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NCAHF News, November/December 1996

Volume 19, Issue #6

COLLOIDAL SILVER PRODUCTS WIDELY CONDEMNED

Colloidal silver is being huckstered as a superior germ fighter by a number of promoters, including the wacky naturopath-veterinarian Joel Wallach.  NCAHF reported that a permanent skin discoloration known as argyria can result from ingesting too much silver. 

Now, even the National Nutritional Foods Association (NNFA) is warning health food dealers and consumers that colloidal silver products have not been proved either safe or effective (NNFA Today, Oct, 1996).  Of this, NCAHF president William Jarvis says, "Pinch me, I must be dreaming!"  Since when does the NNFA worry about unproved safety or efficacy? 

NNFA was a driving force behind the passage of the Hatch Bill forbidding the FDA from regulating dietary supplements on the basis of safety or efficacy.  Most NNFA members live off of the selling of health products that are unproved.  "Let's hope that this new-found concern over public health and safety extends itself to other health food products," Jarvis says.

In addition to the NNFA criticism, a consumer named Rosemary Jacobs of Derby Line, Vermont, has filed a citizen's petition with the FDA asking that all orally-administered products containing colloidal silver be required to carry a warning label. Jacobs asked the FDA to consider banning all ingestible products containing silver unless the manufacturers can prove that they are effective. (Food Chemical News, 10/14/96)

YAM PRODUCTS

Taking hormone supplements is a current fad.  People are ingesting melatonin, DHEA, human growth hormone, testosterone, etc, with a startling lack of fear.  Among the popular items on the growing list are Mexican yam supplements that are alleged to become the building blocks for DHEA or progesterone. 

By way of background, in the not-too-distant past the main source of steroid hormones was animal glands.  This was not efficient because the amounts were very small--it took 625 kg of ovaries from 50,000 sows to produce 20 mg of pure crystalline progesterone.   In 1943, it was found that Mexican yams (Dioscorea species) were rich in steroidal sapogenins that could be converted to progesterone. This hormone and the process used to prepare it were the foundation stones of the Syntex Company (Pharmacognosy, 1988, p.175).

Mexican yam became the principle raw material from which birth control pills (ie, "the pill") are made.  Now the health food industry is peddling Mexican yam supplements as a "natural" way for women to avoid post menopausal estrogen therapy, and for others to provide their bodies with the building blocks of DHEA.   People do not stop to think that any substance that actually has a hormonal effect upon the body is potentially dangerous and must be carefully monitored.

The difference is that the legitimate drug companies are fulfilling their duty to warn users of their products of potential adverse effects while the health food promoters are not.  Worse, they make "natural" seem to be synonymous with "safe" when it is not.

Now comes a report from Aeron LifeCycles Laboratory which says that Mexican yam-containing products do not contain, nor act as precursors to, progesterone, progestin, or DHEA. (Townsend Letter, 10/96, p.104)  This is good news on the safety front, but still leaves users as victims of another dietary supplement hoax.

NEBRASKA OUTLAWS EPHEDRA DIETARY SUPPLEMENTS

In July, the Nebraska State Legislature enacted a law that categorizes products containing ephedra as prescription only. Exempted are FDA-approved over-the-counter products.  The Nebraska law is a reaction to the irresponsible 1994 Dietary Supplements Health & Education Act (DSHEA) which stripped consumers of protection from hazardous dietary supplements. It only deals with one dangerous substance being hawked by the health food industry, but it shows how states can undo the folly of bad laws passed by Congress.  Obviously, what is needed is a total repeal of the DSHEA, but with the industry willing to throw big money at our lawmakers, the chance of getting the right thing done is slim.  The industry is reported to have given $2.5 million to lawmakers "to get its message across."

GNC REMOVES EPHEDRINE PRODUCTS

General Nutrition Centers has removed products containing ephedrine from its 2,700 stores due to the bad publicity the substance has been receiving in the press, which had led to a 20% drop in the value of GNC stock.  Ephedra products make up about 6% of GNC's business.  GNC is asking its manufacturers to reformulate products.   Although a company spokesman declared that GNC was "erring on the side of safety by removing ephedrine,"  NCAHF suspects that the fact that several states have banned ephedrine products following many deaths that have been linked to the substance is a major factor in GNC's decision.  As a national chain it is important to have standard products that can be marketed in all states. (FDA Hotline, October, 1996)

Comment: In some products ephedrine is being replaced with phenylalanine.  According to Graedon's Best Medicine, (Bantam, 1991) "There may be a risk of hypertension with l-phenylalanine, so this amino acid should not be taken unless under a physician's supervision."  Graedon says that l-phenylalanine also carries a possible risk of malignant melanoma, which is no small matter to sun-loving health enthusiasts who make up an important segment of consumers of such products.  Many products continue to contain caffeine in substantially higher doses than a cup of coffee.

CHIROPRACTIC CENTER AT NIH

On September 30, President Clinton signed into law the 1997 Omnibus Consolidated Appropriations Act which includes nearly $1 million for the continuation of the "chiropractic demonstration grants program."  Under the 4-year-old program, chiropractic colleges conduct collaborative demonstration projects with DCs and MDs working together to diagnose and treat spinal and lower back conditions. The bill also establishes a Chiropractic Center within the NIH Office of Alternative Medicine. The primary political support for these developments came from Senators Arlen Spector (R-PA) and Tom Harkin (D-IA). Both states have chiropractic colleges. (Dynamic Chiropractic, 11/18/96)

Comment: Up to now chiropractic had been largely left out of the discussion on "alternative" and "complementary" medicine at NIH. Having a designated center now catapults it ahead of some of the other guilds.  This is an important, and possibly constructive development.  The American Medical Associations 1997 edition of Physician's Current Procedural Terminology now includes an identification code for "chiropractic manipulative treatment" to "influence joint and neurophysiological function." Although some may view this development as another example of the degradation of evidence-based medicine, there is some reason for optimism.   The more association chiropractic has with standard health care, the more limited it becomes in its scope of practice. 

Chiropractic's future lies in treating low back pain, less neck rotation (because of the unjustifiable risk/benefit ratio), and an abandonment of the subluxation concept.   In isolation, chiropractic got crazier.  In association with standard medicine, it will become more sound.

PATIENTS CAN HELP DETECT HEALTH INSURANCE FRAUD

Fraudulent pharmacy practices, such as short counting prescriptions, can steal millions from Medicaid, Medicare, and private insurance companies.  Patients should count the number of pills in a bottle carefully to be sure they are getting the prescribed amount.  If a pharmacy does not provide the full prescription and asks you to return for the remainder, be sure to do it and check the count. Always ask your doctor for the total number of pills being prescribed and match it with the number from the pharmacy.   If the prescription is marked for refills, be sure to get them when the time is due. Ointments and creams should be checked for size.  For example, the patient may receive a 15 g tube while the company is billed for a larger size.  Medicaid and Medicare are said to be the most vulnerable to such fraudulent practices.  This is the type of fraud that is least likely to attract attention of the anti-fraud agencies.   It is small time stuff to them but costs the nation many millions.  Only alert consumers can police such practices.

RAND FINDS LITTLE JUSTIFICATION FOR NECK MANIPULATION

The Rand Corporation conducted a review of the appropriateness of manipulation and mobilization of the cervical spine employing the same technique it had used to evaluate spinal manipulative therapy for back pain.  A panel of nine judges (4 DCs, 4 MDs, and 1 MD/DC) rated cervical manipulation for appropriateness for specified clinical conditions. Each scenario was rated twice--once individually, and then again after a group discussion. A scale of 1 to 9 was used to judge appropriateness based upon the evaluator's opinion of its benefit-risk ratio.

Only 11.1% of 736 indications for cervical manipulation were judged appropriate. The most important finding was the paucity of evidence for the benefit of these procedures. The risks of cervical spine manipulation are well documented. Estimates of risk run from as low as 1 in 40,000 manipulations for mild complications, to 1 in one million for serious complications.

[Coulter, et al. The Appropriateness of Manipulation and Mobilization of the Cervical Spine. Santa Monica, CA, Rand Corp, 1996]

Comment: Although the report discussed the differences between mobilization and manipulation (the latter is more forceful with extension and rotation), there was insufficient attention paid to differences in the risks of these procedures. 

NCAHF contends that, since neck stiffness and/or soreness are self-limited, and that there is no important medical benefit to neck manipulation, any risk of stroke or paralysis--no matter how small--is unacceptable.  Even if the risk is 1 in one million, the thought of 50,000 chiros nationwide doing 20 to 40 manipulations each working day presents the nightmare of 1-2 patients a day experiencing completely avoidable strokes or paralysis.  Given the history of chiropractic silence on its shortcomings, and an ideology that teaches that everyone will benefit from having his or her neck "cracked," NCAHF can only repeat its strong warning against neck manipulation.

KENNEY PICKS A BONE WITH THE ZONE

The TV tabloid shows are gushing about the latest food fad in Hollywood: going for "the zone" as promoted in the book by the same title written by Barry Sears, PhD (biochemistry, Indiana University).

"The zone," Dr. Sears claims, is a "nearly euphoric metabolic state" in which athletes perform their best, those with weight problems lose their bulk, and all will reduce their risks of serious diseases.  Sears recommends a 40% carbohydrate, 30% fat, 30% protein diet to live in the zone.  Sears contends that the high complex carbohydrate, low fat diets recommended by Pritikin and Ornish, are dangerous.

This has prompted NCAHF vice president, James Kenney, PhD (Rutgers), a nutritionist at the Pritikin Longevity Center, to respond in detail.  Lest readers accuse Kenney of financial conflict of interest, please bear in mind that Sears not only is selling his book but also has a line of BioZone snack bars that will cost users about $40 per week if they follow the "Spartacus Quick Start Plan."  Kenney's critique fills the entire 8 pages of the Sept-Oct Nutrition & Health Forum (formerly Nutrition Forum).

Bonnie Liebman didn't like The Zone either. Her 3-page critique appeared in the July-August, 1996 issue of Nutrition Action. Both give credit and criticism alike on similar points, but for dietitians and nutritionists who want the details, Kenney's critique has 56 references.

CHROMIUM PICOLINATE PROMOTERS SETTLE
FTC FALSE ADVERTISING CHARGES

The Federal Trade Commission announced settlements with three California companies charged with making unsupported claims about weight loss and health benefits for chromium picolinate.  The companies, Nutrition 21, Body Gold, and Universal Merchants, were unable to provide solid scientific evidence to back their claims. [FTC News Notes, 11/4/96]

CAN STANDARD MEDICINE EMPLOY "ALTERNATIVE" &  "COMPLEMENTARY" MEDICINE WITHOUT LIABILITY?

Trial lawyers should be licking their chops as naive hospital administrators rush to market alternative medicine because it is a fad.  The reason is that when things go badly standard medicine cannot be protected from legal liability in the same way nonstandard practitioners have in the past.  An investigation of why the attorneys who have managed to make a good living off of medical malpractice cases haven't been able to make a dent in the problem of quackery uncovered some important reasons why patients this is so.

Deep Pockets

Lawyers pursue "deep pockets," and off-beat practitioners avoid looking like good target.  Many do not carry insurance, a fact that they inform patients about by posting signs in their offices (patients are not always warned but find out after the fact). In a sad case in which a woman was paralyzed from the neck down by a chiropractor, she found that he had no insurance whatever because he had crippled 2 others and could not buy insurance.  Most of his assets were in his wife's name, and his worth was only about $50,000. No attorney was willing to do all of the necessary work for such a paltry collectible award.

Differing standards of conduct

Acupuncturists, chiropractors, naturopaths, etc, do not practice medicine; therefore, they cannot be held to medical standards. Case:

An Oregon woman fell on her tail bone. She went to a chiropractor instead of a physician. He x-rayed her back, but didn't see the fracture.  After some time, she developed chronic, severe back pain.  A physician found that the failure to immobilize her fractured vertebra had caused bone spurs to develop.  She sued but lost because, in the eyes of the law she had gotten what she had paid for--she had chosen the chiropractor "at her own risk."

Other chiropractors had testified that he had followed standard practice for chiropractors.  This defense won't work when it can be shown that patients believed that they were chosing medicine, and that the provider knew--or ought to have known--that the safety of the "alternative" or "complementary" procedure was unproven which is inherent in the definitions of such procedures.  Primum non nocere ("above all, do no harm") is the oldest consumer protection principle in history.

Culpability For Referrals

Even if patients are referred out, medical doctors or clinics referring patients to nonstandard practitioners carry a degree of responsibility if things go badly.   Administrators should be alert to the fact that nonstandard practitioners generally employ a kind of "heads I win, tails they lose" psychology.  When things go well they take the credit, but when things go badly they blame standard medicine.   Alternative practitioners have traditionally substituted patient satisfaction for true clinical effectiveness.  Their ability to convert patients to their way of thinking generally puts the patient on the side of the alternative practitioner when disputes arise.  Barnum wisely advised, "Never try to beat a man at his own game."

A MOTHERING GROUND OF QUACKERY

William T. Jarvis, Ph.D.

During 25 years of studying quackery, I have been struck by the high proportion of major types of quackery that originated in a relatively small region of western Europe.  Herbalisma, magnetic healingb, phrenologyc, homeopathyd, aromatherapye, naturopathyf, orgonomyg, fresh cell therapyh, electroacupuncturei, anthroposophyj, and Gerson cancer therapyk, to name a few.

I believe that the European tradition of alchemy which was embodied in the German alchemist, Paracelsus (1493-1541), seeker of medical remedies, is significant.   Paracelsus, who was extreme in both mysticism and intelligent observation, is an icon who has inspired a devoted following of medical cranks and influential lay persons--among them Prince Charles [1].

Although already familiar with Paracelsus from my study of medical history, I had the opportunity to read Paracelsus's writings first hand while a witness in a case involving the starvation death of a 17-month-old Canadian child.  The Germany-reared herbalist responsible for the tragedy was so devoted to Paracelsus that he had translated his books into English and used them as his source of authority.   Medical historians give Paracelsus some credit for his views, but most of what he taught is very weird by any standard.  Skrabanek said that "Paracelsianism is fundamental to the credibility of holistic medicine, and that it is no coincidence that Paracelsus was resurrected by Nazi leaders in their promulgation of naturopathy." [1]

Naturopathy began in the 19th century German water cure spas, and Germans today are said to be "by far the world's leading spa-goers" with more than 6 million going on a "cure" each year [2].  In Germany, 7 out of 10 general practitioners practice alternative medicine [3].  A dozen off-beat clinics in the region promote unproven cancer cures--most are in Germany. Use of unproven cancer remedies in the region are the highest ever reported: Germany (65.7%), Austria (59%), and Switzerland (52% & 70%). [4] Many of these bogus cancer remedies are available at Mexico border clinics.

A large homeopathic medicine industry thrives in Europe--90,000 of the 126,000 medicines on the market in Germany are "homeopathic and natural medicines." [5] The European Common (EC) Market situation forced pharmacists there to face up to the reality that homeopathy is a delusion.  Even after a debate that acknowledged homeopathy's absurdities, pharmacists voted to continue selling irrational homeopathic remedies.

Despite its name, the EC's European Medicines Evaluation Agency does not evaluate medicines but merely coordinates the evaluations of drugs made by EC member states [6].  Alderidge provides a description of nonstandard medicine in specific European countries [7]. It's not a pretty picture for those who believe in evidence-based medicine.  The next time someone tells you about medicines that are available in Europe that our hard-nosed FDA won't allow into this country--remember its legacy of quackery.

Citations. (1) Brit Med J. 1993;306:1006. (2) Kallenbach. Chicago Tribune, 6/21/1992, sec.5, #7. (3) The Lancet, 1992;340:107. (4) Euro J Cancer, 1991;27:1549-51. (5) New Scientist, 2/6/93, p.7. (6) HealthWatch, 6/94. (7) "Unconventional Medicine in Europe," Advances, 1994;10(2):52-60.

Footnotes: (a) Paracelsus derived the "Doctrine of Signatures" from the primitive idea of correspondences (ie, like is, makes, & cures like). Thus, an herb that resembles an organ or malady is useful in its cure. (b) While experimenting with the magnet, Austrian physician Franz Anton Mesmer (1734-1815) got the idea that the human hand possessed a similar power which he called animal magnetism (Latin anima, "spirit" or "soul"). One hundred years later a magnetic healer named Daniel Palmer invented chiropractic. (c) While living in Austria in 1790, German physician Franz Josef Gall (1757-1828), theorized that the shape of one's skull was a map that revealed personality. He and his pupil, Johann Sebastian Spurzheim (1776-1832) formulated phrenology in four treatises (1810-19). It has disappeared, but its kin, physiogamy (character is revealed in the shape of the face) is still alive. (d) In 1810, German physician Samuel Hahnemann (1755-1843), who earned a living translating classical works into German because he had become disillusioned by his inability to cure his patients, discovered the same primitive idea of correspondences that inspired Paracelsus. (e) Aromatherapy has its roots in the ancient miasmic theory--foul odors cause disease (eg, mal-airia = "bad air" fever) which also gave rise to the French perfume industry--Lemery's Pharmacopee universelle (1697) was used for years as an authoritative source of remedies. (f) Traced to Bavarian Father Sebastian Kneipp's cold water treatment. In 1902, German "Dr." Benedict Lust (1872-1945) purchased the term "naturopath," formed the Naturopathic Society of America. (g) Wilhelm Reich (1897-1957), raised in the hinterlands of Austria, became involved in Freud's burgeoning psychoanalytic movement and rose to prominence in the 1920s. His quest for the biological roots of the libido theory led him to formulate his orgone theory. Reich built The Orgone Energy Accumulator to treat diseases by absorbing "blue bions" or "Cosmic Orgone Energy." The American College of Orgonomy uses and promotes Reich's methods. (h) Originated by Dr. Paul Niehans of Clarens, Switzerland about 1936; consists of injecting fresh embryonic animal cells of the organ or tissue needing rejuvenation. Niehans used a special flock of sheep as donor animals because he believed they did not get cancer. (i) In 1976, German physician Reinhold Voll, introduced a system into American fringe medicine which employs a galvanic device which measures electrical resistance on the skin at alleged acupuncture points. There are many imitators. Many devices are imported from Germany. (j) Rudolph Steiner (1861-1925) Leader of the German section of Theosophy who split off to form a group that would follow his personal revelations of the spirit world. Advocates homeopathy, organic farming, astrology. Devotees promote mistletoe as a cancer remedy (Iscador) on Steiner's say-so in the 1920s. (k) German physician who began treating cancer patients in 1928, fled Nazism to USA; treated celebrities in New York in 1930s. (l) For a gushing tribute to the genius of Paracelsus see Webster, C. "Paracelsus, and 500 years of encouraging scientific inquiry; stood for sensitivity to the environment, social, spiritual, and moral dimensions of health," Brit Med J 1993;306:597-8; and, Skrabanek's letter to the editor responding to Webster's accolades (Brit Med J 1993;306:1006.)

NEW BOOK ON MAGNETISM PROVIDES
TOOLS FOR DEBUNKING VITALISM

Belief in vitalism, "the doctrine that the functions of a living organism are due to a vital principle distinct from physicochemical forces" (Webster's Dictionary); or, "the theory that biological activities are directed by a supernatural force; opposed to mechanism" (Dorland's Illustrated Medical Dictionary) provides the conceptual underpinnings that sustains the perpetual plague of quackery.

Vitalistic Healing Systems

NAME ALLEGED "LIFE FORCE"
Ancient Egypt Ankh
Ancient Greece Pneuma
Anthroposophical Medicine Formative force, ether body, astral body
Ayurvedic Medicine (Hindu) Prana
Chiropractic Innate
Energy Medicine Energy body, aura, Kirlian effect, etc.
Homeopathy Vital energy
Magnetic Healing (Mesmerism) Animal magnetism
Naturopathy Vis Medicatrix Naturae
Primitive Medicine Mana, orenda, tane, gana, sila, oki, etc.
Radiesthesia/Medical Dowsing Radiation
Reichian psychotherapy Orgone energy
Therapeutic Touch Prana
Traditional Chinese Medicine/Taoism Chi, Qi, Ki (Qi Gong "Master" healers)
Wicca (ancient fertility religion) Unspecified (use "pranic healing" ritual)

The "physico" half of the "physicochemical forces" despised by vitalists embraces the physics of magnetism, an understanding of which is key to debunking vitalistic psychobabble.

Dr. James Livingston makes the physics of magnetism clear in his marvelous book, Driving Force (Harvard, 1996). Livingston writes in a delightfully readable style. Readers will not only learn marvelous facts about lodestones, how the earth generates its own electromagnetic field, and the role of magnetism in nearly every modern technology, but they will also see how pseudosciences have exploited the mystery of magnetism for their purposes. Livingston provides useful information on how magnets are used to deceive people for entertainment by magicians, and how these same tricks have been used by phoney psychics, such as Uri Geller, to deceive the public. 

Kusche wisely stated that the less a person knows about a subject, the easier it is to make it into a mystery, in his debunking of the Bermuda Triangle myth (The Bermuda Triangle Mystery--Solved, Warner, 1975).  Livingston explains the lack of science and the appropriate skepticism that should be applied to magnet products that claim to treat pain and disease.

Nikken, Oriental Medical Supplies, and other companies are discussed with the caveat that none of these products have proven value for anything medical. This is contrasted with understandable explanations about how the medical marvels like Magnetic Resonance Imagery, positron emission tomography, and computerized taxial tomography work.

Carl Sagan has said that the appeal of pseudosciences is that they seem to provide insight into the construct of the universe and how things work.  Sagan contends that the realities science uncovers are more wondrous than the fantasies of the mystics. Livingston has filled in the information we need to appreciate what Sagan was talking about. I have put Driving Force on my basic reading list for anyone who seeks the knowledge needed to attack pseudoscience and quackery at their foundations. The book can be ordered from any bookstore or call 800-448-2242; price: $24.95.

CHROMIUM PROMOTERS SETTLE FTC
FALSE ADVERTISING CHARGES

The Federal Trade Commission announced settlements with three California companies charged with making unsupported claims about weight loss and health benefits for chromium picolinate. The companies, Nutrition 21, Body Gold, and Universal Merchants, were unable to provide solid scientific evidence to back their claims. [FTC News Notes, 11/4/96]


Newsletter contents copyright 1996, National Council Against Health Fraud, Inc.
Items may be be reprinted without permission if suitable credit is given.

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