathing along with preparing for our long journey home.Thursday we managed to get about 3 hours sunbathing in before the heavens opened and it poured with rain. Later that evening we took a walk into the town and had dinner in Chinese restaurant we had seen earlier in the week near to the Kmart store. It was
Start of the journey
Today we start our epic journey home. We think it39s around 7000 miles.We have booked a taxi to collect us from the apartment at 8.00 this morning so did not have to be up too early.Check in at the airport all went according to plan. Were a bit surprised that we did not get charged for our extra bag as this is the longest leg of our 4 journeys so far over the last three weeks.The flight from S
Still travelling
We arrived at Madrid at about 6.30am this morning after an 8 hour flight. During that time the clocks also went back which made it even worse.We have another 5 hour wait for our flight to Tenerife. To try to make this a little more relaxing we have booked a lounge for the duration which we believe is near to the gate that our plane will leave from.Whenever we visit Madrid airport we always see
Random Flu Thoughts
I normally write the first draft of this blog the weekend before it is due, and this is no exception. However, I am ill this weekend. Headache, myalgias., painful cough, but only mildly ill. The worst part is the interferon induced brain fog; my thoughts flow with all the speed of pudding and I was not appreciably better as the week progressed, although no cracks about how you can’t any difference in my writing over baseline.
I doubt the cause of my symptoms is influenza. According to the CDC site and Google flu trends there is little influenza activity in the US at the moment, so it is probably one of the innumerable viruses that can cause a flu-like illness. I am also not ill enough to think I have influenza, but I could be having a modified course as I was vaccinated a month ago. Of course, the doctor who treats herself has a fool for a patient and an idiot for a doctor. Flu season approaches, so from my interferon addled brains, flu thoughts.
Flu Vaccine Efficacy
The flu vaccine has a bad reputation in part because it is not the best of our vaccines for preventing illness and those who need vaccination the most are the least likely to respond. Still, I was happy to see the Lancet meta-analysis this month on the efficacy of the influenza vaccine, although it breaks no new ground. It was a nice paper in that they only included studies where influenza confirmed by culture or real-time polymerase chain reaction, not the clinical diagnosis of influenza.
We screened 5707 articles and identified 31 eligible studies (17 randomised controlled trials and 14 observational studies). Efficacy of TIV was shown in eight (67%) of the 12 seasons analyzed in ten randomised controlled trials (pooled efficacy 59% [95% CI 51—67] in adults aged 18—65 years). No such trials met inclusion criteria for children aged 2—17 years or adults aged 65 years or older. Efficacy of LAIV was shown in nine (75%) of the 12 seasons analysed in ten randomised controlled trials (pooled efficacy 83% [69—91]) in children aged 6 months to 7 years. No such trials met inclusion criteria for children aged 8—17 years. Vaccine effectiveness was variable for seasonal influenza: six (35%) of 17 analyses in nine studies showed significant protection against medically attended influenza in the outpatient or inpatient setting. Median monovalent pandemic H1N1 vaccine effectiveness in five observational studies was 69% (range 60—93).
Interpretation
Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking. LAIVs consistently show highest efficacy in young children (aged 6 months to 7 years). New vaccines with improved clinical efficacy and effectiveness are needed to further reduce influenza-related morbidity and mortality.”
Seems on an order of efficacy with seat belts, which decrease death by 70% and injuries by 40%. Neither the seat belt nor the flu vaccine is perfect, but both are better than no intervention at all. The largest problem with the vaccine is the difficulty in choosing the correct strains every year to be in the vaccine. If the JREF ever has a million dollar winner, I hope the new millionaire would use their powers for good and predict the upcoming years influenza strains.
A Universal Flu Vaccine
There is ongoing work to improve the flu vaccine, which is what we really need. The problem with influenza is that it mutates. In the argot of the field it has antigenic drift, so that the organism at the end of the flu season does not antigenically resemble the strain at the beginning of the season and antigenic shift, where there is a whole new strain unknown to world, as happened with H1N1.
There are sections of protein of the virus that do not mutate, regions that are highly conserved, and if those proteins could be isolated perhaps there would be a universal vaccine against all influenza strains. And someone is on track to do just that:
To answer that question, Corti et al. screened 104,000 peripheral-blood plasma cells from eight recently infected or vaccinated donors for antibodies that recognize each of three diverse influenza strains: H1N1 (swine-origin influenza) and H5N1 and H7N7 (highly pathogenic avian influenzas). From one donor, they isolated four plasma cells that produced an identical antibody, which they called FI6. This antibody binds all 16 HA subtypes, neutralizes infection, and protects mice and ferrets from lethal infection. The most broadly reactive antibodies that had previously been discovered recognized either one group of HA subtypes or the other, highlighting how remarkable FI6 is in its ability to target the gamut of influenza subtypes.”
That was a lot of work, but now that they have discovered the key to neutralizing all influenza, the challenge is to develop a vaccine that promote a reaction to that antigenic site and, viola, a universal flu vaccine. I hope we see it in my lifetime. It explains why if there is poor match between the vaccine and circulating influenza there is still efficacy, although decreased, from the vaccine. The lucky few will make antibody to the conserved areas common to all viruses and develop protective antibody in a mismatch year. Vaccine response is always more subtle than one antigen/one antibody.
It really surprises me that this advance is coming from basic science work on the immunology of influenza, I would have anticipated this kind of breakthrough would have come from NCAAM, which has been on the cutting edge of improving patent care and quality initiatives. Like, um, er, well, the brain fog is preventing me from recalling the advances.
Flu Stats
Humans always have difficulties comprehending large numbers. Politics, and life, is small and local. If an event did not happen to you and yours then often it wasn’t important. I am used to thinking about large numbers and influenza, but they do not have the same impact compared to what happened in my own ICU with the initial H1N1 outbreak: all beds filled, all ventilators in use and no place to put the next case which, by some random luck, never occurred. The pandemic affected millions; I remember my 30 cases.
The CDC released estimates (and they are estimates, based to best data and models. If the CDC develops a better technique and changes the numbers, they are not “backing away” from the prior estimates, a phrase that always identifies someone who is both against vaccines and does not understand the tentative nature of all data) on both the effect of the H1N1 pandemic on the US:
43 million to 89 million cases, 195,000 to 403,000 hospitalizations, and 8,900 to 18,300 deaths, including 910 to 1,880 deaths among children aged <18 years, during April 2009–April 2010.
as well as the estimates for what the vaccine accomplished
713,000 to 1.5 million cases, 3,900 to 10,400 hospitalizations, and 200 to 520 deaths were averted as a result of the vaccination campaign.
Not bad prevention considering 61 million Americans received the vaccine, a paltry 1 in 5.
Flu and Pregnancy
There are people who have a marked increased risk of dying from influenza, including the obese and pregnant women (not pregnant men, I hasten to add living in Oregon). 1% of the population is pregnant, but in 2009 pregnancy accounted for 5% of H1N1 deaths.
It is difficult to convince pregnant women to get the vaccine, since people have an understandable fear of anything that could adversely affect the pregnancy. The data available suggests that not only is the vaccine safe in pregnancy but maternal vaccination protects the child against influenza. There is no data to suggest that the flu vaccine increases the risk of miscarriage and some reports suggest that influenza is associated with premature delivery. The effect of influenza infections on pregnancy outcomes has had little evaluation.
There was an interesting epidemiological study this month in JID on the 1919 pandemic that suggested that about 1 in 10 pregnant women had a first trimester miscarriage from influenza
…documented an unusual 5%–15% decline in natality with a trough 6.1–6.8 months after the peak of the severe autumn 1918 pandemic wave in several Scandinavian countries and the United States. On average, 2.2 births per 1000 persons were missing during spring 1919, corresponding to an excess of ~1 in 10 pregnant women infected with influenza during their first trimester having miscarried in autumn 1918. We argue that the most parsimonious explanation for this unusual and temporal birth depression is substantial pregnancy losses following influenza infection in autumn 1918 among women who were then in their first trimester of pregnancy.
Whether vaccination would prevent miscarriage is unknown, but there is strong biologic plausibility to suggest it could. Vaccination benefits often extend beyond the simple concept of one vaccine preventing or ameliorating one infection. There is also all the positive consequences of not having an infection, from potentially avoiding a miscarriage to not having a heart attack.
Moral Imperitive
I am an Infectious Disease blogger over at Medscape and every October I publish a deliberately obnoxious essay on the flu vaccine. The essay is addressed to fellow Health Care Workers (HCW), and does somewhat come from the heart.
Here is my opinion.
Patients in the hospital are particularly vulnerable. They are a population at risk from their care providers. About 1 in 5 cases of influenza are subclinical, hospitalized patients are more susceptible to acquiring influenza from HCW’s than the general population, and 27% of nosocomial acquired H1N1 die.
As HCW’s, it is our responsibility to our patients to maximize their safety when under our care. While not perfect, the influenza vaccine is a reasonable intervention to prevent the spread of flu from HCW to patient. Since HCW’s have ready access to the worlds literature and the best minds in medicine, if HCW’s use any of the standard excuses to avoid the flu vaccine and increase the risk of their patients they are, well, a Dumb Ass. We owe it to our patients to keep them safe.
There was a program a few years back to try an increase the hand hygiene rates in the hospital by enlisting the patients help. It is “OK to ask” if your HCW had washed their hands. I thought from the beginning the idea was bankrupt, and would anyone fly on an airline where it was “OK to ask” if the wheels are down when landing? I took an informal poll of patients on a medical unit and it was unanimous. Everyone understood what “It’s OK to ask” referred to, and not a one would ever ask their doctor or nurse if they washed their hands for fear of making them angry. And really, who wants to piss off the person responsible for their morphine?
Be that as it may, I would suggest that, during flu season, if you or someone you love is in the hospital, ask if their providers are vaccinated against the flu. Remember that being in the hospital probably means you are one of the groups unlikely to benefit from the flu vaccine and that your best protection is to not acquire influenza from others. If your HCW has not received the vaccine, ask for a new provider or, at a minimum, request they wear a mask while involved with your care. I know it will never happen, but there is a lot to be said for public pressure to alter behavior. I have been half thinking about starting a web site to promote the idea, but I haven’t the time.
Dumb Associations
While a blog aimed at medical providers, Medscape apparently has a fair number of Dunning-Kruger amateurs who have taken offense at my suggestion that the vaccine is a good thing for health care providers and their excuses for avoiding vaccination are not grounded in reality. Again, the blog was not directed towards patients, but HCW’s, and since the comments are anonymous, there is no way of really knowing who is commenting.
There are two broad themes as to why people refuse the vaccine. One is straight from Bizarro World: there is a cabal of government, pharma, and doctors whose sole purpose in giving the vaccine is to line the pockets of big pharma and keep people ill. This is a delusional state so at odds with the reality to which I am accustomed, and evidently so common, I am surprised there is no DSM entry for the disorder and there are no clinical descriptions of the phenomena. Most articles that address vaccine refusal have similar reasons.
Predictors of vaccine noncompliance were fear of needles (P ? 0.042), fear of getting sick from the vaccine (P ? 0.000), disbelief that the vaccine is effective (P ? 0.000), ignoring vaccination as a healthy behavior (P ? 0.000), and younger age (P ? 0.026).
and do not mention the paranoid medical-industrial conspiracy delusion that seems to be at the heart of a vocal subset of vaccine refusers. I make no money from giving the flu vaccine or from promoting the flu vaccine. Promoting the flu vaccine, like much of my professional life, is counter-productive to making money. I make money, and can prescribe with abandon to line the pockets of my corporate masters, only when people are admitted with the flu. At least, in the other Bizarro world where people have health insurance. Not always my world. The last thing I would want to do financially is prevent influenza.
Association is Not Causation
The other theme is that they, or someone they knew, had the vaccine and shortly thereafter had some adverse reaction attributed to the vaccine. Like the paranoid conspirators, the idea that the vaccine caused the subsequent disease is not amenable to logical refutation. It is a motto in the skeptical world that association is not causation, but it is a concept that is paid little attention.
Humans underestimate the role of randomness in their life and I recommend the Drunkards Walk as an excellent book on the topic. You have to know the background rate of events to know if there is an increased rate associated with a vaccine as a hint that the vaccine is potentially causative. For example
On the basis of the reviewed data, if a cohort of 10 million individuals was vaccinated in the UK, 21·5 cases of Guillain-Barré syndrome and 5·75 cases of sudden death would be expected to occur within 6 weeks of vaccination as coincident background cases. In female vaccinees in the USA, 86·3 cases of optic neuritis per 10 million population would be expected within 6 weeks of vaccination. 397 per 1 million vaccinated pregnant women would be predicted to have a spontaneous abortion within 1 day of vaccination.
Random badness happens and it takes an immense, and for some impossible, effort of will to ignore what appears to be an association. Take, as example, death. People die. People get the vaccine. A hefty segment of those who get the vaccine are at risk of dying from underlying diseases. So you would predict that there would be a cluster of people who will die shortly after receiving the vaccine, but not due to the vaccine, as if anyone would be convinced otherwise:
In October 2006, four deaths occurred in Israel shortly after influenza immunization, resulting in a temporary halt to the vaccination campaign. After an epidemiologic investigation, the Ministry of Health concluded that these deaths were not related to the vaccine itself and the campaign resumed; however, vaccine uptake was markedly reduced. Estimates of true background mortality in this high-risk population would aid in public education and quell unnecessary concerns regarding vaccine safety. We used data from a large HMO to estimate mortality in influenza vaccine recipients aged 55 and over during four consecutive winters (2003, 2004, 2005 and 2006). Date of immunization was ascertained from patient treatment files, vital status through Israeli National Insurance Institute data. We calculated crude death rates within 7, 14 and 30 days of influenza immunization, and used a Cox Proportional Hazards Model to estimate the risk of death within 14 days of vaccination, adjusting for age and comorbid conditions (age over 75, history of diabetes or cardiovascular disease, status as homebound patient) in 2006. The death rate among influenza vaccine recipients ranged from 0.01 to 0.02% within 7 days and 0.09-0.10% at 30 days. Influenza immunization was associated with a decreased risk of death within 14 days after adjustment for comorbidities (Hazard ratio, 0.33, 95% CI, 0.18-0.61). Our findings support the assumption that influenza vaccination is not associated with increased risk of death in the short term.”
Yet I know, and you know, that any event after a vaccine will be credited to the vaccine, even, as with death, the preponderance of data points to the influenza vaccine decreasing mortality.
It Was Better Back in the Day
As a grumpy old fart who thinks that medical training was better back in my day, I have one piece of data in support of that assertion. An abstract at IDSA, and reported in Medscape suggests
“that more recent graduates were 15% less likely than older graduates to believe that vaccines are effective. The younger graduates were also less likely to believe that inactivated or oral polio, measles, mumps, rubella, and varicella vaccines are safe.
Great. I suppose that my initial hypothesis was wrong. Having access to the worlds literature and the best minds in medicine is not so conducive to understanding the benefits of vaccines. Given the other nonsense taught in medical schools that is given the patina of respectability, what should I expect?
<!--<!--
Spinal Fusion: Chiropractic and Subluxation
A spirited exchange about chiropractic arose in response to a recent post proposing “The Cure” for the legalization of implausible and unproven diagnostic methods and treatments. Some comments pointed to the implausibility of the chiropractic “subluxation” and the lack of robust evidence of efficacy/effectiveness for spinal manipulation, as well as the difficulty of understanding what exactly “chiropractic” is, or does, that distinguishes it from other manual therapists. In response, other comments were posted positing that the Science-Based Medicine blog “is not informed on contemporary chiropractic practice,” that “the profession does not support [the chiropractic] subluxation as a cause of disease,” that chiropractors who treat the chiropractic subluxation are “on the fringe,” and that the chiropractic “subluxation” is no longer taught in chiropractic colleges as a clinically relevant concept, but merely as an artifact of chiropractic history.
However, a review of recent chiropractic literature does not appear to support the latter opinions. The same concerns as raised on SBM are shared by chiropractors themselves and are discussed in articles appearing in peer-reviewed chiropractic journals. Nor is the chiropractic literature as sanguine on the demise of the chiropractic “subluxation” as a clinically relevant condition which is both diagnosable and treatable.
Despite the concerns expressed by chiropractors themselves, the chiropractic literature continues to discuss the chiropractic “subulxation” as if it were a clinically relevant condition subject to diagnosis and amenable to treatment for both non-musculoskeletal and musculoskeletal conditions. This same view of the “subluxation” is taught in chiropractic colleges in North America and Australia.
Chiropractic 101: the subluxation
A June, 2011, article in the journal Chiropractic and Manual Therapies explored, as the title explains, The prevalence of the term subluxation in North American English-language Doctor of Chiropractic Programs. The authors, one from the School of Education at the Indiana Institute of Technology and the other a D.C. on the faculty of Bridgeport College of Chiropractic in Connecticut and the School of Chiropractic and Sports Science at Murdoch University in Australia, studied the academic catalogs of 16 North American chiropractic colleges for use of the term “subluxation.” The authors chose these catalogs as an indication of “what domains of knowledge are taught in the classroom and what domains are evaluated in assuring student competence.”
Their conclusion?
The concept of the subluxation in chiropractic is a controversial subject with a paucity of evidence. With the exception of three schools, all English-language DCPs [Doctor of Chiropractic Programs] in North America mention the concept of the subluxation either in course titles or descriptions and/or their respective missions. Despite the lack of evidence for the subluxation construct, it appears to be very much a key part of chiropractic education.
Some schools may state that they are not subluxation-focused or heavily engaged in the teaching of subluxation. Nonetheless, most schools continue to teach about the subluxation in what seems to be more than just a historical context. We believe that this puts the profession in an awkward position because the skeptic and/or critic of subluxation can point to chiropractic education as outdated and unscientific. Chiropractic education will have to address this issue if the chiropractic education enterprise wishes to become scientifically competitive with other healthcare sciences and produce graduates who are critical thinkers prepared as the evidence changes to change their practice and throughout their careers.
The authors specifically rejected the notion that the subluxation was taught simply as an historical concept:
One might argue that a historical presentation of the subluxation may be all we are finding references to in our research of the DCP curricula. This would be a reasonable argument if the subluxation was mentioned in only one course in a DCP program or if it was only in what was described as a philosophy course. This, in fact, only occurred at two colleges (Texas Chiropractic College and the University of Bridgeport College of Chiropractic), however, with an aggregate average of 13.5 appearances [in the catalogs] and many of those in technique classes it seems unlikely that this is purely to explain the history of [the] term in the chiropractic profession.
In support of their conclusions, the authors referenced other research finding:
- Over 88% of chiropractors surveyed favored retaining the term vertebral subluxation complex.
- Over 70% of chiropractors reported that subluxation is important to their clinical decisions and guides their clinical care of patients.
- A strong majority (over 75%) believed that subluxation was a significant contributing factor 50% or more of visceral disorders.
The article concluded with a prediction that just the sort of examination of current statutory scope of practice for chiropractors I’ve been advocating could occur: “Future research should determine if changes in regulation and research change the prevalence of the use of the term subluxation in chiropractic curricula.” [Emphasis added.]
A closer look at Canadian Memorial Chiropractic College
Despite the fact that the study found “no mention of the term subluxation” at Canadian Memorial Chiropractic College [CCMC] another article in the chiropractic literature, Attitudes of clinicians at the Canadian Memorial Chiropractic College towards the chiropractic management of non-musculoskeletal conditions, revealed that “although the concept of chiropractic treatment for non-MSK conditions is controversial, students at the Canadian Memorial Chiropractic College . . . are exposed to a variety of opinions on the subject.” In a survey of clinicians supervising interns at one of six clinics in the Toronto area, all of whom had been educated at CMCC, 50% either “agreed” or “strongly agreed” that chiropractic could be effective for the treatment of asthma, chronic pelvic pain, constipation, dysmennorhea, infantile colic and vertigo.”
This study was published in the Journal of the Canadian Chiropractic Association, which describes itself as “the official, peer reviewed, quarterly research publication of the Canadian Chiropractic Association.”
To understand the significance of 50% figure, one must realize that the referenced treatment of non-MSK conditions by chiropractors is subluxation-based: the detection of spinal “misalignments” and their “correction” through adjustments.” Without ever using the term “subluxation,” this is evident in the article’s explanations for treatment of various non-MSK conditions. [Note also the improper use of “case studies” as “evidence.”]
Asthma:
Chiropractic treatment [that is, adjustments] has been thought to be beneficial in the treatment of this condition as it posited that it may modify the autonomic system and elicit viscerosomatic reactions to it. Additionally, it has been hypothesized that misalignments at the levels of the upper C-spine create spinal reflexes that can induce asthma and correcting the misalignments could potentially alleviate the symptoms.
Constipation:
In a study conducted by Alcantara and Mayer on three pediatric patients, they found successful resolution of the condition after a regiment [sic] of spinal manipulative therapy by observing an increased frequency in bowel movements, with less straining and pain. Similarly, a case study done of a 64 year old Caucasian female demonstrated a positive resolution to chronic constipation after ten treatments of spinal manipulative
therapy.
Infantile colic:
Since an‘adjustment’ theoretically causes sympathetic stimulation which, based on physiology, in turn relaxes the smooth muscle of the gastrointestinal tract, reduces peristalsis, and inhibits bowel function, infantile colic could be effectively treated through manual therapy.
Vertigo:
A retrospective study conducted by Elster showed 100% positive response with either symptoms having improved or completely reversed within one to six months of care using a treatment plan of upper cervical adjustments.
In sum, while the CCMC does not openly mention the chiropractic subluxation in its academic catalog, its students are trained by chiropractors who accept the existence and clinical significance of the subluxation and the utility of detecting and correct it for a variety of conditions, as described in an article which wholly fails to question the concept.
National University of Health Sciences
Another institution which, according to the study of academic catalogs, did not mention the subluxation is the National University of Health Sciences (NUHS), which educates naturopaths and acupuncturists as well as chiropractors. However, had the authors examined a broader range of the school’s literature in divining support for the chiropractic subluxation and its putative effect on human health they would have found it in the form of the Journal of Chiropractic Medicine, published by NUHS and described on the school’s website thus:
Published quarterly, this peer-reviewed indexed journal meets the modern-day chiropractic physician’s need for practical and cutting-edge information with concrete clinical applications.
A review of the first 25 articles, published during 2010-2011 (a full fifteen of which were case reports) appearing in a
PubMed search for the Journal of Chiropractic Medicine, turned up the following:
According to Quackwatch, “applied kinesiology is a pseudoscience based on the anatomically and physiologically impossible notion that muscle-testing enables the practitioner to determine ‘weaknesses’ of organs throughout the body that ‘correspond’ to nutrients placed under the tongue.” Application of various applied kinesiology diagnostic methods and treatments is described in this Journal of Chiropractic Medicine article, including:
Insalvation refers to the fact that the taste buds on the tongue can detect extremely small concentrations of substances within a fraction of a second of stimulation. Oral nutrient evaluations are used in AK because they are clinically useful in the assessment process. Exposure to taste elicits a variety of neurologic, muscular, digestive, endocrine, cardiovascular, thermogenic, and renal responses . . . [T]here is considerable evidence in the literature of extensive efferent function throughout the body from stimulation of the gustatory and olfactory receptors with actual insalivation . . . Insalivation of choline (a component of the neurotransmitter acetylcholine) corrected this finding.” [It is unclear what “finding” was “corrected.”]
In a swipe at the patient’s pediatrician, the article adds:
The previous treatments did not deal directly with the craniosacral system, nor did they appear to evaluate adequately the sensory input into the nervous system from the musculoskeletal and viscerosomatic system (adrenal glands and lungs). Applied kinesiology theory suggests that to resolve biomechanical, biochemical, psychosocial, and sensory problems, many areas of the body must be examined and corrected to achieve long-lasting symptomatic relief.
Cessation of cyclic vomiting in a 7-year-old girl after upper cervical chiropractic care: a case report. The lead author is an Assistant Professor at Palmer College of Chiropractic. From the abstract:
A 7-year-old girl had a history of cyclic vomiting episodes for the past 4 ½ years. She also had a 2-month history of headaches and stomachache. . . The patient received low-force chiropractic spinal manipulation to her upper cervical
spine. [As described in the article, “The directional misalignment was determined as an anterior-right misalignment by using pediatric Duff analysis on her upper cervical radiographs.”] There was improvement in her symptoms within an hour after the chiropractic manipulation. . . This case study suggests that there may be a role for the use of chiropractic spinal manipulative therapy for treating cyclic vomiting syndrome.
Use of multimodal conservative management protocol for the treatment of a patient with cervical radiculopathy. The author is an Assistant Professor in the Department of Chiropractic at D’Youville College, Buffalo, NY. The article describes chiropractic treatment following “Gonstead chiropractic protocols” of a patient with a disk protrusion at C5-C6. Here’s a description of the Gonstead System from the Gonstead Clinical Studies Society, quoted in Keating JC, Charlton KH, Subluxation: Dogma or Science? Chiropractic & Osteopathy. Vol. 13, August 10, 2005:
Minor displacements of the spinal bones, known as vertebral subluxations, can cause endangering stress to the spinal cord which acts as the main line of intelligence for the whole body. These displacements, or subluxations, are the cause of many of the unwanted health conditions that people suffer from every day. Although there have been many valuable techniques that have been developed in the chiropractic profession, the Gonstead System is considered a ‘gold standard’ for chiropractic techniques because of its record of safety and effectiveness in correcting vertebral subluxation . . .
In addition to the articles describing “subluxation”-based treatment, of these 25 most recent articles in the Journal of Chiropractic Medicine, three discussed diagnostic techniques for the detection of chiropractic “subluxations.”
Standard deviation analysis of the mastoid fossa temperature differential reading: a potential model for objective chiropractic assessment. The author is an Assistant Director of Research at Sherman College of Chiropractic:
The mastoid fossa temperature differential (MFTD) reading is described as having been used in chiropractic since the 1950s. A temperature is obtained, without making contact, in the mastoid fossa area on both sides. An MFTD “is calculated by subtracting the mastoid fossa temperature on one side from the other side.” While “the clinical significance of the MFTD readings has yet to be determined,” nevertheless “one method for interpreting MFTD readings is with pattern analysis, where an abnormal set of baseline readings are identified and thought to be related to the condition known as vertebral subluxation.”
Computer modeling of selected projectional factors of the 84-in focal film distance anteroposterior full spine radiograph compared with the 40-in film distance sectional views. Two of the authors are chiropractors in private practice and also involved in research at the Gonstead Clinical Studies Society:
While acknowledging that the role of the full-spine anteroposterior full spine radiograph is “controversial,” the authors conclude that “working knowledge of the A-P full spine view is important . . . [as it] may be used for scoliosis
evaluation; and additionally, there are doctors of chiropractic who use the A-P full spine as part of their assessment when viewing of the full spine.” And what might they be “assessing” in the “full spine?” Although not specifically
admitted in the article, full-spine radiographs are used by chiropractors for the “detection” of “subluxations.” Peterson DH, Bergmann TF, Chiropractic Technique, Principles and Procedures, 2nd ed. (Mosby 2002), 75-79.
Geometry of colplanar stereoscopic radiographic pairs for analysis of the lateral cervical radiograph: a study using mathematical models. The author is a Research Assistant Professor at Sherman Chiropractic College. The article is of interest only to those who use X-rays to detect the presence of cervical “subluxations.”
In sum, a review of the most recent 25 articles in the NUHS- published Journal of Chiropractic Medicine reveals that NUHS has hardly rejected the chiropractic subluxation, even though its academic catalogue does not mention the term.
Life University College of Chiropractic
A recent article about chiropractic education shows how instruction in the detection and correction of subluxations is part and parcel of the core training of chiropractic students at Life University College of Chiropractic. The article, Self-Perceived Skills Confidence: An Investigative Study of Chiropractic Students in the Early Phases of a College’s Clinic Program, was written by an Associate Professor at this chiropractic school. Categories of student self-assessment surveyed for the article
. . . were those used in the early clinical curriculum. They included radiograph interpretation of the pelvis, occiput, atlas, and vertebral spine, using full-spine listings (Gonstead type) with the spinious process as a reference, and descriptive listings (fixation, malposition, misalignment, restriction) with the vertebral body as a reference, and motion palpation assessment of the corresponding anatomical areas.
Spinal manipulation categories were those used in the clinical curriculum. They included basic manual intersegmental full-spine (Gonstead-type) and diversified procedures . . .
This description is, quite literally, a textbook example of student training in the detection and correction of the chiropractic “subluxation.” Scaringe JG, Gaye, LJ, Palpation: The Art of manual Assessment (Chapter 10), Scaringe JG, Cooperstein R, “Chiropractic Manual Procedures (Chapter 12) in Redwood D, Cleveland CS, eds., Fundamentals
of Chiropractic (Mosby 2003). It was accepted for publication in a peer-reviewed chiropractic journal, the Journal
of Manipulative and Physiological Therapeutics (May/June 2010), and won a chiropractic research reward.
More “subluxation” in recent chiropractic literature
The chiropractic journal articles summarized above demonstrate that the chiropractic “subulxation” is still taught in North American chiropractic colleges as a clinically relevant condition capable of “detection” and “correction.” They also show that the putative “subluxation” is uncritically presented as such in current peer-reviewed chiropractic literature.
Even those chiropractic journals which appear to be more oriented toward an evidence-based assessment of manual therapies have recently published articles which uncritically accept subluxation-based chiropractic diagnostic techniques and therapies. In addition to the articles noted above, we find:
From the Journal of Manipulative and Physiological Therapeutics:
Interexaminer reliability of supine leg checks for discriminating leg-length inequality (2011): Discusses “functional leg-length inequality,” a bogus diagnostic method used to determine “subluxations.”
A retrospective study of chiropractic treatment of 276 Danish Infants with infantile colic (2010): Without ever describing the proposed mechanism of action by which “chiropractic manipulation” is purported to affect infantile colic, reaches the conclusion that “the findings of this study do not support the assumption that effect of chiropractic treatment of infantile colic is a reflection of the normal cessation of this disorder.”
Running posture and step length changes immediately after chiropractic treatment in a patient with xeroderma pigmentosum (2009): “A 5-year-old female patient with XP (type A) volunteered to participate in the experiment with the consent of her parents . . . [T]he patient was assessed for spinal dysfunction and adjusted (full spine) using diversified techniques . . . Adjustments were delivered in an attempt to correct any or all of the spinal dysfunctions that the clinician [a chiropractor] found at the time of the experiment.”
Journal of the Canadian Chiropractic Association:
Chiropractic care for patients with asthma: A systematic review of the literature (2010): States, without criticism of the lack of scientific plausibility underlying the concept, that “in treating asthmatic patients, the objective of chiropractic spinal manipulative therapy (high amplitude, low velocity thrusts) is . . . to affect nervous system activity.”
Chiropractic care of a pediatric patient with symptoms associated with gastroesophageal reflux disease, fuss-cry-irritability with sleep disorder syndrome and irritable infant syndrome of musculoskeletal origin (2008): “it was determined that the patient had spinal segmental dysfunctions of the atlas and the 4th thoracic vertebrae. The atlas was determined to have a right posterior rotation and right laterally malposition with respect to the C2 vertebral body (VB). The 4th thoracic VB had a posterior malposition with respect to C3VB. Following craniosacral technique procedures, cranial distortions of the right parietal and temporal bones were determined as well as aberrant motion of the mandible at the right temporomandibular joint (TMJ).” And so on.
More criticism of chiropractic, by chiropractors
Admirable for their criticism of the “subluxation,” other recent articles in the literature critical of chiropractic reveal the “subluxation’s” continued presence in the current practice of chiropractic in North America and in Australia. As well, they demonstrate that some of the same criticisms of chiropractic posted on SBM have been expressed by
chiropractors themselves.
An article published in Chiropractic and Manual Therapies this year, authored by 3 chiropractic academics, found that “patients searching the Internet for chiropractic wellness information will often find a lot of poorly done, useless
information that will not help them maintain health or become well.” Significant to our discussion here, of the
sample studied:
- 77% of sites contained information on chiropractic “subluxation”
- 60% had information on “innate”
- 34% contained obvious anti-vaccination information
- 34% had information that was anti-drug (prescription or medical use of drugs)
The authors concluded that “the depth of information on the sites analyzed was poor and was
rarely evidence-based.”
Another article, published in Chiropractic and Osteopathy (as the journal Chiropractic and Manual Therapies was formerly named) in 2010 surveyed a sample of non-practicing chiropractors and their reasons for leaving chiropractic practice. Due to the small sample size and low rate of response, the authors state that “generalizations to broader populations should be made with caution.” Yet, the results reveal a notable congruence between the negative opinions about chiropractic expressed on SBM and those who had actually left the practice of chiropractic:
- 80% agreed that business ethics in chiropractic were perceived as questionable.
- 62% disagreed with the statement that chiropractic education is an asset when pursuing another career.
- 60% agreed that dogma and philosophy of chiropractic were reasons to abandon active practice.
- 71% believed that associates in a chiropractic practice are often encouraged to prolong the care
of patients. - 74% believed that the chiropractic profession lacked cultural authority.
- 58% agreed that the political problems in chiropractic were factors in being perceived as a
quality clinician.
This frustration with chiropractic was shared in another recent article in the same journal authored by an Australian chiropractor and based on a lectured delivered at the Annual Conference of the Chiropractic & Osteopathic College of Australasia, in 2010. The author bemoans the fact that
- The Chiropractors Association of Australia (CCA) “actively promotes subluxation based chiropractic.”
- “Chiropractic trade publications and so-called educational seminar promotion material often abound with advertisements of how practitioners can effectively sell the VSC [vertebral subluxation complex] to an ignorant ublic.”
- The CCA and the Australian Spine Research Foundation (ASRF) “are promoting ‘wellness care,’ which involves the detection and adjustment of VSC’s,” noting a recent statement in the ASRF’s newsletter that “. . . it is not possible to be well if vertebral subluxation complex is present as a vertebral subluxation complex represents a non-homeostatic state . . . . which makes a state of wellness impossible.”
- Of the three chiropractic teaching institutions in Australia, the program at RMIT University
promotes what the author calls “the subluxation myth.”
Conclusion
Criticisms of chiropractic on Science-Based Medicine are not the reflection of misunderstanding of contemporary chiropractic practice in that, according to chiropractic literature:
Subluxation dogma continues to be a part the education and training of chiropractors in North American and Australia.
Subluxation-based chiropractic remains an integral part of chiropractic practice in North America and Australia, as demonstrated by the uncritical acceptance of articles discussing its implausible diagnostic methods and treatments in peer-reviewed chiropractic journals, its presence in surveys of chiropractic practice in peer-reviewed chiropractic literature, as well as the aforementioned inclusion in chiropractic education.
<!--<!--
Potential market for alternative medicine left untouched
A few days ago, I had the good fortune to share lunch and ideas with David Gorski and Kimball Atwood. Kimball was on his way from a talk at Michigan State to one at Brigham and Women’s, one of the country’s best-known teaching hospitals. David was planning a future talk for a group in Florida. These guys have been thinking and writing about alternative medicine for a lot longer than I, and it was great to pick their brains, toss around ideas, and just hang out on a nice fall day.
We were discussing many of the inanities of so-called alternative medicine touted for use in “real” diseases, that is, not just symptomatic care. There have been, for example, an number of studies out of China in the last few years claiming that acupuncture helps with in-vitro fertilization. All of these studies have been terribly flawed, and the reasons for these flaws are interesting, but irrelevant beside the primary flaw: the ideas are so implausible as to render any conclusions invalid. It is very difficult to understand how acupuncture in any of its forms could improve chances of conception, either in vivo or in vitro.
During our visit, Kimball brought up a rather interesting analogy: if acupuncture could increase fertility, shouldn’t it also be able to decrease it? We have scads of alternative treatments for the common cold, back pain, headache, multiple sclerosis, diabetes—everything, really. Why not contraception? After all, no one likes condoms, and the pill comes with its own baggage. Nuva rings and IUDs are convenient, but can be annoying to use, or can cause problems in certain patients. And almost all contraception relies solely on the woman. The only possible contribution a man can make is condom use or vasectomy.
Where is the alternative medicine community? They are usually pretty keen on getting involved in common medical problems. Undesired pregnancy is a common problem. Where are the studies on acupuncture for contraception? Homeopathy? Chiropractic?
How would these treatments look? Acupuncture could perhaps stimulate the qi involved with spermatogenesis, causing a feedback inhibition, right? Homeopathy, well, if a lot of sperm heading to the egg are the cause of pregnancy, then a little bit of sperm should do the trick I’d think. You could even put them in a lozenge. And with vertebral subluxations able to cause all manner of medical problems, shouldn’t a good chiropractor be able to shove around a vertebra, impeding sperm production or release? Contraception is big business. Where are these guys?
Let me very clear that I am a traditionalist when it comes to contraception, preferring those methods that have been proven safe and effective. I don’t give medical advice online, but I might make an exception here.
Speaking of implausible, after looking at some of Kimball’s slides, I wanted to do this just for giggles.
Common cuts of beef vs. Reflexology chart
<!--<!--
Return of an old foe
In 2000, a panel of experts was brought together by the Centers for Disease Control and Prevention (CDC). They came to discuss whether measles was still endemic in the United States, that is whether it still existed in the general background of US infectious diseases. They concluded that measles had been eradicated in the US, and that the occasional cases imported from abroad were stopped by a wall of vaccinated Americans.
Welcome to the future. The US is in the middle of its largest measles outbreak since 1996. Most of the cases originated abroad, brought back by unvaccinated travelers, either American residents or foreign visitors. This has so far led to 12 outbreaks (that is, a cluster of three or more connected cases) mostly among the unvaccinated. Of the 139 cases who were US residents rather than foreign visitors, twelve had documentation of adequate immunization.
The surprise isn’t that a few cases should slip through the wall of vaccination, but that the wall has so many chinks in it. The number of measles cases being imported, and the falling vaccination rates of Americans may reach the point soon where we no longer need to import our measles as it will once again become endemic.
Measles isn’t just a curious disease that we learned about in medical school (“cough, coryza, conjunctivits”); it’s a serious disease that leads to pneumonia in 1 in 20 children, and brain inflammation in 1 in 1000. Outside the US, it causes hundreds of thousands of deaths yearly.
We must increase our efforts to vaccinate all US residents properly (including undocumented residents). If measles does take hold once again in the U.S., the blame will fall squarely on our health care system’s failure to deliver vaccine, and on those who for whatever reason delay or avoid vaccination altogether.
It used to be that Americans viewed public health battles with excitement, a battle against fear itself, against the fear of children choking to death from whooping cough, or becoming paralyzed by polio. Now, as we sit behind our crumbling shield of vaccination, we have become complacent. If we fail to act, our complacency will be replaced by very real fears, especially for our children.
<!--<!--
Steven Fowkes (Part 2 of 2): Nutrients for Better Mental Performance
Last week, in part 1, I covered Steven Fowkes’ “cures” for Alzheimer’s and herpes. In part 2, I will cover a video where he goes further afield. It is titled “Nutrients for Better Mental Performance,” but he also discusses sleep, depression, hangovers, and a lot of other topics.
Some of what he says are simple truisms: mental performance is affected by everything related to health such as sleep, food, vitamins, minerals, detoxification, nutrients, amino acids, hormone replacement, pharmaceuticals and herbs. Metabolism is the key to brain function: 3% of the body uses 20% of the energy. Macronutrients, micronutrients, exercise, water, and breathing are important too.
We knew that.
Which nutrients promote optimal brain function? All of them: any deficiency will affect the brain. Fowkes goes beyond the evidence to claim that some nutrients are needed at super-physiological levels; Mother Nature is not optimal. Some supplements appear to work but the effects are not sustainable. It’s not about parts, but about how things work together.
Energy production is essential. Anaerobic metabolism only produces 2 ATP molecules from a glucose molecule compared to up to 38 ATP from aerobic metabolism. He says this is inadequate. He says it’s enough to support unicellular life but not multicellular life (this is not true: there are multicellular organisms that are obligate anaerobes). He says it’s not enough to give you robust life, consciousness and a working brain. So aerobic metabolism is essential to preventing and treating Alzheimer’s.
He shows how a complex cascade of effects from an imbalance between mercury and glutathione affects a series of other processes and leads to Alzheimer’s, and he recapitulates some of the material from his Alzheimer’s video, but this presentation is not about Alzheimer’s: it’s about mental performance in everyone. What nutrients are commonly deficient enough to impair mental performance? The elderly are deficient in melatonin, B12, and pregnenolone. Teenage boys are deficient in zinc. Everyone is deficient in Vitamin D and magnesium. 30% of teenagers have a 10-point IQ increase just from RDA level supplements.
He says some hormones are neuroprotective, but estrogens have an anti-metabolic effect and impair energy production, which explains why women have more stamina than men. This is also why when men get inflammation they produce estrogen and start gaining weight and have more health problems. These statements are taken out of context from research that has little or no clinical significance. In contradiction to numerous published studies, he says estrogen has a profound adverse effect on the brain.
How to Get a Better Night’s Sleep
He has lots of advice for better sleep, from truisms to highly questionable recommendations:
- Pay attention.
- Use consistent background sound.
- Sleep with regularity.
- Sleep in the dark (melatonin).
- Wake up with red light to mimic sunrise and sunset.
- Try tryptophan for serotonin.
- Eliminate inflammation (from allergy, infection, gut).
- Balance A and D.
- Digestive enzymes.
- Zinc with every meal to tighten up your gut and prevent undigested food particles from passing in and producing inflammation.
- If a drug is needed, use Xyrem, which is a nutrient and enhances stages 3 and 4, which are decreased or absent in old age. This means you are not really asleep at night. Note: Xyrem is a brand name version of the date rape drug GHB and it has only been approved for the treatment of cataplexy associated with narcolepsy. It can have serious side effects. Ironically, one listed side effect is difficulty falling asleep or staying asleep. It is absurd and dangerous to recommend it as a sleeping pill.
- Do-it-yourself sleep studies with camcorder — wakenings, breathing, etc. Note: No home studies can replace sleep lab studies, which should be done on anyone suspected of sleep apnea because it can lead to life-threatening complications.
Depression
Alternatives to SSRIs (which he calls SRI’s): B vitamins, correcting mineral deficiencies, discovering unrecognized toxicities like lead toxicity. Most laboratories measure statistical norms, others look at functional needs. Rather than measuring the amount of a mineral, he recommends measuring the function of enzymes that use the mineral. Treat hypothyroidism. He’s had hundreds of clients come to him with thyroid test results and only one was done right. Patient with low normal tests take thyroid and their energy goes up, their depression resolves, they start sleeping better, and they lose weight. Load with neurotransmitter precursors: 5-htp, DLPA. Shift estrogen dominance with iodine therapy to increase estriol which improves infections, etc. Measure estrogen levels in men. Add 5htp or tryptophan to SSRIs to prevent habituation. Note: This is all non-standard advice not supported by evidence. Depression is a potentially life-threatening condition (suicide), and unproven “alternatives” to effective treatment could be dangerous.
Milk is Bad
Raw milk has good fat structure that is destroyed by homogenization; homogenized milk causes irritation of the vascular system. Raw milk is “way better,” but in terms of allergy it may not be better at all. (He doesn’t mention that in terms of infection risk, it is much worse!) Casein, whey, galactose are the problems with milk. Low fat doesn’t help because milk solids are added and they cause cataracts. Milk causes osteoporosis and it causes an inflammatory response in 95% of blacks and 50% of whites. Milk is not a good source of calcium; grain is better. (But he tells us to avoid grain too!)
He recommends a test for milk allergy that is positively bizarre: go off all dairy (including eggs!?) for 2 weeks and then re-challenge with one drop of milk under the tongue. If a metronome synchronized to your body slows down, or if you freak out, or if your pulse rate goes up dramatically, you’re allergic to milk.
Or gullible. The test doesn’t discriminate.
Bread is Bad
Gluten is extremely difficult to digest and undigested gluten protein has an inflammatory effect that causes all kinds of degenerative problems and stress to your gut, and leads to heart disease and probably cancer as well. Corn and red meat are also difficult to digest. And yeast, because we don’t have good enzymes to digest the cell wall.
Avoid grain. Eat a Paleolithic diet (what we are best adapted to): unlimited greens, fruit, nuts, meat when you can kill it. If you have to eat gluten or dairy at Aunt Mildred’s house at Thanksgiving, take digestive enzymes with you to ease the burden.
Questionable Statements
- Vaccines cause autism (false!)
- There is a conspiracy to cover up information about natural treatments.
- Doctors are ignorant.
- Monitoring urinary pH is a reliable way to monitor acid/base balance and health (Not!)
- “Subclinical hypothyroidism” is a common problem. (Here he doesn’t even get the terminology right. He attributes a variety of symptoms to a low level of hormone that doesn’t register on blood tests, whereas subclinical means abnormally low on blood tests without any symptoms.)
- Estrogen/testosterone ratio is a risk.
- Ketosis treats end-stage organ failure. (No, but ketosis is a result of end-stage kidney failure).
- If you’re insulin resistant, depending on glucose for energy, your energy is sabotaged: your brain is living on 90 or 70 volts instead of 100 volts. Ketosis puts you back up to 100 volts.
- Alcohol causes addiction through glucose addiction, serotonin addiction, and NADH addiction.
- Hangovers can be reliably prevented or cured with vitamin C and cysteine.
- Nutrasweet (aspartame) is an excitotoxin, an irritant to the brain, and can aggravate calcium toxicity in the brain.
- He blames epigenetic effects of generations of poor nutrition as the reason that “There’s a lot of falling apart going on around us: autism is way up, brain cancer is way up.” (They aren’t way up; and besides, he already blamed autism on vaccines.)
- Wheat has estrogens that make male animals infertile, for the buffalo. (!? I’m guessing he meant that plants produce toxins to try to defend themselves against herbivores. I’m pretty sure the male buffalos didn’t go infertile from eating estrogens in wheat. And I think he meant bison.)
- Mustards have mutagens (Did he confuse Grey Poupon with nitrogen mustard?)
- Alfalfa sprouts have an ingredient that produces autoimmune disease in humans and chimpanzees. (In fact, alfalfa sprouts have been used to treat autoimmune disease.)
- Plant toxins are not different from manmade ones, but we are adapted to eating phytotoxins. (If they’re not different, shouldn’t we be equally adapted to both?)
- If you have residual effects from anesthesia, tell your doctor you need T3 monotherapy.
Some of these are clearly false, some need qualifying, some are speculations mixed with a grain of truth that I didn’t have the time or inclination to untangle.
“Myths to Live By”
He calls his dietary advice “myths to live by” and prefaces it by saying:
I’m not going to say this is all quite scientific, because on some level it’s based on prejudice, philosophy…
- Low carb vegetables.
- Eat meat (insects OK) to supply B12 (tiny to moderate amounts, maybe just the bugs in your grain as in India).
- Cultivate ketosis (go in and out of ketosis weekly or monthly to exercise your metabolism).
- Consume tropical oils.
- Eat less carbs and calories than your peers.
- Assume industry ads are lies.
- Assume the food pyramid is upside down.
- Assume your doctor is profoundly ignorant (doctors will never say “I don’t know” – they’ll just make it up).
- Assume all experts are biased.
He recommends Gary Taubes’ book Good Calories, Bad Calories. He favors low-carb and Paleolithic diets.
Tests?
He recommends nonstandard and unreliable lab tests and do-it-yourself home trials.
- Ask your doctor for RBC trace mineral profile (30-40 nutrients), normative blood vitamin levels, Spectrocell functional medicine test for nutrients, urine chelation challenge for heavy metals.
- Try a nutrient and see if you notice a difference. (We all know how reliable “try-it-for-yourself” is!)
- Cultivate computer games (Tetris, etc.) to measure small differences that you might not notice otherwise.
- 1 week should be enough to see an effect of supplementing things like B12. (Not!)
He tells an anecdote about a patient who was supposedly almost killed by doctor who gave him potassium based on low blood levels even after the patient and his wife told him the patient was a potassium over-accumulator. The excess potassium needed to normalize his blood potassium test drove him into heart failure and even when he was on digoxin, the doctor wouldn’t admit that he was wrong. The patient had to leave AMA to save his life. Really? “Potassium over-accumulator” is not in my medical dictionary, and Googling for the phrase got only one hit: Fowkes’ video itself.
Bottom Line
I’ll be polite and simply say I do not consider Steven Fowkes to be a reliable source of health information. Some of his facts are wrong, his speculations have not been tested with clinical studies, and some of his advice is frankly dangerous.
<!--<!--
