f Ed's Guide to Alternative Therapies Ed's Guide to Alternative Therapies


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This page was last modified August 23, 2011.

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I'm a board-certified anatomic and clinical pathologist and operator of the largest one-person medical information site on the web. As a pathologist, it's my job (among others) to examine tissue, tell what's the matter, and predict the behavior of the disease and response to therapy. Like most other pathologists, I'm extremely successful at this. Like most other pathologists, I take a lot of pride in this. (Call us arrogant if you like. I am an honest physician who engages in public debates. When I catch somebody deliberately deceiving the public, they never defend their cases on the facts, but almost always call me "arrogant" or "elitist" and claim I am secretly in the pay of the wicked pharmaceutical companies.) And if I screw up even once, I'm in MAJOR trouble.

Unlike many M.D.'s, I'm open-minded about what's known as "alternative medicine", i.e., therapies that are not recognized by mainstream medicine. During the 1980's, I reviewed alternative medicine and found there was little to recommend. As the alternative medical community has responded to pressure to defend its claims by the usual methods of science, some areas have improved.

This site aims to let the public know what empirical evidence is available for various alternative remedies, especially studies published in refereed journals. This will enable people who must make decisions to rely on more than anecdotes and advertising.

This site will always be under intensive construction. Only a fool pretends to know everything. I cannot buy or read a book, but I am interested in your personal experiences ("anecdotes"), and especially in real work by real scientists (i.e., people taking serious precautions against self-deception.) Unless you specify otherwise, I'll feel free to quote you.

I would be remiss without placing links to Quackwatch . The fact that I am less likely than some members to dismiss alternative claims out-of-hand probably reflects our differing life experience. Remember there are plenty of bad doctors in both "mainstream medicine" and "alternative medicine".

Here's the ranking system that this site will use:

CONFIDENT The remedy has a plausable mechanism and has been given some basic tests, and/or has solidly passed two good, clear, controlled studies

OPTIMISTIC The remedy makes sense pathophysiologically, and there is at least impressive anecdotal evidence

DOUBTFUL The anecdotal evidence seemed interesting to me, but that's all there was.

PESSIMISTIC I can see why somebody might have thought of this. But if this actually works better than a placebo and a little human kindness, we are all going to have to make some major readjustments in how we think about health and disease. Don't spend too much money, or get your hopes up.

Bold indicates the remedy has passed a controlled, reasonable-sounding study for this use. Underlining means it failed. Claims that lack substantial testing are unmarked.

Here are some things that are NOT "alternative medicine".

Here's how to evaluate an "alternative" claim. I am not going to consider alternative systems of diagnosis. As a pathologist, I remain open-minded on the subject. If you know of any that show predictive value (i.e., you can predict which people in the community will and will not come down with XYZ better than I can), please let me know.


The fruit of the acai palm tree, which like everything else contains some biologically active molecules, was presented as a multi-level marketing scheme in 2004. Claims included weight loss and "cleansing". The shady work of the marketers is now history, as is Oprah's successful lawsuit against them. A pilot study of acai for weight loss was a miserable and total failure (Nutr. J. 10: 45, 2011). At least the juice seems not to be toxic or carcinogenic (Toxicology 278: 46, 2010. There junk journal claims ("adding it to cigarets prevents emphysma in mice"), etc., etc.


References to follow.

Many people who have experienced acupuncture treatment believe that it caused physiologic changes beyond just suggestion and relaxation. As acupuncture moves from folk medicine into real scientific therapeutics, physicians will insist on sorting out the placebo effect and the cultural overlay.

Acupuncture appears to have effects on neurally-mediated reflexes. Because the reflexes are so subtle, studies will remain empirical for a long time to come. Positive studies will need to be replicated, especially since the strong feelings that some people have in favor of acupuncture may introduce bias. This will probably happen soon, but to date, there are no findings of effectiveness (i.e., this particular acupuncture procedure works in this particular situation) that are robust after being replicated in several different series.

Serious studies of whether traditional acupuncture is actually more effective than placebo now use sham acupuncture as the control. In "sham" acupuncture, the operator deliberately needles the wrong points. This isn't double-blind, but it's a start. There are positive results (i.e., real acupuncture is significantly more effective than sham acupuncture) for nausea and vomiting after gynecologic surgery (weak), epicondylitis, anxiety in the emergency pre-hospital care setting, and even parental anxiety during anesthesia induction in a child. In one study of nausea and vomiting after tonsillectomy, the control group did better and the sham group did worse than those not treated at all.

In a few instances, acupuncture has proved superior to a standard medication. One example is an electrical technique for post-operative nausea and vomiting after cosmetic surgery. In another instance, stimulation of a particular needle-point proved as effective as a standard anti-emetic for post-operative nausea and vomiting in children. Another study obtained a similar result for children undergoing anesthesia in the dentist's office.

In the anesthetized patient, the placebo phenomenon is less likely to be operating. Electro-acupuncture is now widely used in Europe to reduce the need for anesthetic agents, and the effect was strongly significant in a US double-blind study.

There are also numerous negative studies, in which particular techniques applied to particular clinical problems showed no significant effect. This is in spite of the fact that acupuncture proponents might be reluctant to share a negative study. An electrical technique failed for low back pain. Another electrical technique failed to reduce the need for anesthetics. A major study showed no effect for asthma. Urologists were unable to obtain any benefits by needling the "kidney-ureter-bladder" meridian. "Minute sphere acupuncture" failed to help postoperative pain or morphine use. Despite an apparent effect in one study of cocaine addicts, acupuncture did not outperform relaxation or sham treatment for cocaine addiction in a second study. Unlike some other complementary therapies, acupuncture did not show an effect in a major study of chronic low back pain. Although two non-blinded studies of acupuncture for tinnitus suggested an effect, four blinded ones showed no significant effect.

Some large studies have actually not included a sham-acupuncture group when it would be easy to do so. These do help make it clear that acupuncture is relatively safe. Recent studies without a sham control but with positive results compared to no-acupuncture include one for low back pain in the elderly, another for nausea and vomiting during cyclophosphamide infusion for rheumatic disease, another for wheelchair-user's shoulder, another for childhood constipation, and another for labor pain. Two British studies found that a trip to the acupuncturist gave good results for chronic headache patients at relatively low cost to the health care system. The question was, "Is this worth the money?" rather than "Is this anything more than a placebo?" The authors characterized their own approach as "pragmatic". In turn, there are ethical questions involved in placebo treatment, even to make people feel good.

Some studies of electroacupuncture claiming to show a benefit (i.e., for low back pain, nausea and vomiting of pregnancy, nausea and vomiting of myeloablative chemotherapy) have used as controls a non-electrical apparatus, which is not really blinding.

Physiologists are starting to characterize the reflexes involved in needle insertion. One surprising finding, awaiting confirmation, is the induction of mirror-image electrical activity when a myofascial trigger point is stimulated. Controlled studies showing no clinical benefit (for example, post-stroke leg spasticity) still showed curious reflex effects from treatment. Animals have reflexes in response to acupuncture treatment that may be abolished by certain medications.

Despite the training they receive, several acupuncturists examining the same patient are likely to recommend widely different needle placements. This was demonstrated in a test using a low-back- pain patient, and perhaps this is no different from other physicians. Practice is likely to become more standardized as the scientific work continues. Acupuncturists will need to decide how much to retain of the cultural trappings and imaginative physiology. We can expect that most will regard the "theory" as something to be treasured as a bygone age's attempt to understand the riddles of the body. Instead, its practitioners will recognize that the effects are really mediated by subtle reflexes that are not fundamentally unlike the other processes by which the body maintains its health.

Acupuncture seems to be safe overall. One acupuncturist perforated the right ventricle of the heart causing hemopericardium, and there have been several instances of pneumothorax. I have been pleasantly surprised with how few other complications have been reported during the last few years. My friends in oriental medicine asked me to mention that it's now standard to use single-use, presterilized, disposable needles.

Artemisinin for cancer DOUBTFUL

The anti-malarial drug artemisinin and its relatives are being promoted by the alternative-medicine community for cancer in general. There is some interest in their possible anti-cancer properties, and a few decent papers, mostly focusing on which patterns of gene expression predict that the drug will kill cells in tissue culture (Pharmacogenetics Journal 6: 269, 2006). They're well-known to do this, because they are poisons, and the fact that they kill cancer cells (J. Med. Chem. 49: 2731, 2006, from the Hop) should come as no surprise. Especially, they may have activity as angiogenesis blockers.

The foremost proponent in the US seems to be Dr. Henry Lai, whose professional degree is in psychology and who teaches in the department of bioengineering at U. Wash. His focus on the effects of non-ionizing fields on humans seems to have led him into fringe medicine, and he has been writing papers about artemisinin as an anti-cancer agent since 1995. He notes that breast cancer cells reportedly (a few old papers in obscure journals) tend to have more surface transferrin (iron-binder) than their benign counterparts. So artemisinin (which generates toxic free radicals when exposed to iron) could induce apoptosis selectively in breast cancer. He managed to demonstrate this effect in a culture of breast cancer cells awash in iron-binder (Life Sciences 70: 49, 2001). Artemisinin alone was a dismal failure. At least he's honest. It sounds to me as if the breast cancer cells simply were more adherent for the iron-binder; the experiment does not support the claim that they have greatly increased transferrin surface levels. However, around this time, Dr. Lai speculated about how one could saturate the allegedly-increased transferrin molecules with enough iron, not mentioning that flooding the body with iron is itself dangerous. The iron-bearing pigment that accumulates in malaria is orders-of-magnitude richer in iron than one could possibly accumulate simply from having extra surface transferrin. (At least, both are ferric.)

Readers should know that there are no reports to date (despite ten years of interest, especially by Dr. Lai) of artemisinin inducing even a partial remission of any cancer in any animal system. The claim that there are 350 papers showing an effect on cancer is just another lie. The 88 that I found were mostly cell-culture studies without benign cells as controls. Conspiracy buffs who assume that the drug companies have shunned artemisinin since it's a naturally-occurring substance and therefore less profitable should note that taxol (a similar case) became part of mainstream breast cancer therapy as soon as it proved to work.

There just might be an effect. Dr. Lai actually got a chance to try it as a breast cancer preventative in mice in 2006 (Cancer Letters 231: 43, 2006). This was the only in vivo study I could find. He claimed an effect with p<0.1 (i.e., suggestive that the effect might be real). He ended his abstract "Since artemisinin is a relatively safe compound that causes no known side effects even at high oral doses, the present indicate that artemisinin may be a potent cancer-chemoprevention agent." Dr. Lai was somehow unaware that the year before the neurologists at UC-Frisco had reported a grisly case of toxic brainstem encephalopathy after artemisinin treatment for breast cancer in a lady who'd just had a cancer resected and thought it would be a good idea to add artemisinin (Ann. Neuro. 59(4): 725-6, 2006). Brainstem side-effects of artemisinin are in fact known clinically (NEJM 336: 1328, 1997). Thankfully, her illness subsided when her artemisinin was discontinued. Cause and effect? We can't prove it, but it's worrisome.

If you want to try artermisinin for cancer prevention or treatment, it's your decision.

UPDATE: 2011. The discussion continues. A correspondent who believes herself to have been cured of breast cancer entirely by artemisinin brought to my attention a very lively ongoing discussion as to whether the substance produces neurotoxicity (see Clin. Inf. Dis. 43: 1618, 2006.) This actually does not reference the index case. Dr. Lai continues to publish both on animals and cell culture and has findings that are interesting. There are still no reports of cancer regression in an animal system, but Cancer Letters 231: 43, 2006 (which is an elite journal) published the results of a model in which the treated animals got fewer / smaller tumors after treatment with a carcinogen (anti-cancer effect, altered carcinogen metabolism, or someting else?) I'm going to stand by my statement, "There just might be an effect", and wait with hope for the success of Dr. Lai, an investigator who is obviously a sincere and decent person.

Beta-mannan to reverse dysplasia of the cervix PESSIMISTIC

Beta-mannans are presently being promoted by one individual as able to reverse most cases of dysplasia (pre-cancer) of the cervix. The principal promoter bases his claim on anecdotal evidence, but does claim 95% success.

Mannans are found in tomatoes and may have something to do with their empirical link to a lower rate of some cancers. They may prevent some of the mutations that accumulate to cause cancers. It's harder to see how they would reverse the mutations once they have happened. ("That'd be like reversing loss of virginity.") The promoter claims instead that beta-mannan stimulates the immune system, which is weak in Americans because of our alleged poor diet and smoking habits.

To his credit, the principal proponent has a side-note that urges women with frank cancer to get the required surgery.

People considering this "complementary remedy" need to know the facts.

Until I see a publication, I'll reserve final judgement. But I'm very much afraid this one won't work out.

The principal promoter of this complementary remedy is none other than the author of the old "Phantom Notes", which I found very helpful when I was on my surgery rotation. They were a superb resource; curiously, we had to send away for them and get them delived to us by mail. A few months later, a sheaf of "Bible Prophecy" stuff "that proved the truth of the Christian religion" was mailed to our PO boxes from "The Phantom". My Jewish friends especially did not appreciate this. "Bible Prophecy" still appears on the "beta mannan for cervical dysplasia" site. Again, you'll need to draw your own conclusions. In September 2003, a correspondent shared with me the court decision in a lawsuit against Dr. _______ for plagairism in connection with the Phantom notes. The judge had some very harsh things to say about him even back in the 1970's.

Anti-Malignin Antibody Test for Cancer PESSIMISTIC

See my notes. This allegedly is an extremely sensitive and specific way of determining whether cancer is present in the body, and its proponents talk about its making pap smears, mammograms, and so forth obsolete. But after more than 20 years, only the original "discoverer" has described this substance as really existing. In a short (unrefereed) letter in "Lancet" announcing that his serum stains three different kinds of cancer cells, the discoverer failed to mention any control using any benign cells. (If the fundamental idea is correct, benign cells would be unstained.) I'm ready to draw the obvious conclusion. To the lab's credit, there is no talk of "conspiracies" or "cover-ups" or "persecution".

Botanicals for DiabetesDOUBTFUL

There is presently an online promotion of a "secret" natural remedy for both type I and type II diabetes. You'll have to find the site yourself, but the claims are obviously bogus.

A supposed scientific article is appended to the site. It is clear that this was not accepted for publication, even by a non-refereed junk journal. For starters, the composition of the remedy is not given. Second, the authors mention at least three previous studies but do not cite references. Third, there are no controls. There are also illiterate expressions. ("There is a remarkable phenotypic difference in Type 2 Diabetes. The connective importance of the genetic and environment causes of type 2 diabetes varies between people.") These people claim, in their ad, to make pancreatic islands regrow, but there are no tissue studies in the article. This is a sensational claim, and if there were any reason to think it were true, some scientific journal would have grabbed up the evidence. The shabby quality of the work is shown by the ad page, which states "The clinical study further concluded, '... treatment with _____ partially brought about a regenerative capability for the damaged endocrine tissues as evidenced by increased islet cell numbers and resulted in restoration of near normal architecture of pancreatic islet (sic.).'" Anyone who reads the fine print will see that this is simply untrue. The study cited shows nothing of the sort, but simply makes this statement about a second, unreferenced study. Even the name of the "independent lab" that supposedly did the tests is concealed from the reader.

If you want to send these people a few hundred dollars for their secret mix, that is your business.

Right now (2005), current articles in the genuine scientific literature on the use of "natural" remedies for diabetes are conspicuous by their absence. For a review of how herbalists design complementary therapy for diabetics, see Acta. Diab. 41: 91, 2004. "The ten most frequently suggested herbal remedies were gymnema, psyllium, funagreek, bilberry, garlic, Chinese ginseng, dandelion, burdock, prickly pear cactus, and bitter melon. The ten most frequently recommended dietary supplements were biotin, vanadium, chromium, vitamin B6, vitamin C, vitamin E, zinc, selenium, alpha-lipoic acid, and fructo-oligosaccharides." The reviewers felt some of these might help at least some. This is far from the grandiose claims made by the current promotion.

Bromelain / pineapple for goiter and so forth PESSIMISTIC

Bromelain is an enzyme in pineapple that, as it happens, pathologists use in blood bank testing. In July 2010 I was alerted to promotion of magic pineapple juice, especially as a treatment for goiter (enlarged thyroid gland). This is very, very surprising. If enough bromelain were to get through your gut mucosa to have any effect, it would start by gravely altering your red cell antigens, like it does in lab.

Just to be sure, I ran a check of the NIH database that would find any study -- even a mouse study in a bottom-class junk journal -- on bromelain / pineapple and thyroid disease. Exactly nothing.

Various plants contain various chemicals that can enlarge thyroid glands. There may perhaps be something in some plant that has as as-yet-unknown effect on thyroid glands. The burden of proof is on the person trying to sell you the magic pineapple extract. It's your money.

If you have a goiter, the most important thing to find out is "Why?" Common nodular goiter often responds well to conventional treatment with thyroid supplementation. Medical disease of the thyroid is likely to kill if not diagnosed properly. And of course there's plenty of thyroid cancer. It's your life.

Follow-up: When I originally heard of the claim, I did not believe that any bromelain would make it through the gut mucosa. A correspondent brought to my attention Am. J. Phys. 273: G139, 1997. After taking 3 grams of bromelain a day, plasma levels reached as high as 5,000 picograms/mL. A picogram is one trillionth of a gram. I did the arithmetic and assuming a serum half-life of one day, one molecule of bromelain out of 600,000 will be absorbed. No drug company would issue an oral preparation with such a poor level of absorption. I stand corrected, and would invite the promoters of magic pineapple juice to take some of the stuff, or pure bromelain, intravenously and see how much good it does them. By the way, when I was in the blood bank, technicians were warned against inhaling bromolein powder because many people (maybe 50% of technicians) become allergic to it by this route and develop skin and lung problems.

Cesium Chloride for cancer PESSIMISTIC

Cesium is an ion that cannot bond covalently with any other atom or molecule under any circumstances in a living body. Except for its ability to interact with electrical membranes, with potentially lethal results especially in the presence of kidney failure or if given by vein, it is as inert a substance as you can introduce into your body. However, taking a large dose is presently being touted as a cancer preventative or remedy, especially by a group representing itself as the "Life Science University Medical Center" or the "Life Science Universal Medical Center". (One must be a misprint, which is surprising in their own publication. I've taught in accredited medical schools for a quarter-century and I have never heard of them.) The author claims to conduct experiments in Rockville, Maryland, suggesting to the unwary that they are affiliated with the National Institues of Health. These people report an uncontrolled series of 50 end-stage cancer patients who were given cesium chloride plus other "holistic" remedies. The reported results are hard to understand:

The percent of survival (sic.) of breast, colon, prostate, pancreas and lung cancer accounted (sic.) to (sic.) approximately 50% which was higher than noted for liver cancer and the lymphoma patients treated.

An overall 50% recovery from cancer by the Cs. therapy was determined in the fifty patients treated. Data from the autopsy (sic.) indicated the absence of tumors in patients dying within fourteen days of the Cs-treatment.

One wonders what killed the people who died if they had no tumors. The author is a person using the pen name "Annie Appleseed" who admits to having no medical qualifications, but apparently claiming she performed and supervised these activities in 1981-2. It is hard to understand how the three patients in coma were fed whole grains and vegetables. Even harder to understand is why, if these accounts are true, there was never a publication, not even in an unrefereed junk journal. Further, why was this not noticed by the communist nations? Cancer was rampant in Russia and China, and they had an effective spy network. The supposedly-corrupt profit-driven capitalist medical establishment would have had no way of stopping the use of an effective cancer remedy which (had it worked) would have been a masterful stroke in the propaganda war against the West.

Of course, there is no refereed-journal publication on cesium chloride's anti-cancer effects. The explanation of how cesium chloride is supposed to work is obvious baloney. Supposedly, cesium in the extracellular milieu causes the pH of the cell to increase. Cesium chloride is cited as an alkaline salt, which raises the pH of the fluid itself. Cesium can supposedly enter a cancer cell but not a benign cell, and neutralize the acids that supposedly cause cancer. Finally, they claim that the pH in a cancer cell is "as low as 5.5", and that cesium in the milieu raises the pH to 8.0 which results in cell death within hours.

People considering this proposed mechanism should remember their high school biology. Simply because a cell is not dividing does not cause it to die. (Consider your healthy brain, heart, muscle, and most other cells.) Cesium chloride is not an alkalinizing agent any more than is table salt. Ask a grammar-school chemistry teacher. The claim that cesium can enter cancer cells but not benign cells is referenced only to the work of Brewer, a mid-1900's cancer charlatan with a physics background and if its own proponents believed it, they could easily test their own claim in any tissue-culture lab and publish in one of the junk journals for an honest reference. Of course they have not done so. The idea that unnamed acids cause cancer and can be neutralized is like saying the moon is made of green cheese. The claim that a cancer cell might have an internal pH of 5.5 is ridiculous. (Below 6.5 will kill any cell in a few minutes. And the dyes I use to stain cancer cells include pH indicators similar to litmus; of course no such pH change is evident.)

Of course, there are anecdotes. One patient whose cancer supposedly was observed by the author to shrivel to almost nothing within one hour after cesium administration. (Regrettably, soon afterwards she fell and broke her neck from a cancer-related hip fracture.) If this had actually happened anywhere near the National Institutes of Health, it would have been stolen by one of the research piranhas and published in a real journal. Of course there is no such publication, and "Annie Appleseed" cites a massive conspiracy.

Other sites repeat the grossly false claim that Otto Warburg's 1931 Nobel Prize was awarded for demonstrating that anaerobiasis causes cancer. He actually distinguished between aerobic and anaerobic metabolism and figured out how the cytochromes work. You can read his Nobel Prize lecture for yourself if you still don't realize that these people are trying to sucker you. Not surprisingly, these people also repeat the false claims that the Hunza people and reservation-dwelling Hopi people have a remarkably low incidence of cancer, attributed this time to abundant cesium in the diet.

Cesium chloride is a common chemical that costs almost nothing, though there might be a fee for administering it orally. If the proposed mechanism is accurate, then it should be sufficient therapy to provide a cancer cure. However, its proponents say it only works when given with other holistic remedies and a diet, typcially of uncooked foods, and under the supervision of a holistically-minded nutritionist.

Cesium in combination with aloe vera went to law in Maryland after a physician and two other people pretending to be physicians promised cures for cancer and AIDS. They went to prison. It used to be described at the Maryland Attorney General's site. At his site on coral calcium, Steve Barrett claims the regimen actually killed some people, but I couldn't find anything to support this.

Some of the cesium chloride sites accuse mainstream physicians of willful ignorance, attribute the vilest motives to them, compare them all to Hitler, etc., etc. If you still wish to become involved with the cesium chloride people, that is your business.

Citrus bergamot for dyslipidemia OPTIMISTIC

The oil from the peel of an exotic orange has been used for decades by aromatherapists for various reasons. It is pungent and fragrant. The oil components also have some pharmacologic activity; it contains naringin, the bitter substance in grapefruit which is known to have a host of pharmacologic actions and especially drug-interactions.

One article from Spain in 2009 has been much-cited but I could not find it in a literature search, reports are that it has no controls, and the results seem too good to be true (which usually means they won't be verified.)

The one article in a NIH-listed journal (the obscure Fitotherapia 82: 309, 2011, from the med school in Catanzaro, Italy) gives results of oral trial on rats and people; there was a moderate cholesterol-lowering effect and some tendency to lower blood glucose in diabetics. The effects were most marked in folks with the metabolic syndrome. The authors simply called for some real, quality studies on humans because the kind of work they were doing is prone to false-positives. They did note that the oil inhibits HMG-CoA reductase just like today's statins.

That's it so far. Remedies that actually work generally get snapped up by the research piranhas and become mainstream, even when nobody stands to make a lot of money.

There's also a rat study in which the oil, injected into the blood, made the rats excited; no surprise. I eat orange peel myself sometimes, and if you want to try this out, it's your choice.

Clay Eating / Clay Therapy DOUBTFUL

Using clay as an aid to health. Special miracle clays from exotic locations (some of which supposedly concentrate cosmic energies) are sold to the "alternative and complementary community." There are probably some reasonable uses for clays in cosmetics, and I can't address the use of clay as a deodorant.

The claims are extremely diverse. Common sense would suggest that clay-eating would alter the gut flora and physical properties. For many years, a kaolin clay-based formulation has been in use in mainstream medicine as a diarrhea remedy, and some obscure journals are now looking at bentonite as well. Clay is included in some animal feeds, and some species consume certain clays selectively. Pilot studies are just now starting to appear in support of some of the more reasonable health claims for humans.

A study out of U. Az. confirmed the common-sense idea that components of clay are 'cidal for some pathogenic bacteria (J. Antimicrob. Chemo. 61: 353, 2008. Some obscure journals are looking at other clays especially for control of functional bowel syndrome, and it's not surprising that some clays adsorb and thus protect from mycotoxins. Thanks to my correspondent Kjell K. for bringing these to my attention.

Clay eating is known medically as "geophagia", a variant of pica. It's seen among the mentally ill, and in some places it's a cultural phenomenon, mostly among the poor (do we dare say "ignorant"?) See J. Roy. Soc. Med. 95: 143 and 274, 2002; South. Med. J. 95: 1228, 2002. One group in J. Exp. Bio. 207: 319, 2004 speculates how the widespread practice may have developed (trace-mineral availability, diarrhea control). Known hazards are intestinal obstruction (Archives de Pediatrie 11: 461, 2004), perforated colon (Acta Chir. Belg. 99: 130, 1999), lead poisoning (Clin. Ped. 43: 189, 2004; Amb. Ped. 3: 37, 2003), hypokalemia (a young mother-to-be's agonizing misadventure: Ob. Gyn. 102: 1169, 2003), and toxacara roundworm infection (you can get it in the US: South. Med. J. 91: 882, 1998; massive problem in Sri Lanka: Southeast Asia Journal of Tropical Medicine 34: 7, 2003; Brazil Curr. Op. Ophth. 12: 450, 2001; in Trinidad TRS Trop Med 96:139, 2002; several others).

Given that many members of the "alternative medicine community" believe that mercury in dental fillings is a terrible health hazard, it is surprising that there was no outcry after eating certain clays was found to produce clinical mercury poisoning (Conn. Med. 61: 207, 1997) or that there are no assays for mercury levels or other poisons on the clay promotion websites. If the consumers were clear thinkers, you'd think they'd demand to know.

I was able to find single hard-science study of a health claim for clay. A clay-based product was promoted for sheep to protect from locoweed toxicosis. It failed a controlled test miserably (J. Animal Science 75: 1867, 1997). As a food additive, there are two small controlled studies showing benefits for pigs and rats respectively. There may be more such in the future, with positive results.

One article that really helped me understand how people adopt their "cherished beliefs" was MMWR 47(43): 928, 1998. A lady from an anti-immunization family almost killed her baby by putting "health and beauty clay" on the umbilical stump, causing a dreadful anaerobic infection and neonatal tetanus. The clay was of course laced with tetanus spores, probably from decades of horse manure. When the baby recovered, the mother refused to have the child immunized because of "concerns about potential adverse effects".

Clay-eating is widespread and most people seem not to be harmed. Please be sure your clay comes from someone you have good reason to trust.

Colonic Irrigation for "Autointoxication" PESSIMISTIC

Colonic irrigation with saline with or without phosphate is standard for a variety of diseases of the large intestine, including chronic fecal incontinence and the acute management of some mechanical and functional problems.

Presently there is a resurgence of interest in the old claim that the colon contents produce poisons that damage the rest of the body. This is actually true in liver failure, in which enemas and laxatives help appreciably with the brain malfunctions. (Octopamine and other bacterial products from the gut, if allowed to bypass the liver, act as false neutransmitters, sort-of-like "reverse prozac"). Evidence that anything like this happens when the liver is healthy hasn't been forthcoming.

I own a popular book promoting colonic irrigation. It showcases pictures of barium enema x-ray photos, and states that the areas where the colon is narrow are sites of "toxic bowel settlement", a substance (variously described as "slimy" and "cement-like") that accumulates on the wall of the colon, and that colonic irrigation removes. This is just a bold lie. The pictures represent the narrowings by which the colon propels its contents ("peristalsis"). As a pathologist, I have opened hundreds of colons and never seen anything like "toxic bowel settlement".

The practice is reasonably safe. In the 1970's, one colonic irrigation parlor gave amebic dysentery to a Colorado town because it wasn't changing its tubing. Thankfully this must be exceptional.

If you go to get your colon irrigated, you will meet a practitioner who is unhurried, kindly, and takes time to explain things. Your experience will probably be pleasant, and perhaps this will itself make you feel better. For a review by a physician who's less charitable than I am, see J. Clin. Gastro. 24: 196, 1997.

By now I have heard from several colon-irrigation activists. Sites they have shared include one depicting what I recognize to be a blood clot (link is now down; apparently those irrigationists are rough enough to make some folks bleed, though apparently not seriously). There have also been electron micrographs of what I recognize to be nonspecific intracellular changes inside colonic epithelium, and a molecular biology article on membrane carbohydrate changes in colon cancer (was at Mayo, now down). I do admire these people's persistence and commitment. But I think any fair-minded person with some tough science background will see that this isn't "toxic bowel settlement" as described by the irrigationists.

Cranberry Juice for Bladder Infections CONFIDENT

This is an example of a folk medicine that eventually yielded up its secrets. Cranberry juice helps prevent, and helps people recover from, common bladder infections. Anthocyanin in the cranberry prevents the formation of fimbriae, the velcro that attach the common infectious bacteria to their sanctuaries on the bladder wall. Read more about it in J. Urol. 159: 559, 1998.

Stay tuned for cranberries to prevent oxidation of LDL particles and thus as a help in preventing atherosclerosis (Life Sciences 62: PL381, 1998).

EDTA Chelation for Atherosclerosis PESSIMISTIC

Administering EDTA (ethylene-diamine tetra-acetic acid) by vein is promoted as a remedy for atherosclerosis, the common "hardening of the arteries" that causes most heart attacks, strokes, claudication and gangrene of the legs, and abdominal aortic aneurysms. EDTA chelates calcium and some other metals, binding the atoms and causing them to be removed from the body.

Proponents usually claim that it works by breaking up the plaques by removing their calcium. This is enough to make any pathologist crack up laughing. Most atherosclerotic plaques contain little (if any) calcium, distributed only in patches, and the calcium actually accumulates late in the plaques. Further, it's in deep, less accessable than the calcium in bone. So the proposed mechanism is biologically implausable.

Given by vein, EDTA binds calcium in the blood, interfering briefly with nerve function and causing the fingers, toes, and lips to tingle. The therapist may tell the patient that this means additional oxygen is reaching these body parts as a result of the clearing of the blood vessels. This is probably how the chelation therapy scam originated. Even a kid will realize that if additional oxygen were reaching these tissues, they would change color.

Chelation therapy has spawned a healthy-lifestyle, self-help subculture, and this probably accounts for its successes. Exercising, diet changes, and other habit changes can reverse most atherosclerosis. We in pathology have known this for a long time, and you'll often hear us comment about how North Americans prefer to have our chests cut open than to change the way we live. It seems to me that the chelationists are the price that mainstream medicine has paid for failing to focus on more whole-person ways of making atherosclerotic plaques shrink and even vanish.

The literature contains the usual anecdotes, mud-slinging, and talk about vested interests and freedom of choice. The single serious controlled study of chelation therapy for atherosclerosis showed no benefit over placebo -- the therapy flunked miserably (Circulation 90: 1194, 1994). Nebraska review: Ann. Pharmacotherapy 27:1504, 1993 (concludes worthless), also Texas Heart Institute Journal 24: 81, 1997. More sympathetic accounts: Circulation 96: 1031, 1997 (Exeter's Department of Complemenetary Medicine), J. Card. Nurs. 10: 78, 1996 (pro), By the way, EDTA might deplete your bone mass (Danish Med. Bull. 40: 627, 1993); otherwise the safety profile seems good.

Chelation techniques are basic to the therapy of lead poisoning, iron overload in the overtransfused, and Wilson's disease. However, if the technique actually worked for atherosclerosis, then Leonid Brezhnev, who possessed the world's greatest information-gathering system and who suffered terribly from atherosclerosis at the end, would have used it to save his own life.

Update: As of late 2006, everything in the mainstream refereed literature is unfavorable to the idea that chelation therapy has value in atherosclerosis. See Nat. Med. J. India 19: 24, 2006 (review), J. Am. Coll. Card. 41: 420, 2003 (from U. Calgary, focus on endothelial function; miserable failure); Science 297: 1109, 2002 (announcement that for political reasons, the NIH would test chelation therapy; no paper ever appeared and this almost forces the obvious conclusion); Mayo Clin Health Letter 20: 4, 2002 considered the therapy worthless. For true-believers, Cochrane Database CD002785 decided that the question can be considered unsettled if you simply crunch the numbers, the pro-alternative medicine journal "Alternative Medicine Review" (3: 4, 1998) published a single-author (from UCLA Berkeley) no-new-data panegyric declaring chelation therapy to be of proven value, and there is a junk-journal publication from Saudi Arabia (Diab. Obes. Metab. 3: 417, 2001; rabbit study).

Enzyme Therapy for CancerPESSIMISTIC

Administering oral enzymes is a logical, easy treatment to replace digestive enzymes that are deficient in advanced cystic fibrosis (mucoviscidosis), chronic pancreatitis, and a few less common diseases. Injectable enzyme therapy is a logical (if horribly expensive) mainstay for the treatment of severe Gaucher's disease, and we can hope that the prices come way, way down someday.

Proteolytic enzymes have found some use in breaking up scar tissue from breast cancer surgery (an obscure Czech journal). Replacement of the specific enzyme missing in xeroderma pigmentosum is presently under study (Photoderm. 12: 122, 1996), but this is to prevent, not treat, cancer and replacing the enzyme after the damage is done would be useless. There is talk about someday administering specific enzymes to remove cancer cell surface receptors (Eur. J. Gastro. 7: 939, 1995), but this is totally unlike the "enzyme therapy" now being promoted for cancer and most other diseases.

Perhaps because of media reports of these these successes and ideas, mixes of enzymes are now being promoted as an "alternative" cancer remedy (and a remedy for many other things).

There are current reports on enzyme therapy (one each) for rheumatoid arthritis (Acta Univ. Carolin. Med 40: 101, 1994 -- an article that makes the implausable claim that 25% of orally-administered enzyme is absorbed into the bloodstream without inactivation and concentrates at disease sites), multiple sclerosis (an obscure Czech journal, the abstract promises statistics), "vascular disease" (an obscure Czech journal that claims "a concentrated sophisticated research and approximately 150 clinical studies" to support its use), benign breast cysts (an obscure German journal) and fever blisters (an obscure German journal, "works as well as acyclovir" which is to say not very well, and the writers only measured the differences on day 7 and day 14, when the fever blisters would self-heal anyway). No abstract gives any statistics, though mainstream abstracts of basic studies almost always do. The very dubious claim that oral enzymes are protected from oral digestion is repeated in Ceska a Slovenska Farmacie 45: 51, 1996. If it's true, it'd be a major discovery but there've been no reports from mainstream scientists, some of whom must have tried to confirm it.

In the past four years there have been no articles in the refereed journals indicating any effect of any enzyme on cancer. This cannot be for lack of trying by the zealous Czech promoters.

What I like best about oncologists is the attention they give to the basic comfort measures and humane care for those dying of cancer. For a few kinds of cancer, chemotherapy has been a miracle cure. Nowadays, the biotech molecules are more promising. But over the past 30 years, cancer chemotherapy has been most lucrative when it offers a slim hope of longer survival (or rarely cure) at a great financial and human cost. As the heavy hand of managed care comes down hard on today's oncologists, we can expect a new wave of "alternative" cancer remedies.

If you choose enzyme therapy, I hope you will not spend a lot of money on it.

Follow-up (2005): This is still being promoted. A reviewer in Cancer 2001 mentioned anecdotal reports but nothing "compelling". A reviewer from the "Department of Natural Medicine" at the university hospital in Zurich accepted all previous reports at face value (Drugs 59: 769, 2000), and admitted that no one knows the mechanism by which they are working. The claim that orally-administered proteolytic enzymes somehow induce antiproteases in the body, while the same enzymes that everybody makes naturally in much larger quantities don't, is an extraordinary claim that demands extraordinary evidence. Since they have a department of natural medicine in Zurich, you'd think the team would get with the school's biochemists and confirm this. They have clearly either not done so, or gotten results that they chose not to publish. This invites an obvious conclusion. A group at Nebraska Med School has found that orally administered pancreatic enzymes prolong survival in mice with pancreatic cancer by improving nutrition (Pancreas 28: 401, 2004). Go figure. Replacing pancreatic enzymes is a mainstay of treatment of pancreatic disease, including chronic pancreatitis and cystic fibrosis. This has nothing to do with the supposed mechanism by which "alternative-medicine enzyme therapy" works, and if an operator cites this article, put your hand over your wallet. A study from an obscure institution in an obscure journal (Cancer Chemo. Pharm. 47-S: S-23, 2001), that found that oral proteolytic enzyme tablets caused less mucositis in head-and-neck cancer patients getting radiation therapy was deeply flawed by an inexplicable failure to use any blinds or placebos. I could find no further publications, not even in the junk journals.

Fucoidin (fucoidan, "Limu Moui") DOUBTFUL

This polysaccharide from seaweed is now available as a drink for which a host of grandiose, vague health claims are made.

The promoter is a company that is a front for another company that in 1995 was required by the Feds to pay $250,000 because of all the false claims it had made for its weight-loss, bodybuilding, and disease-prevention products. The pattern of deception is still obvious. According to the website, "scientific study has shown that Limu Moui contains a veritable storehouse of natural minerals and vitamins, glyconutrients, amino acids and polysaccharides that can help support immune function." Of course there is no reference, but all seaweed used to be alive and therefore contains this stuff. They also quote a Japanese researcher Kyosuke Owa as saying the product contains antibodies like mother's milk, which can't be true. A search of the NIH database yielded no comments on seaweed or fucoidin by anybody of that name. In fact, there are only six articles total by anybody by the name of K. Owa, and they are all either about recombinant DNA or the blink reflex. So the authorship is as much a lie as the content. The site goes on to claim an extraordinary degree of longevity among Tongans. The only documentation that I could find is a study in the Japanese Heart Journal from January 1988, which found that Tongans tend to be massively obese but to have lower cholesterol and blood pressure measurements than do equally fat people elsewhere, that the most prevalent diseases on Tonga were the same ones as in the rest of the developing world, and that "the Tongan lifestyle" which had been promoted as a means of longevity wouldn't be effective. The New Zealand Medical Journal 99: 630, 1986 found Tongan children to have stunted growth from chronic malnutrition.

Fucoidin is very useful in the biochemistry lab, especially now that it's been found to be a binder to the selectin receptor. Oral fucoidin has found some experimental use as an agent to coat stomach ulcers. Since it is probably not absorbed orally, it might have interesting effects on the flora of the large intestine. So the health effects might be unpredictable, varying greatly from individual to individual. Given by vein, fucoidin is under study as an alternative to heparin.

One of my correspondents expressed concern about people drinking the stuff, since when given by vein it is a potent anticoagulant and could make somebody bleed to death. Thankfully, the stuff is a polysaccharide and probably won't even be absorbed through the gut.

Follow-up: One of the proponents of fucoidin wrote me (9/8/04) pointing out, "Please refer to www.pubmed.gov and search fucoidan. You'll see almost 600 studies, not 6 as you mention you found." I was referring to 6 studies by writers named K. Owa. There are presently 602 studies of fucoidan in the medical literature. Almost all document in vitro properties and a few suggest possible therapeutic uses. You can find this sort of stuff for most any natural compound. The one paper I did find interesting is In Vivo 17: 245, 2003, a mouse tumor pilot-study from a Japanese school of allied health. They reported improved survival. This is quite a remarkable claim and after a year is still awaiting confirmation. Until it finds support (and most such claims don't), I'll stand by my assessment as "doubtful". I was also very pleased to note that the new website has discarded the most egregious claims. We may hear more in the future about this intersting molecule, and I hope some use is finally found for it. In the meantime, I suspect that people who wish to experiment on their own may do so safely.

Follow-up (March 2006): Fucoidin is finding some use in tissue-culture work because it blocks a receptor the processes apoptotic white blood cells (J. Leuk. Bio. 74: 810, 2003). An attempt to use it to control neutrophil damage to the lungs in ARDS in animals was a failure (Anesthesiology 103: 996, 2005). An obscure school in Turkey reported a small study (two groups of five rats each) and felt fucoidin might help after smoke inhalation (Burns 29: 307, 2003); there has been no follow-up. There's still nothing to suggest that this is an up-and-coming treatment for any human disease.

September 2006: A correspondent concerned about the widespread promotion of fucoidin shared an abstract (was at the NIH, link is now down) from a Danish group. Taking fucoidin makes one strain of meningitis bacteria much MORE lethal for rats. I would not generalize this. This particular bug protects itself with a gooey capsule, and fucoidin is additional goo that probably just thickens the capsule and protects the bugs. However, it does shed some light on the claim about hundreds of articles showing how good the stuff is for you.

Fulvic Acid

This is presently being promoted as a cure for tumors, as part of a "colloidal mineral" regimen.

This is an obvious fraud and differs from most of the others because fulvic acid is not just a harmless placebo. Readers should know that

I predict (October 2001) there will be successful criminal and/or civil actions against the people who are selling fulvic acid as a nutritional supplement. Someone should go to prison for this.

Follow-up: No criminal prosecutions so far -- politics during the past ten years has been strange. Click here to find out what happens to a company that sells fulvic acid without using the right lawyer weasel-language. Click here for a business analyst's approach to the promotion of fulvic acid as a cynical investment fraud. In 2011, a bottled water company announced "black water", with just enough fulvic acid added to turn the water black. Find it yourself -- there's much about "nature's secret power" and so forth. This is appealing and some people will fall for this.

Gallstone Flush PESSIMISTIC

People who have gallstones, or think they have gallstones, are invited to "flush" them out by swallowing a concoction of 1/2 cup of olive oil, a big grapefruit, 4 tablespoons of Epsom salts, and three cups of water.

Interesting things will appear in the toilet bowl soon after. But I'm afraid that they're not your gallstones. Here's why:

  • Real gallstones are faceted polyhedra, like the ones in the picture on the links below, or else shaped like mulberries. What you'll get from the recipe are spheres. One of my correspondents describes a friend who saved the spheres and displayed them to his friends.
  • Real gallstones hurt bad when they pass through the cystic and common bile ducts.
  • Real gallstones sink in water. (As an autopsy pathologist, I'm very familiar with this.) The "gallstones" you'll produce from this recipe will float, as the "alternative thinkers" themselves point out. (They claim that real gallstones float, too. Liars.)
If you know a little basic chemistry, you'll realize what is happening. The Epsom salts are magnesium sulfate, and the grapefruit contains some complex carbohydrates. When these slosh around in the stomach and small intestine, they'll form a tough film that will encase drops of olive oil. This will produce some yellowish balls that will float in the toilet.

Hulda Regehr Clark, the author of "The Cure for all Cancers" and "The Cure For HIV/AIDS" promotes this. Since she claims to have both a doctorate in naturopathy and a Ph.D. in something (the latter implying having done substantial original lab research), one would think she would have made an experiment with a real gallstone and discovered that it sinks. There's a nice photo, which she stole from my friend, pathologist Ed Klatt MD. She calls them "such small stones" though they're obviously 7-10 mm across. She thinks the stones she displayed formed in the liver and "rolled" into the gallbladder, which is silly. You see many more stones in the gallbladder because that's where bile is concentrated and stored; if they all "rolled" there from the liver, we'd see much more biliary colic. She says gallstones "can be of any color", which is a hoot. She also claims that the major cause of gallstones is wearing shoes.

If you want to believe these people, that is your business. If you try the purge, please chew your grapefruit up thoroughly. Otherwise, you're asking for a gastic bezoar and a trip to the endoscopist to remove the obstruction.

    Gallstone cleansing: The premiere site is now down.

    The other site, from Hulda Regehr Clark, is finally down (2010). Much of the material on these two sites was identical though it's not clear who has borrowed from who. I generated a good deal of excitement over this in 2002.

Follow-up: April 2003. My notes on the gallstone flush have generated considerable "controversy". I look forward to a real surgeon taking these people on a visit to the surgical ward to see whether it's really true that 99% of people who pass a gallstone have no pain, or whether most gallstones sink or float in water. (The impurities make them heavy. They sink. If you have any doubts about who is massively ignorant, go ask any general surgeon or pathologist.) There are also photos, some of which appear to be real smooth faceted gallstones, and others showing shaggy surfaces that are obviously not gallstones. Instead of continuing to sling mud at me, these people should take somebody with ultrasonographically-proven gallstones, administer the "flush", and repeat the ultrasonogram. If there are now no gallstones, publish the finding in a non-refereed junk journal. The fact that nobody's done this invites the obvious conclusion. If you are presented with the physical results of a "gallstone flush", cut it in half. Real gallstones have concentric layers of colors often varying from pale yellow through black, sometimes with a center of radiating crystals.

The world is full of crooks. It's your money.

If you decide to take these people to court, I would welcome the opportunity to testify on your behalf. No charge. I'll bring several people's gallstones and show the court what happens when you put them in water.

Almost all real gallstones sink in water.

Follow-up: August 2007. My cyberfriend Marlene Curyer, who tells me she's not at all hostile to alternative health claims, decided to try the gallstone flush, complete with Chinese herbs. She also decided to take my challenge and get an ultrasound before and after a gallstone flush. "To say I was disappointed is vastly understating the case. There appeared to be more stones (my surgeon concurred). On top of that, I immediately felt worse... I have had pain and nausea on a daily basis since the last flush. Previously, these episodes had been uncomfortable but infrequent." Of course, to date no one has written me about a gallstone flush shown to have worked by real imaging. The mud-slinging on the message boards has also stopped. Thanks.


The familiar spice, Zingiber officinale. As an agent for control of post-operative nausea in day-care surgery, a ginger extract did almost as well as metoclopramide in one double-blind controled british study (Anaesthesia 48: 715, 1993, Kingston Hospital), but failed another miserably (Anaesthesia & Intensive Care 23: 449, 1995, from South Africa). A little study found an effect in controlling the nausea induced by 8-MOP in photopheresis (Derm. Nursing 7: 242, 1995). A few people have occupational skin allergy to ginger (Contact Dermatitis 35: 157, 1996; Cutis 52: 288, 1993). As an anti-platelet drug, ginger extract showed no effect in the most recent studies (Eur. J. Clin. Nutr. 50: 772, 1996, Dutch; Thrombosis & Haemostasis 71: 110, 1996, British). Ginger specimens obtained in ethnic food stores in the UK proved to be laced with a variety of fungal toxins (Food Additivevs and Contaminants 13: 833, 1996). A variety of other claims (anti-arthritic, anti-rhinovirus) remain untested in humans. "Ginger Jake", the Jamaican bootleg liquor that was laced with tri-ortho cresyl phosphate and permanently paralyzed drinkers during Prohibition, belongs to medical history.

Guaifenesin for FibromyalgiaDOUBTFUL

The familiar expectorant guaifenesin has a devoted following amomg self-help groups for fibromyalgia despite one negative study in 1996 (click here). The drug has some poorly-understood brain and muscle effects that are starting to be worked out (JABFP 17: 240, 2004; some obscure journals; it's used to anesthetize horses Vet. Record 149: 147, 2001; others). One writer who presents himself as a physician postulates a mechanism involving phosphorus homeostasis that does not fit what we know about fibromyalgia or the human body, and that he offers only as speculation. Otherwise there is nothing about the promotion that seems antiscientific -- no claims of persecution, no bizarre mixtures, no links to organized quackery. A known hazard of overuse is kidney stones (J. Alt. Comp. Med. 10: 967, 2004; Urology 63: 175, 2004). There has been one fatal overdose (guaifenesin was combined with two other cold remedies: AJFMP 20: 199, 1999).

Herxheimer Reaction

Over the years, I have had several correspondents who have written me telling they have gotten sick after taking some "complementary / alternative / holistic" remedy. (Most took fulvic acid.) They were told that they were experiencing the "Herxheimer reaction", that they were sick from toxic products from the bacteria killed by the remedy, and that they needed an additional remedy. Other names are "the healing crisis" and "the detox reaction."

You're being played for a fool. The Herxheimer reaction was well-known after a patient with advanced syphilis was treated with penicillin. The immune system reacted to the dead syphilis bacteria. It usually lasted only a few hours. In very advanced syphilis, it can last a few days and is managed with glucocorticoids (J. Neuroim. 18: 360. 2008). We are seeing it in the other spirochetal diseases -- Lyme disease, leptospirosis and borelliosis. Less than 1% of patients treated for borelliosis showed the reaction (Trav. Med. Inf. Dis. 7: 160, 2009), and severe Herxheimer reactions even in syphilis are now reportable. Not surprisingly (given that a Whipple patient has maybe a few pounds of bacteria on board), there's been one report of a Whipple's patient geting a herx-like reaction on initiation of treatment, which responded quickly to glucocorticoids (Gut 33: 132, 1992). I'd expect the same from bacillary angiomatosis.

In 1992, an Australian pathology group looked at the possibility that killing other bacteria (not just spirochetes) could release endotoxin and make people sick ("Antibiotic induced release of endotoxin: A reappraisal"; Clin. Inf. Dis. 15: 840, 1992), by analogy with the Herxheimer reaction and the tumor lysis syndrome. They came up with a "maybe." Anti-endotoxin therapy was a bust in subsequent years. This is the last I could find in the peer-reviewed literature.

The only place to deal with bunko artists is in a court of law, under oath -- not in "Wikipedia." If an "independent thinker" talks to you about the "Herxheimer reaction", "Herx", or "Jarisch-Herxheimer" because some phony remedy made you sick, contact a real physician, a good tort lawyer, AND your local district attorney. If you have been injured, I will take you case as a courtesy.

HIFU for prostate cancerOPTIMISTIC

It's difficult to know whether the use of computer-assisted high-intensity focused ultrasound for prostate cancer belongs here. Especially now that many more early, relatively non-aggressive prostate cancers are being detected by blood marker screening, there is interest in HIFU as initial treatment. This is genuine, done by real physicians, and journal articles are starting to appear (Eur. Rad. 20: 48, 2010); we await the results of the controlled studies that are now in progress. The hope is less morbidity and comparable cure rates compared to radiation and/or surgery. As a pathologist, I would not be surprised if this turns out to be the case. We'll wait and see.

Ionized Drinking WaterPESSIMISTIC

There is presently a heavy promotion for the new version of the old "water ionizer". The supposed scientific basis is so obviously untrue that I would be wasting my time and yours discussing the claims.

People want easy, comforting explanations, even if they aren't true. It is no surprise that many people are willing to believe that foods that we have been told repeatedly are "bad" (i.e., meat, alcohol, processed foods) are "acidic", that this is the basis of ill-health, and that a special kind of water can neutralize the damage. These are all sucker claims, and those making them are either scientifically illiterate or cynically scamming the public.

The people who brought this to my attention told me they were considering purchasing the device for $4000. That's a lot of money. Before you do this, please show the advertising material to a chemistry teacher at your local high school, or a local kid who passed the advanced placement chemistry test.

The promoters are unlikely to end up in legal difficulties because they make no real therapeutic claims, offer no real studies, do not tell people to ignore symptoms or refuse lifesvaing treatments.

Click here for a real chemist's explanation of this scam.

Iscador / Mistletoedoubtful

Mistletoe extract was tried by Rudolf Steiner in 1920 as a cancer treatment and named "Iscador". Steiner was a physician, moralist, astrologer, dancer, independent thinker, and much more. His "anthroposopy" movement still has followers, and interest in mistletoe was renewed in 2001 when actress Suzanne Somers opted for mistletoe instead of adjuvant chemotherapy (following surgery and radiation) for breast cancer. I trust that she had accurate information about the plusses and minuses of adjuvant chemotherapy. I'd be the last person to argue with any woman's educated decision to forego it after surgery and radiation for early breast cancer.

Particular plant extracts will probably have a variety of effects. No one has looked at the effects of injecting extract of grass clippings or V8 vegetable beverage simply because neither has been suggested as a cancer treatment by someone as likable as Dr. Steiner. Inject ground-up plant material, and somethiing will happen. In 2010, some folks at the Swiss "Research Institute of Organic Agriculture" (I know nothing else about them) reported a high-school-science-project level study of Iscador versus placebo showing a possible treatment benefit for horses with sarcoidosis (13 in each group -- J. Vet. Med. 24: 483, 2010) with p<0.5 (i.e., one chance in twenty of getting this good a result by dumb luck). The group reported on the "tumors", although the masses in sarcoidosis are known by every medical student in the world not to be tumors at all. A private lab ("Bradel Scientific Consulting") in Germany, where botanicals are very popular, found some activity on natural killer cells and published in a "complementary medicine" journal (Forschende Komplementarmedizin 17: 63, 2010). A group at University of Kracow, Poland, reported a small study on mice, which seem to produce fewer globulins of all sorts when given a big dose of mistletoe (they called it "effects of Iscador preparations on the reactivity of the mouse immune system" but it's simply basic hospital lab tests that when under-produced suggest compromised immunity; Neuroendocrinology Letters 30: 530, 2009).

A group from U. of Freiburg's "Center for Complementary Medicine" did a study in 2002 of injected Iscador, with placebo control. Everybody who had injected mistletoe got local reactions, which were more severe at higher doses (no surprise). Eosinophil counts increased in people who got injections if the lectins were there, and haptoglobin (the acute phase reactant) went way up in the patietns who were injected with mistletoe (i.e., the injections made them systemically ill). I am not making this up: see J. Altern. Comp. Med. 8: 857, 2002. Afterwards (Eur. J. Med. Res. 10: 411, 2005), the same group did a controlled study involving repeated subcutaneous injections over weeks of Iscador, purified mistletoe lectin, Iscador depleted of lectin, and placebo. People who were getting the injections of Iscador and lectin had increased neutrophils and eosinophils compared with controls, as well as more circulating interferon. The obvious conclusion is that the Center for Complementary Medicine is just making people allergic to injections of mistletoe. There were no "severe" side effects. If the "Center for Complementary Medicine" really believes it is onto something, we look forward to more studies with ragweed, marijuana, or poison ivy as controls / "prospective botanical cancer adjuvant treatments."

A welter of different effects have been reported, but there's no consistency as usually becomes obvious when something clearly works. Recently (Curr. Mol. Med. 10: 430, 2010), a German oncology clinic looked at its use as an adjunct to chemotherapy and claimed some overall benefits both to symptom control and overall survival time (the claim "overall survival" in the abstract is misleading, since no one survives advanced pancreatic cancer). The team admits to using "a novel methodologic pharmaco-epidemiological design and statistical approach" to what should have been a straightforward comparison of groups; the study was also retrospective despite being randomized.

There is a review of previous studies in BMC Cancer 9: 451, 2009), which emphasizes the very poor quality of the work and the publication bias (proponents will only publish studies that show some effect or other; this was confirmed by the statistical analysis itself). The group concluded:

Future studies evaluating the effects of Iscador should focus on a transparent design and description of endpoints in order to provide greater insight into a treatment often being depicted as ineffective, but highly valued by cancer patients.

No reasonable person woud argue. Mistletoe should be extremely cheap and happily nobody is reporting serious adverse reactions.

Lactobacillus acidophilusCONFIDENT

Taking powdered lactobacilli for painful diseases involving the gut, especially for "spastic colon", is a classic remedy with origins that are probably lost to history. It has always seemed effective but never had a believable explanation. No less distinguished a journal than Nature Medicine 13: 35, 2007 published research from France offering an explanation that I strongly suspect is the right one. The bacterium incudes the expression of mu-opioid and cannabinoid receptors on the cells of the intestinal epithelium, and works on the gut much as morphine would locally.

Leaky Gut SyndromeDOUBTFUL

For over a decade there has been a popular claim that increased permeability of the gut causes a host of symptoms, mostly subjective. On the face of it, there is no reason to think it is implausable, and it is entirely testable. An experimenter could choose a small, non-toxic molecule that is ordinarily not absorbed by the gut, and is cleared by the kidney if injected. It could be given by mouth, and the experimenter could then measure how much (if any) of the molecule appears in the urine.

A group of pathologists at the medical school at McMaster University (Ontario, Canada) became very interested in the popular claim. Their results appear in the journal Am. J. Physiol. Gastr. Liv. Phys. 280: G7-G13, 2001, a prestige journal for physiology. They found support for the common-sense idea that I've outlined above, and that evidence from the lab (tissue culture, animals) suggests that in various models, stress can make the gut leaky, a fact they could demonstrate easily.

Since then, evaluating overall intestinal permeability in this way has become routine in the scientific community. The preferred molecule seems to be sucralose ("Splenda", the artificial sweetener), which is not altered in the colon and is therefore an ideal way of assessing permeability of the whole gut (Ann. Clin. Biochem. 42: 224, 2005). The pop claim is still under study, with some good publications, mostly in idiopathic or severe liver disease. A Chilean group reviewed the claims and presented some new work (using the small-sugars sucrose, lactulose, and mannitol) in Hepatology 43: 715, 2006; they use the term "leaky gut" as a standard term. No less distinguished a journal than Nat. Clin. Pract. Gastro. Hep. 2: 416, 2005 reported work from Maryland on studies of intestinal permeability as a cause of idiopathic bowel disease; again, the term "leaky gut" is now almost standard. Finland's Public Health Institute has an animal model applicable to end-stage liver disease and the authors like the term "leaky gut syndrome" (Metabol. Brain. Dis. 20: 393, 2005). Whether "leaky gut" is cause or effect or both in Crohn's disease remains debated (Am. J. Gastro. 97: 1867, 2002). One mainstream journal published an article without new data that mentioned the "leaky gut" idea that's central to pop claims about vaccines and autism (Exp. Bio. Med. 228: 639, 2003); since no description of the anatomic pathology has been forthcoming As a pathologist, I remain profoundly skeptical. (I recognized that the original Wakefield article, which had no controls, actually described normal anatomy.) However, it's entirely possible that some poorly-understood illnesses (with or without demonstrable pathology) could be caused by increased intestinal permeability.

In April 2007, I used a search engine to find whether any "alternative and complementary practitioners" were using sucralose to confirm the diagnosis of "leaky gut syndrome". I did not find a single practitioner. What I found instead was a great deal of rhetoric by people who diagnose and treat "leaky gut" without any regard for what is now a standard, common-sense method of science.

Of course, many of the sites contained warnings about the evils of "Splenda" and "all artificial sweeteners"; these balance sites on the dangers of "refined sugar". You'll need to decide for yourself whether these are simply attempts to please people who want to feel intellectually and morally superior by telling their friends that that anything that is artificial and/or pleasant must be harmful. In reaching your decision about cane sugar, you can review what we really know about the way our bodies handle the various simple sugars, and then try to figure out why the "alternative and complementary medicine" community doesn't campaign equally hard against fruit juice and honey.

The right conclusion seems obvious. If a "complementary" practitioner diagnoses "leaky gut syndrome" without using what is now a standard, cheap test used by real-science labs around the world, put you hand tightly over your wallet. You are probably being offered a phony diagnosis, a generous dose of human warmth and attention that is unavailable from mainstream medical practice, and a bunch of expensive placebos.

Live Blood Cell AnalysisPESSIMISTIC

In June 1998, I was shocked and sickened by an E-mail from a man who believed his body was filled with parasites that would kill him. It turned out that he'd suffered from unexplained pains (maybe fibromyalgia) and had visited two "Live Blood Cell" testers. They showed him his blood on a video screen under darkfield (a spectacular sight for anyone). Between the red blood cells were various smaller structures that both practitioners told him were "parasites." One said they were "possibly rickettsiae".

I am well-aware of "alternative practitioners" who show people their own blood cells on a TV screen, along with "holistic" interpretations. (You can find the technique described at various fringe sites on the 'web, some of which say the pictures are best interpreted by "medical intuitivists", i.e., people who admit they're following no rules of fair evidence for interpretation.) But I'd never stopped to consider the impact this might have on a client.

As a pathologist, I'm very familiar with darkfield exams, and the fact that when blood is cooled slightly, proteins precipitate and form unpredictable patterns. These are a familiar phenomenon of physical chemistry. Brownian movement creates the appearance of purposeful movement.

These structures just aren't parasites -- or if they are, we're going to have to rethink everything we know about chemistry, physics, and the basics of biology. For starters, they have no nucleic acid -- the hallmark of all living things, and of all infectious particles except the non-moving prion molecules. Yet the poor fellow believed he was going to die -- based on what these people showed him on a TV screen.

Of course there are no articles in the refereed literature demonstrating any use for "live blood cell analysis." Now there are surely some micro-organisms that we haven't yet discovered. As a resident, I kept seeing wiggly little bacteria in ulcer craters, and pointing them out. We now know that helicobacter is the basic cause of common ulcers. Science is self-correcting. Since then, I've kept my eyes open for other bugs, and am open-minded about the current work on chlamydia and atherosclerosis. Of course, there are surely many exotic infections -- hantavirus, ebola, and many others -- and thankfully we recogize them fast enough when they occur.

So if you are involved in "live blood cell analysis", I understand how you got the mistaken impression that you're looking at undiscovered disease agents, and I ask you to stop deceiving yourself and the public.

Manipulative medicine (osteopathy, chiropractic)CONFIDENT

References to follow.


References to follow.

No-Dairy Diet for Breast Cancer PESSIMISTIC

A lady who claims to be a Ph.D. geochemist is currently popularizing the claim that "giving up milk is the key to beating breast cancer." Corresondents have told me avoiding cheese seems to be especially important.

If this individual is a scientist, then she knows how to do a pilot study or a retrospective epidemiologic study. Instead, she has taken her case directly to the public, even though she claims to have data.

Diet unquestionably plays a role in risk for some cancers, and it could be important in breast cancer. Whether diet could possibly effectively treat an established cancer is less clear. One recent study on breast cancer and cheese is in Nutr. & Cancer 38: 151, 2000. The group at the National Public Health Institue in Helsinki looked at conjugated linoleic acid and concluded, "A diet composed of CLA-rich foods, particularly cheese, may protect against breast cancer in postmenopausal women, but it is impossible to assess the independent effects of CLA in this study." Not surprisingly, the next group to study the effect, the Dutch epidemiologists at Zeist, found a "weak positive" correlation between breast cancer risk and conjugated linoleic acids, and concluded only that they could not confirm the Finnish results. The Uruguayan government did a retrospective questionnaire study of breast cancer patients, and their multivariate analysis (published in the obscure Eur. J. Cancer Prev. 11: 457, 2002) found "significant" increased risk of breast cancer with whole milk, chocolate milk, and Gruyere cheese, and "significant decreased risk" from ricotta cheese and skimmed yoghurt. This kind of study is notorious for producing bogus results and there has been no confirmation. The folks at the Cancer Prevention program at Duke actually examined the claim in a real paper (Am. J. Clin. Nutr. 80: 5, 2004) and concluded "the available epidemiologic evidence does not support a strong association between the consumption of milk or other dairy products and breast cancer risk." Harvard (JNCI 94: 1301, 2002) found no relationship between dairy product intake and breast cancer risk whatwoever. A group at Bethesda (JI 90: 226, 1998) examined the pop claim that eating a lot of fatty foods / dairy products during the teens puts a woman at significantly increased risk for breast cancer; it evidently doesn't.

There has been no published study of the effects of a non-dairy diet (or even a vegetarian diet) on breast cancer once it has actually developed. The author of the pop claim states she has friends in Mainland China who can show a striking correlation between milk consumption and breast cancer risk, but no one is publishing, not even in the junk journals.

A new version of the pop claim includes the claim the bovine growth hormone is a breast cancer risk. This is just a lie -- the hormone is biologically inactive in humans (J. Am. Coll. Nutr. 24(S6): 556-S, 2005).

It is not surprising that the main website that I found promoting the dairy-and-breast-cancer claim also carries a banner ad for a colon cleanser.

In considering this author's claims, please remember that it takes only a few moments to form an impression, and years to refute it. When subjects as emotional as breast cancer and diet are under consideration, these claims are easy to understand.

Oleander Soup DOUBTFUL

Oleander soup is being promoted on several websites (2005) as "cancer's natural enemy", along with the familiar talk about a vicious conspiracy by organized medicine to suppress the truth.

The oleander plant itself is a deadly poison, killing its human and animal victims by the same mechanism as an overdose of digitalis. In Sri Lanka there are so many deaths that one can actually do big-sample statistics (Lancet 362: 1041, 2003) on the cost-effectiveness of various treatment strategies. So if you plan to ingest the substance, be sure you know what you are doing.

Three articles, all in obscure journals, mention properties of some ingredients of the plant. J. Nat. Prod. 68: 198, 2005 describes three new terpenes and reviews the dozen that are already known. Some of them slow the growth of cancer cells in cell culture, probably simply because they're poisonous, period. Like many other componds, they're ICAM inhibitors and hence might be anti-inflammatory. Oleandrin is a cardiac glycoside and turns out to suppress activation of nuclear factor kappa beta and activator protein 1 in cell cultures (Bioch. Pharm. 66: 2223, 2003; Cancer Res. 60: 3838, 2000, from M.D. Anderson). This is also the poisonous component, so it would be impossible to separate the heart poison and the "anti-cancer" activity from the soup.

The only animal study is from Turkey and it's on oleander as an anti-inflammatory for skin problems (J. Ethnopharmacology 89: 123, 2003).

The patented hot-water extract is called "Anvirzel" (Ozelle pharmaceuticals). One of my correspondents tells me that this has been FDA-approved for compassionate use (i.e., an unproven-but-probably harmless substance okayed for political reasons). Its proponents are impressed by the fact that a researcher at M.D. Anderson (Robert Newman) has written about it. One group (Anti-Cancer Drugs 11: 455, 2000, Newman is co-author) applied the extract to four cell lines. It was toxic to the two human lines and not to the two animal lines. Obviously this is too few cell lines, but they wrote, "From these results we conclude that Anvirzel and Oleandrin act in a species-specific manner." I am very surprised that anybody published this. "Annie Appleseed" writes, "Extensive in vitro research has been conducted by Dr. Robert Newman, Chief of Pharmacology MD Anderson Cancer Cener, Houson, Texas. Dr. Newman has tested ANVIRZELTM (sic.) against a broad spectrum of human malignant cell lines, has demonstrated that ANVIRZELTM has a high order of efficacy." Either this is a shameless lie or Dr. Newman didn't publish what would have been very interesting data. Another paper from Dr. Newman's team looked at the prostate cancer cell line and found that Anvirzel was a radiosensitizer (Cancer Letters 185: 145, 2002), as a caspase-3 activator, like other medicines. Accoring to Bioch. Pharm. 62: 469, 2001, Anvirzel was undergoing phase I clinical evaluation as a potential treatment for cancer; the authors mention that the cardiac glycosides in Anvirzel block fibroblast growth factor 2 production by a human cancer cell line, similar to other models of cardiac glycoside activity on FGF-2, which is somehow tied into the sodium-potassium pumps on which they work. There's another paper from Newman/M.D. Anderson (J. Exp. Ther. Onc. 2: 278: 2002), describing the pharmacology in mice, with no reference to any anti-cancer activity. This is slim pickings, especially in an institution like M.D. Anderson where the research piranhas will grab up anything that looks promising. You will need to ask the remedy's proponents what happened to the clinical studies.

To their credit, the oleander soup proponents warn patients against eating raw oleander, which the acknowledge is poisonous. Since the poisons are glycosides, they are probably destroyed by heating. I've heard of no fatalities yet.

Nobody has reported looking at oleander as a cancer remedy for lab animals, even for publication in a junk journal. This is despite many other herbalists who do try this sort of thing. As they talk about massive conspiracies against the health of the public, the oleander soup proponents are trying to get people to eat a well-known deadly poison without even trying it first on animals.

If you want to try oleander soup, it's your decision.

Plasma Generator PESSIMISTIC

The prototype is the "Rife Type Plasma Generator" (my link is now down), an adaptation of a device used by an independent thinker in the 1930's as a treatment for cancer and other diseases. I felt this link deserved attention, as it describes the survival of a patient with liver metastases who was reportedly told she had only a very short time to live, and who has survived for about a year. There's no controlled study, one-year surivals in patients with liver metastases are not extraordinary, and I cannot think of a plausable mechanism. Although I am pessimistic about this device actually proving itself by the usual methods of science, I am impressed by the obvious sincerity of the proponents at this site, and their detailed, candid reporting of what seems to be a genuine patient story. For this reason alone, I'd urge you to visit and see an example of how this kind of thing SHOULD be done.

RECAF for Cancer DiagnosisDOUBTFUL

A company called "BioCurex" is offering the public a series of tests for cancer based on the claim that the receptor for alpha-fetoprotein is widely expressed on malignant cells but not on benign cells. The site is filled with information for investors, and I've had inquiries from members of the public who want to be tested. The site claims (February 4, 2008) that "results have consistently proven that BioCurex successfully detects over 90% of all cancers in blood or tissue samples -- levels significantly above any present method." There are descriptions of presentations at open scientific meetings, but I could not find any peer-reviewed papers, accepted or published.

Click here for a copy of the scientific paper, which I downloaded on February 4, 2008. The results are sensational, and if they are correct, will certainly find their way into the peer-reviewed literature soon. There are 61 citations, but none with a title that seems to suport the claim that this is a tumor marker -- able to distinguish benign from malignant cells -- and a possible therapeutic target that has been successful in animals. Interestingly, BioCurex claims to be in collaboration with Abbott Labs, but clicking their link to Abbott's supposed news release about the relationship reveals "no results." One problem that I have with the paper is that the pathology photos are all in black-and-white, making them un-interpretable. Since this is a .pdf document, it would have been every bit as easy to have them in color. Photo 3B, which supposedly illustrates a tiny metastatic focus against a non-staining normal background, also appears to show massive, intense staining of what looks like the benign lymph node connective tissue structure.

In 2008, I have contacted the company and expressed an interest in working with them to assist in evaluating their claims can withstand scrutiny by the usual methods of science. As a pathologist, it would be a simple matter to confirm or refute the claim, made in the review, that cancers stain and non-cancerous tissue does not stain. All sections taken from resected cancers contain benign cells. There are always tumor blood vessels, and usually surrounding normal tissue. It would be a simple matter to stain one section from each of perhaps 100 known cancers, from the local hospital pathology lab. If the company's claim is true, then most of the cancers should light up, without any staining of the benign cells either within or adjacent to the tumor. This is normal procedure for pilot-studying a proposed new immunostain.

I was able to find (again, Feb. 2008) only two peer-reviewed articles applicable to the subject. One is from Tum. Bio. 27: 283, 2008, from a Japanese group that found a high level of expression of alpha-fetoprotein receptor in gastric cancers. An article from Expert Review of Anticancer Therapy 2: 709-735, 2002 (this is an obscure journal of which I'd never heard before) deals with alpha-fetoprotein in cancer, but simply states that there's now an agreement that a receptor exists. This isn't original work, but a review with a great deal of speculation here about possible future directions.

The company has the integrity to note, in the report, that its findings remain to be independently confirmed. Since it is soliciting investors, we can hope this will happen soon.

As a physician concerned about the well-being of the public, I must caution visitors simply to avoid basing any major health decision solely on the results of a "RECAF" test for cancer.

Follow-up (August 31, 2008): Despite their expressed eagerness to have independent review, the promoters have not responded to my e-mails.

Follow-up (July 6, 2011): A correspondent pointed out that the promoters have a scientific article out, in "Tumor Biology", published online May 28, 2011. The company's web-page states that it was peer-reviewed and cites excited comments from two peer-reviewers, but it was accepted two days after it was received. You are free to evaluate these claims yourself, or review them with your physician. I have a few open questions:

  • It seems a little strange that the mean and median levels of RECAF in the blood of low-stage ovarian (I am assuming) cancer patients are higher than that of advanced-stage cancer patients. This is unlike any other tumor marker.
  • The authors have the integrity to note that for a cancer marker to be useful, its levels in healthy people cannot have much overlap with levels in people judged to be sick. In fact, this is one reason that screening for ovarian cancer with CA125 has been a bust. However, the overlap between RECAF in normals (0.031 to 7.421) and cancer patients (1.917 to 17.216) speaks for itself. To their credit, the authors acknowledge this and the paper is about using RECAF simply as an adjunct to the clinically useless CA125 test. (I hope I am interpreting the table correctly, since there are commas where it looks like there should be decimal points.)
  • The authors describe their work twice as a "retrospective case-control study." Nothing that I could find in the paper indicates that this is true. No attempt was made to match the "healthy women" who provided the control sera with the women with the ovarian cancer. In fact, we do not even know whether the groups were of comparable ages, ovarian cancer being mostly an older woman's disease. Click here to learn what a real case-control study is, then decide whether the authors are representing their paper truthfully.
  • Since the investigators (the Pacific Biosciences Research Center) is in Richmond, British Columbia, Canada, it's a little surprising that the blood tested was "collected and processed at the N. N. Blokhin Cancer Research Center in Moscow".
  • There are about a dozen common types of ovarian cancer, easily distinguished by microscopy. The authors will want to look next at the influence of cancer subtype of RECAF levels.
  • There is nothing any more about their antibody being useful as a stain for cancer cells. Perhaps the group has reconsidered this claim.
  • Look back at the group's past claim that their test picks up 90% of cancers. A glance at Fig. 4 shows that with the chosen specificity cutoff, only half of the ovarian cancers would have been detected. (Of course, anyone can design a test that will be positive in 90% of cancer patients if the cutoff is set very low and almost everybody with or without cancer tests positive. To their credit, the group has done further work and are now trying to find a useful cutoff level. Whether they have succeeded is for you to decide.)
I think I'm a pretty good judge of character, and this work appears to be that of decent, fair-minded, people who think they have something that may be useful. On the evidence, no other group is interested enough in RECAF to try to confirm the results. I will remain at best "doubtful."

Relaxin TabletsDOUBTFUL

The pregnancy hormone relaxin is presently being offered for sale in pill form.

The hormone has a host of interesting effects, and may someday find therapeutic uses in humans, especially in scleroderma.

However, relaxin is a protein and when it hits the stomach, we sould expect it would be almost entirely destroyed. (This is why you can't take real insulin in pill form.) A search (April 2006) of the NIH database showed 30 animal experimental models in which relaxin is used. In every instance, the substance is administered directly into the tissues, typcially by mini-pump or intraperitoneally. No one is administering relaxin orally.

The relaxin manufacturer claims that because women note breast tenderness, nausea, and/or increased menstrual flow, it is proof that the hormone is absorbed. However, there are no placebo controls, so assuming cause-and-effect in an unblinded study is sub-science. If the relaxin salespeople really believe that their hormone is absorbed orally, it would be a simple beginning to give somebody a few relaxin tablets and measure blood relaxin levels afterwards. If significant amounts of the peptide are actually absorbed, it would be so surprising that many medical journals would rush to publish it. It's not impossible that there really is absorption. So far, there's been nothing.

This fact alone tells me that its proponents don't really believe their own claims.

Let me know if I've missed an article, or if something does get published. A high school kid, working with a university lab, could determine experimentally whether relaxin is absorbed orally. Its proponents obviously haven't. In the meantime, it's your money.

Salivary Crystallization Testing

This is presently being promoted by a lab in Oregon as a way of diagnosing disease. The patient's saliva is dried and examined under the microscope. (This resembles the bona fide test in which cervical mucus is examined for the ferning that suggests ovulation.) The literature states that this is a classic, mainstream, generally-accepted test. This is simply not true. There used to be a Lithuanian site (www.arborita.lt) talking of a study in which women were questioned about their phase in their cycles, and then tested by salivary crystallization. Total numbers matched fairly well, but the authors do not state the tests results matched the clinical data for individual women. No trained scientist would omit this critical piece of information. They also sell a kit. The site operator explains that if you see a pattern you don't expect, just repeat the test until you get what you want. Can you believe that? I'm sorry the link is no longer up -- it speaks for itself.

Selenium and Vitamin E for Osgood-Schlatter'sDOUBTFUL

There is a current (2011) promotion of vitamin E and selenium for Osgood-Schlatter's, the very common situation in which a painful bony lump forms at the insertion of the quadriceps tendon onto the upper front of the tibia, typically in an athletic teen. The medication is inexpensive, the promoters do not talk about long-term needs for the supplement, and it may be sold with an affordable brace.

I could find nothing to suggest that Osgood-Schlatter's has anything to do with vitamin E deficiency or selenium deficiency. The one refereed journal article I could find was from a Czech group in Physiol. Res. 56: 243, 2007. A small group of experimental animals with experimental osteochondritis of the knee were given either a placebo or a mix of glycosaminoglycans, vitamin E, and selenium. Synovial fluid composition was different and microscopic healing seemed faster in the treated group. The lesions in the animals aren't Osgood-Schlatter's as this doesn't involve synovial fluid. Further, it's no surprise that supplementing glycosaminoglycans speeded healing in a model involving pathology within a joint space.

I would simply urge visitors not to spend too much money on this, but thankfully its proponents aren't asking for much. Osgood-Schlatter's generally gets better by itself on the standard rest-immobilization-cold-elevation treatment (the value of which is recognized in the promotion), or on no treatment. It may not be evidence-based, but these people seem decent. You decide.

Ozone (selected applications)OPTIMISTIC

During the past decade, there has been some interesting work on ozone for a variety of illnesses. Ozone injection into herniated disks has been tried extensively and was found helpful by a group of reviewers in Sao Paulo (Pain Physician 15: E115, 2012) which is not surprising. As an oxidizing agent, it's found use in periodontics (J. Med. Life 5: 59, 2012; as a treatment for caries it seems to fail Dental Update 39: 275, 2012). It's no surprise that it seems to help diabetic foot ulcers (Diabetes Tech 13: 1255, 2012) and genital infection in cows (Repro. Dom. Animals 47: 293, 2012). It's not surprising that this free radical is helpful in a mouse model of acetaminophen toxicity (Env. Tox. 34: 81, 2012). Life has taught me that claims that are too good to be true (an Egyptian group reports disappearance of hepatitis C from the blood on ozone treatment -- J. Alt. Comp. Med. 17: 259, 2012) probably aren't true; you can watch this. You'll need to decide for yourself whether the changes in blood levels of malondialdehyde and so forth after breathing ozone reflect a beneficial effect in preventing oxidative damage (Irish J. Med. Sci. 180: 703, 2012); there are a host of other studies showing that inhaling ozone cause one or another blood parameter to go up and down. With today's proteomics, a group claiming that ozone "appears to activate critical longevity genes that can prolong survival" (Curr. Aging Sci. 3: 177, 2010) has a great chance to prove it and we eagerly await more. (Perhaps a model of increased longevity in lab animals?)

I stand by my statement that ozone therapy for cancer and HIV is a cynical fraud. As of 2012, in a field full of militants, I could not find a single refereed paper on ozone and HIV, or anything suggesting ozone suppresses the growth of cancer cells. Even the Italians writing in J. Alt. Comp. Med. 11: 257, 2005, who believe the "alternative" claim that cancer cells overgrow because they survive hypoxia better than normal cells, acknoweldge the failure of all previous "oxygenation approaches". Cancer patients will be told of the obviously-false "Warburg" cause of cancer (cancer cells carry out less oxidative metabolism than healthy cells -- we know why, and this isn't the cause.) They may then get the idea that ozone, being a variant of oxygen, will help. Hydrogen peroxide and ozone generators are cheap. There's not even a mouse model.

Death from ozone quackery: Am. J. For. Med. Path. 21: 144, 2000.

Serratiopeptidase DOUBTFUL

Serratiopeptidase ("serrapeptase") is a serpin protease made by serratia bacteria. Interestingly, it's produced by these microbes in a silkworm's gut and allows it to dissolve its cocoon. There are various claims over the past forty years that it is an anti-inflammatory. A study on dental inflammation and pain proved serratiopeptidase to be a complete and utter failure (Int. J. Oral. Max. Surg. 38: 350, 2009). Since there are companies that are built around the substance and they want to survive, it's now being promoted instead for atherosclerosis. One Japanese woman taking "Serrapeptase" was allergic and became severely ill (Japanese article UI 19348276).

If you're offered serratiopeptidase to be taken by mouth, you are being played for a fool, as the protein will dissolve in the gut. In fact, even to get it rubbed into a wound (where it could conceivably help healing by disrupting problem proteins), it has to be encased in alginate microspheres (Artificial Cells 39: 44, 2011). Two groups found it could be delivered orally by engineering a special aquasome (Nanomedicine 6: 419, 2010) or microsphere (J. Microencapsulation 26: 306, 2009), but no therapeutic claim was made -- the authors were simply looking at a way to get proteins past gut digestion.

The molecule is being studied as a way of keeping staphylococcal and listeria biofilms off indwelling medical devices; of course, it's injected to cover the device, not taken in pill form (Int. J. Immunopath. 24: 661, 2011; Microbial Pathog. 45: 45, 2008; J. Bone Joint Surg. 88: 1208, 2006). A gel to treat periodontal disease, which is caused in part by biofilms, is under study (AAPS PharmSciTech 7: 76, 2006).

Shark Cartilage PESSMISTIC

The account in the "Skepical Inquirer" (Sept/Oct 1997, p. 44) reviews the claims of "countless positive reports of tumor reductions from patients using only BeneFin shark cartilage"; according to the author, all that has actually been forthcoming is three studies in which "virtually all patients previously received either chemotherapy, surgery, radiation, or some combination thereof." The article describes only a no-controls study in which cancers look different under the microscope before and after administration of shark cartilage.

Lott told me that his work showed only that the three products yielded slides of the magnified tumors that looked noticeably different from each other.
It's no surprise -- cancers are notoriously protean, and if you sample different portions of the same tumor, even on the same day, the differences will impress a non-expert, including many physicians.

The current fad for shark cartilage has done major harm to some shark populations, especially in the Caribbean. Environmentally-conscious people in the industrialized nations who deplore the hunting of rhinos and tigers for use in quack remedies should remember this when they are considering trying this (frankly silly and obviously deceitful) "alternative remedy". Joe Marcus, graduate student at Harvard's Biological Anthropology program, put it this way in a note to me: "Consuming shark cartilage preparations for unproven medical benefits might seem to be a harmless waste of money -- but it poses a serious threat to the ocean ecosphere."

Sharks do so get cancer. FDA Consumer July-August 2000, p. 7, from Hopkins & GWU.

Silver Colloid PESSIMISTIC

I would be remiss if I did not warn visitors about this insidious health fraud.

Silver-based preparations are a mainstay of burn care. It is quite possible that ingested silver has some effect against minor infections. A few years ago, the mayor of a Florida town tried to distribute it widely as part of a campagin against HIV infection.

If you use these remedies, which are still available over-the-counter, you will accumulate silver in your body. There will be no way to get rid of it. There are two serious complications.

  • Argyria, and

  • Massive brain damage.
In the present political climate, it is unlikely that colloidal silver will be banned in the United States. Still, the FDA emphasizes that isn't a shred of non-anecdotal evidence that it works (J. Tox. 34: 119, 1996; Federal Register 64: 44653, 1999).

Argyria turns the skin permanently gray-blue, causing serious disfigurement. Websites promise this won't happen, but it's a lie. I have had three correpondents with argyria write me asking for help. I could offer none. In one case, I offered to help DFS take a kid out of a home where he was being given colloidal silver. You can read about argyria in Cutis 66: 373, 2000; Clin. Exp. Derm. 28: 254, 2003; Int. J. Derm. 42: 549, 2003.

The neurology team at Western Ontario published (Neurology 62: 1408, 2004) an account of a colloidal silver enthusiast who over the course of four months brought his levels tremendously high. He developed myoclonic status epilepticus (i.e., uncontrollable, never-ending jerking of his body), and progressed into coma. He went into a persistent vegetative state and was allowed to die 5.5 months later.

Colloidal silver is of unquestioned value in wound and burn care. People will continue to draw the erroneous conclusion that drinking it must be good for you, too. I urge you in the strongest terms not to ingest colloidal silver. Call me unspiritual if you want.

Follow-up: The fad seems to have died down, with only a few companies promoting colloidal silver for oral intake and an average of only one report per year of people giving argyria to themselves or their children. For a massive review of silver's interesting antimicrobial properties, including its use in wound care, implantable prostheses for heart and bone, and even in clothing and bedding for the sick, see Curr. Prob. Derm. 33: 17, 2006 (from the venerable Charing Cross hospital).

Sodium Bicarbonate for Cancer PESSIMISTIC

A Dr. Tullio Simoncini of Rome, who styles himself an oncologist (i.e., a cancer specialist), has decided that doses of sodium bicarbonate, the familiar baking soda already used by mouth and intravenous injection in medicine, will cure cancer. He believes that cancer is caused by infection with the fungus candida, and that sodium bicarbonate will make the cancer regress by destroying the fungus that grows with it.

This does not square with my thirty years experience with both cancer and candida. The English site reads, "Based on years of scientific and clinical research, at the centre of every cancer tumour is a common fungus, Candida albicans." Candida is very easy to see through the microscope, and I've very rarely seen it within a cancer, or heard of anyone else seeing it. I'm afraid I do not understand the reasoning or experience by which Dr. Simoncini arrived at his conclusions. So far as I can tell, this is a bald assertion. Click on the link "candida and cancer always concurrent" and you'll find a reference stating only that one author found candida somewhere in the tissues in 79% of cancer patients (which doesn't surprise me, as the fungus is ubiquitous and tends to overgrow especially people who have gotten antibiotics and/or been in the hospital). The common yeast infection that women often get, and the familiar "oral thrush" of babies is candida, yet most of these people do not have cancer so the statement "candida and cancer always concurrent" is perhaps just one of the errors in English that the site contains. There are the usual anecdotal accounts of wondrous cures. To their great credit, his friends acknowledge the need for proper research and clinical trials. They are soliciting donations, but in a low-key sort of way.

On the "frequently asked questions" page, Dr. Simoncini asks my question for me: "Why did he not publish in scientific magazines?" His answer is, "He has always been crossed by official authorities. Moreover many articles have been published in the press about his therapy. Now a series of cases in his clinic must prove that his therapy works."

I think I have some sense for people, and it seems clear to me that Dr. Simoncini is motivated by altruism. He cannot profit on sodium bicarbonate, and has staked his reputation as a physician on something in which he clearly believes. He has nothing to gain, and much to lose, by pursuing independent medical thought. He is himself aware of this (click here). Today (August 21, 2008), I am sending the following e-mail to Dr. Simoncini. It is my hope that he and I can work together.

Dear Dr. Simoncini:

As a pathologist, I read about your work with much interest. My own experience leads me to be pessimistic about your main claim about the cause of cancer. But I am fascinated by the deep mycoses, and have always wondered about the impact of fungi and other gut flora on health.

I am very sorry to read that you have not published because you have "always been crossed by official authorities." I trust you have something, presumably some animal work, and some papers that were rejected by peer reviewers. I could review these and with your permission make them available to the public.

In the United States, I believe that no new therapy is tried on humans until there is a promising animal model. I've also learned that much in science can happen by serendipity. If you have papers for which publication was refused, would you please send them to me along with the rejection letters? This will surely convince others of your sincerity.

In the meantime, I am letting others know I have written you. Although I believe it is a long shot, I hope you are right.

Follow-up: August 24. Nothing from Dr. Simoncini yet. It is my understanding that Italy, like the USA, requires that all human studies be approved by an Institutional Review Board. I would invite prospective donors to inquire first what Institutional Review Board he has approached so that his study will be in compliance with the law. You may also want to ask why successfully eradicating a candida infection in a cancer patient, which is commonplace in the clinic, doesn't cause the tumors to shrink.

Follow-up: September 7. Still nothing. If I hear, of course I'll post his reply.

Tauroursodeoxycholic acid for bodybuilders doubtful

A bile acid is presently being promoted to bodybuilders who have taken anabolic steroids and are concerned about liver damage, especially peliosis. It is suggested that tauroursodeoxycholic acid can reverse damage, and specifically that it will increase the excretion of glucuronide metabolites of anabolic steroids which are supposed to be the molecules that cause the liver damage.

I'm a pathologist, not a pharmacologist, but a literature search for the past ten years did not turn up anything to support the claim that glucuronides are the active species in anabolic steroid hepatotoxicity. Nor are these claims supported by the referenced journal articles. The closest one, J Pharmacol Exp Ther. 2003 Jul;306(1):279-86 examined ursodeoxycholate, which is known to prevent cholestasis due to ethinylestradiol (a female hormone), and concluded that seems to do so by preventing its glucuronidation. It's entirely possible that the bile salt now being sold could do the same thing for anabolic steroid users. Other medications that cause cholestasis aren't nearly so noted for causing peliosis or adenomas as the anabolic steroids are, and the claim in the advertising that all of these have a common molecular origin seems to me to remain unproven.

Obviously, the next step is an animal experiment, like the one described above. Again, my search shows nothing of the sort.

I could find nothing to suggest that tauroursodeoxycholic is unsafe. Several peer-reviewed scientific articles have suggested value as a neuroprotective agent in stroke, Huntington's, and macular degeneration of the eye. Ital. J. Gastro. Hep. 31: 462, 1999 describes a study in which tauroursodeoxycholic acid given for the year following liver transplant caused no harm but showed no beneficial effect. Hepato-Gastroenterology 47: 1045, 2000 found the substance helpful in managing both ongoing liver cell destruction and cholstasis. In 2003, Cochrane's Database found bile acids to lower transaminases in hepatitis. Tauroursodeoxycholic acid was a miserable failure in a trial as a hepatoprotective agent in children on total parenteral nutrition (J. Ped. 141: 237, 2002).

Like it or not, anabolic steroid use is widespread. Tauroursodeoxycholic acid is safe. There is not yet any good evidence that it will help with cholestasis; however, this may be forthcoming, and in the meantime it's probably good that it's available. It is less likely to prevent or treat peliosis or adenomas.

Tea tree oil for acne confident

This is a covering agent with some biologic activities, and intensively studied by biochemistry types. It is widely used for acne, and in a good placebo-controlled study it was strikingly successful (Indian J. Derm. 73: 22, 2007). This strengthens some older work and I'm now ready to go with "confident". No one has looked at whether it may be synergistic with benzoyl peroxide (the best over-the-counter remedy), topical clindamycin (which requires an Rx), or topical retoinoic acid derivatives (which can be pricey).

The substance has also found use for scabies and otitis externa. It's a phytoestrogen and has caused gynecomastia in prepubertal boys.

Thymic Extractpessmistic

An over-the-counter remedy consisting of oral thymus tissue is being promoted for patients with hepatitis C. Injected interferons derived from thymic lymphocytes are a mainstay of hepatitis C control. More generally, it's being offered as a way of "rejuvenating" the immune system and so forth.

Any interferon, or any other thymus-derived protein, hitting the stomach is going to be digested into amino acids rather than getting into the bloodstream. And thymus isn't likely to contain much interferon anyway.

Ethics would require that thymic extract for hepatitis C be tested first on patients for whom conventional therapy had failed. This has been done. Not surprisingly, the thymic extract failed miserably (Ann. Int. Med. 129: 797, Nov 15, 1998).

A single favorable report on oral thymus extract (J. Vet. Med. Sci. 61: 811, 1999) comes from an obscure, third-world medical school, and it was done on just-hatched chickens. A group in Poland uses the stuff, but injects it. The current sites promoting "Thymic Protein A" are full of basic stuff about the thymus and the immune system, but aren't going to tell you the truth. One has to wonder whether these people are knowingly deceiving the public.

UPDATE (2008): Thymus extracts are still around, and are occasionally covered, mostly in obscure Eastern European journals. Genuine products include "thymomodulin" (an extract that's approved in Italy for oral or injected use), "thymostimulin" (an extract of peptides given by injection) and "thymus factor X" (an injectable extract). Most recently, injected thymostimulin has progressed to human studies as a palliative for end-stage liver cancer.

There are still sites promoting "thymic protin A". This is not a protein recognized to exist by the mainstream scientific community. A search of the NIH database shows no references to the substance. In other words, thymic protein A has been sold for around a decade without anybody showing by the usual methods of science that it even exists. Today, you can buy pills of the "purified" protein that are supposed to strengthen weak immune systems to fight infection, and weaken overactive immune systems causing autoimmune disease. Even the sites remark on how marvelous this is. An interview with the "discoverer" suggests the fact that he was awarded a patent makes his discovery valid. The principal site has the endorsement "the best single immune system supplement available", from a man who directs a "research center" linked to obvious disinformation mills. The blurb states "Two studies were completed one involving chronic fatigue syndrome (CFIDS) which showed improvement both clinically and by diagnostic testing, the second study involving Epstein-Barr (EBV) patients, it also showed improvements both clinically and by diagnostic testing." Everyone makes errors in grammar, but I believe the author is also being deceptive. The studies are not referenced, but I tracked the first to the "Journal of Nutritional and Environmental Medicine", which is not a scientific journal recognized by the NIH; there are no controls described to rule out the placebo effect, and the study was paid for by the manufacturer of "thymic protein A". The interview the the discoverer indicates that the Epstein-Barr work was an unpublished "pilot study." Once again, it's your money.

Turkey Tail Mushroom for Cancer DOUBTFUL

This mushroom ("Coriolus versicolor") has been promoted by Dr. Weil and others as able to stimulate the immune system to fight cancer. Whether or not you believe in this kind of thing in principle(most immunotherapies for cancer have been total failures), you should know what is and is not known about this fungus before you invest a lot of money or hope.

I had not heard of the International Journal of Medical Mushrooms before finding a journal reference (13: 227, 2011) confirming that even very large doses of the mushroom's extracellular polysaccharopeptides given orally seen non-toxic to mice. There is a single too-good-to-be-true paper on Plos One from the department of anatomy at Hong Kong looked at a strain of mice that spontaneously develop prostate cancer. Reportedly, all untreated mice got cancer and no treated mice got cancer. The extract was provided by "Wonder Herb Health Products", and the authors did NOT declare any conflict of interest, which in 2011 is bizarre. Click here for the paper, which also contains some not-at-all-surprising information about alterations in cells in tissue culture. Like many other substances, adding it to a tissue culture annoys macrophages (J. Medical Food 9 175, 2006). Andrew "Balanced Living" Weil based his endorsement on a non-peer-reviewed presentation at the International Conference of the Society for Integrative Oncology reporting "improved immune response" in cancer patients given the mushroom. Click here for the paper. All that you'll find is that in a tiny study prone to the effects of small-sample statistics, a few women in the high-dose group had more T-killer cells on board. The authors' own strong words of caution got ignored by Dr. Weil.

The stuff has been around for a long time and is probably harmless. Its proponents talk darkly about turkey-tail mushrooms being unpatentable and therefore of no interest to the hated pharmaceutical industry. If the wonder-mushrooms actually worked, the research piranhas would probably have grabbed "turkey tail" up as they've done for other non-patentable botanicals such as vincristine and taxol. It's your money.

Ultraviolet Blood Irradiation (non-standard uses) DOUBTFUL

Phoropheresis of blood is established in the treatment of T-cell leukemias that attack the skin, and hard-to-treat heart transplant rejection. There are a few other T-cell-based illnesses for which the technique may be useful. The leukocytes are removed, treated with psoralen, irradiated, and reinfused. Well and good.

Some alternative practitioners are currently removing blood, irradiating it with ultraviolet rays, and reintroducing it into the circulation for other illnesses. All publications have been in obscure Eastern European or Communist Chinese journals, with only English abstracts available. The original contribution (Fol. Hem. 109: 470, 1982) is a study of the technique in severe angina, without any controls. The report is, frankly, bizarre. The authors claim that every one of the patients who went on to have a myocardial infarction developed elevation of antistreptolysin antibodies, and that these went down in response to therapy. Since other enzymes, but not antistreptolysin O, usually become elevated post-MI, and go down with or without treatment, something is obviously wrong here. The authors go on to say that "the mechanism of action of ultraviolet own [sic.] blood irradiation is complicated and requires further exact investigations." These have not been forthcoming. Between 1995 and 1999, there were only three papers, all from Russia. One is about technique (Meditsinskaia Tekhnika 3:30, 1999). One is a patient series with controls conspicuously absent (Problemy Tuberkuleza 1:42, 1998), and one is an article that claims that the procedure reduces the numbers of tubercle bacilli in the bloodstream in TB patients (Problemy Tuberkuleza 3:48, 1999). Since tubercle bacilli are not usually present in these patients' blood in the first place, something is once again obviously wrong. In 2000, a group at the U. of Science and Technology in Hefei, China, found they could increase superoxide dismutase levels in spinal-cort injured rabbits by UV radiation of the blood, and speculated that this might be helpful for healing (Chinese Med. J. 113: 991, 2000); the absence of any further word on outcomes invites a conclusion. I have found nothing since (2011).

Venus Flytrap Extractpessmistic

Several websites promote venus flytrap extract ("Carnivora"), given intravenously or orally, as a natural medicine effective against a variety of diseases. They cite the work of a Dr. Helmut Keller, in Germany, who observed that the plant digests insects, but not itself, and thus "it must have a powerful immune system." Proponents claim "it has been used successfully for the treatment of chronic diseaes, including most forms of cancer", and "it is highly effective for the total elimination of the human immunovirus (HIV) in vivo from human blood and may be considered an effective treatment for AIDS." Proponents also claim that Dr. Keller's work is the basis for nine publications in medical journals, and that the Institute for Tumor Biology in Freiburg, Germany discovered that "Carnivora blocks the proteinkinases in the tumor cell and deprives it from its necessary proteins, it prevents the angioneogenesis of metastases and it decreases the mitosis rate of malignant tumor cells." The chief active ingredient is supposed to be plumbagin.

People who are considering paying good money for venus flytrap pills or injections need to know the truth.

  • A search of the medical literature, using the NIH database, back to the 1960's, shows a few hundred articles by eighteen different H Kellers. Not one of them ever published anything about venus flytrap extract or anything that seems related.
  • Plumbagin is a real substance, but no one named Keller ever published on it in a medical journal, and no one has reported testing it as a medicine, as an anti-cancer agent, or for its effects on the immune system.
  • No one has reported the venus flytrap ("Dionaea muscipula") extract as having any medicinal effects or action on cells in the lab.
  • The company site itself lists as "immune-supporting nutrients" found in its product such things as arginine, cysteine, histidine, proteases, and lipopolysaccharides. These are present in all biological substances, including nasty things. Droserone is a real substance and is a possible antimalarial (Planta Medica 64: 237, 1998). Hydroplumbagin is also a real substance. Although the company website claims Dr. Keller is the discoverer, it was already known as early as 1969 (Pharm. Weedblad. 104: 45, 1969). There are no references whatever to diomuscinon or diomuscipulon. Myricetin is an interesting flavinoid that is a free-radical quencher, has some antibacterial properties, and one recent study looks at its anti-mutagenic activity. It is abundant in red wine and many different berries. Quercetin is also on the list, and there are two articles in obscure Russian journals suggesting that it be used in hepatitis B and shigellosis respectively. That's it. There is a nice review of both flavonols in Free Radical Research, December 1999.
  • There is a real Instute for Tumor Biology in Vienna, but I have never heard of, and could not find, one in Freiberg.
  • The venus flytrap does not have an immune system like ours. It doesn't digest itself because its enzymes don't work on its cellulose. This is the same reason that we can't digest grass or toothpicks. Our own stomachs don't digest themselves either, because of a layer of special protective molecules, not because of any "immune system" ability to tell self from other.
  • A page supposedly by the discoverer is full of misspellings that no bioscientist would publish: "photobol esters" for phorbol esters, "asparagin acid" for asparagine, and more. The claim that the plant digests only the cells of insects that are undifferentiated and correspond to bacteria is pure nonsense, and no authentic scientist would subscribe his or her name to such a statement.
If you still want to eat powdered venus flytraps or be injected by vein with venus flytrap fluid, that is your business.

Vitamin C for AtherosclerosisPESSIMISTIC

There was a claim at alacercorp.com [now down] that ascorbate (vitamin C) administered as salts protects from atherosclerosis and may reverse it. I'd like to believe this, and the proponent (Jay Patrick) seems sincere and well-intentioned. However, his account of atherosclerosis has little resemblance to the disease I've come to know and hate so well. The intimal cells simply do not replenish themselves every 2-3 days as he claims; in fact, I've looked at these cells daily for almost twenty years and never seen a healthy adult's intimal cell in division. His idea that lack of nutrition makes them roughen with age is unsupported, and the claim that the intima "bleeds" is absurd -- the intima does not even possess its own blood vessels. Mr. Patrick, in his eighties, claims that a technician told him that his lack of calcium in his coronary arteries was "a new record in an 82 year old man." That's just not true, Mr. Patrick. I do autopsies, and it's common even for the old-old to be free not only of calcium, but of any significant coronary disease. To Mr. Patrick's credit, his healthy lifestyle probably has protected him. In the meantime, antioxidants including vitamin C might reasonably be thought to slow atherosclerosis by eliminating oxidized LDL's. Some honest work is underway -- and disturbingly, one distinguished English group has found that ascorbic acid, combined with the iron present in the both in health, actually enhances generation of free radicals that oxidize LDL's (Biochim Biophy Acta 1304: 223, 1996). Be careful.

Vitex (Chasteberry) for premenstrual syndromeCONFIDENT

One of the herbal remedies that appears to do exactly what many people use it to do. A reasonable good study from Louisiana (open-label) found it to be as effective as the well-established medication fluoxetine (J. Fam. Pract 58: 552, 2009). The plant has effects on sex hormones that are poorly-understood, like most everything else about the sex hormones.

Wilson's Syndrome DOUBTFUL

A current fad diagnosis. People interested in complementary medicine are invited to take their temperatures frequently. If it falls "a few tenths of a degree below 98.6 degrees" and they have any of a host of general symptoms, they are told the diagnosis is established. Since the true average human body temperature is 98.2 degrees, that makes for a lot of "Wilson's syndrome."

If the model were correct, it would be easy to prove, and its proponents have clearly either made no effort to do so, or have been unsuccessful.

On the other hand, I have always suspected that some people don't make enough thyroid hormone for their personal metabolism, and that a trial of a small amount of supplementary thyroxine might be useful in a person with vague complaints, especially chronic fatigue. More in my main set of notes.

Venous angioplasty for multiple sclerosis DOUBTFUL

Click here for the 2009 paper from University of Ferrara on malformations of the veins draining the head being more common in people with multiple sclerosis.

At this writing (August 2011) the work remains to be duplicated. The article sparked tremendous interest in venous angioplasty in patient with multiple sclerosis who have these lesions. To the credit of the medical community, some real prospective studies are now underway, and it's now being offered as an unproven remedy. It proved well-tolerated in one series (Phlebology 25: 283, 2010); the expected call for major formal studies (Ann. Neuro. 67: 283, 2010) expressed the expected safety concerns.

Dr. Zamboni's work has been misrepresented by proponents. Only a fool would deny that there is an major autoimmune component in multiple sclerosis. Dr. Zamboni correctly states in his paper that venous obstruction "at the level of the liver and of the cutaneous tissue" is capable of causing "inflammation, sclerosis, and degenerative lesions." However, these known skin and liver lesions are not patchy, exacerbating-and-remitting lesions, and sclerosis in the liver and the skin is by definition an entirely different process from multiple "sclerosis". (It's an unfortunate accident of language -- "sclerosis" in bone, in kidney, and in central-nervous-system has a distinct meaning for each organ separate from its meaning in general pathology.)

Enough of this. It is possible that slowed transit time of blood through the brain could tip the balance of the chaotic immune system toward vulnerability to antoimmune disease. Since multiple sclerosis involves the optic nerves and spinal cord, these lesions are harder to explain. Venous angioplasty seems easy, safe, and cheap. Evidence at this time is anecdotal. A June 2011 review in an obscure journal (Rofo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 183: 523, 2011) described "present conclusive data confuting the theory of chronic cerebrospinal venous insufficiency in multiple sclerosis". In August 2011, a study from the Dallas VA published online in the Archives of Neurology found no greater frequency of vascular anomalies in MS patients than in controls.

FOLLOW UP: August 21, 2011

A fellow-pathologist and a leader in our profession posted the following to a pathology list-server. I was given permission to quote it on the condition of protection the pathologist's anonymity.

Dear Colleagues,

A very dear family member has MS. she treats with dedicated academic neurologists at a well regarded international medical center. Also I collect and read literature which I comment upon and send to her. She has substantial unimpaired intellect and regularly up dates with her doctors. The Zamboni Cure is not endorsed.

Accordingly I know about The Zamboni Cure. The prospective father-in-law, ( that had MS) of a young man I know introduced him to me at a convivial dinner. Subsequently the prospective father-in-law conveyed he was interested in The Zamboni Cure. My advice was it had no demonstrated merit, was expensive, not covered by insurance and possibly dangerous.

He was desperate. He was confined to a wheelchair, which was a great frustration. He ignored all advice. In secret he had it done in the office of a local practitioner. During the procedure he crashed. EMS was called and he was transported to the nearest hospital. He had devastating brain damage from which he died, after months of expensive care, which ironically, was substantially covered by insurance. I postulate he suffered air embolism.

The widow does not wish to pursue a claim, not even investigate the records, which I volunteered to do gratis. Her attitude is he did it knowing full well the possible danger and lack of likely benefit.

Yohimbine for Erectile / Ejaculatory Dysfunction CONFIDENT

Yohimbine, from a fragrant bark, has various effects on the nervous system that are poorly understood. It's both an alpha-2 adrenergic antagonist and a stimulator of norepinephrine release.

There is now an impressive amount of literature on the effects of yohimbine for male sexual dysfunction (J. Urol 159: 433, 1998 & BMJ 317: 478, 1998 confirmed what everybody already knew).

In a trial for women with unwanted low libido, yohimbine released norepinephrine but didn't help the lack of sexual drive (J. Sex. Mar. Ther. 24: 43, 1998). The selective serotonin-reuptake inhibitor antidepressants (Prozac and its family) are famous for delaying or preventing ejaculation, and yohimbine is now accepted as helpful to reverse this (Bull. Menninger Clinic 59: 232, 1995).

Use it with caution, as yohimbine has potent effects on the autonomic nervous system. The usual side effects are headache and nervousness. One study (Arch. Gen. Psych. 54: 246, 1997) found that yohimbine made the flashbacks of post-traumatic stress disorder worse, perhaps by releasing norepinephrine. People with panic disorder also seem to have a more striking response to yohimbine (Psych. Res. 71: 27, 1997). The J. Urol. article reported that "serious adverse reactions were infrequent and reversible." Nevertheless, I wouldn't use it if I were hypertensive or had Raynaud's syndrome.

Zeolite for Cancer PESSIMISTIC

Zeolite is a mineral (actually a family of minerals), an aluminum silicate with curious physical properties that make it useful in water-softeners. It's used in cattle and poultry feeds in the US. Eating the powder is an old Eastern European folk remedy. Like fucoidin, it might alter the flora of the large intestine, perhaps in turn altering the body's internal milieu and perhaps helping with "just not feeling well."

As "Cellular Zeolite" and "Natural Cellular Defense", the mineral is presently (2006) being multi-level marketed in the US. There are discussion boards about what a great money-maker it is going to be. The claim is that the particles enter the blood and are highly effective in destroying epithelial cancer cells because of the molecular structure of the crystals.

The claim seems to me to be altogether unsupported.

The group at the Ruder Baskovic biochemistry labs in Zagreb reviewed zeolites in medicine and concluded that the stuff is almost insoluble at the pH ranges found in the human body. "Minimal amounts of free aluminum or silicium from the ingested zeolites are resorbed from the gut." They conclude that if zeolite has any real effect on human health, it is by influencing the transit time of food through the gut, by altering the fecal flora, and/or by working on the lymphoid tissue of the gut. This in and of itself may make a person feel better. The team warned that the stuff is a mutagen, and might be a carcinogen like asbestos (Lijecnicki Vjesnik 122: 292, 2000). The same team did some animal studies and there are two pilot-study publications (Anticancer Res. 23(2B): 1589, 2003 and J. Mol. Med. 78: 708, 2001). The second publication focused on a single cell culture and had no controls. It simply demonstrated that adding the absorbant from a water-softener to a flask with one line of cancer cells interferes with their growth. I hope no one finds this surprising.

If the mineral had actually entered the bloodstream as microcrystals as the current marketers claim, it would have been the scientific marvel of the year and would have resulted in a major publication. Back in 1999, zeolite was packaged in Croatia as "Megamin", and the local scientists denounced it as a cynical scam (Arhiv Za Higijenu Rada i Toksikologiju 50: 67, 1999).

What is most disturbing is a "Scientific Research Monograph" promoting the "Natural Cellular Defense", written by an marketer posing as a scientist. Visitors should know that as of 2006, R___ J.D___ still has no scientific journal publications, although he claims to do lifestyle education for physicians overseas and have a teaching position at a Florida business school. The paper presents no original work, but reviews the work of other people on zeolites. Yes, they interact with other molecules, and have some effects on cell membranes in tissue cultures. What R___ J. D____ fails to tell his readers is that there is not the slightest evidence that the stuff ever leaves the intestines or gets anywhere near a tumor. A seventh-grader should be able to see through the nonsense. Perhaps to avoid prosecution for quackery, at least for this, he makes no claim of a cancer cure.

You can also find a patent document online, where Harvey Kaufman and Lifelink Pharmaceuticals have patented zeolite as "a method of treating epithelial cell cancer" (US Patent 6,288,045). The evidence cited in support of the invention are some photos of cells from somebody's mouth in tissue culture evidently being injured by the powdered rock. The patent claims they are cancer cells. The patent also makes the claim that the substance "has a 100% kill rate within 72 hours against buccal mucosa and ling [sic.] squamous epithelial cell cancers. It is not cytoxic [sic., the author means cytotoxic] to healthy human cells." However, the control cells in the photos are from an oak tree from the next experiment (which relied on the false pop claim that oak galls are cancers). The patent goes on to talk about detoxifying carcinogens, and the claim rests on the obvious fallacy that removing the chemicals that caused the cancer will treat the cancer. (I wish this were true. You could cure lung cancer by stopping smoking.)

There follows a frankly hilarious account of the marketer taking cheek scrapings, putting them in tissue culture medium, adding an unnamed carcinogen plus saccharin in an unidentified vehicle, and believing that the morphologic changes mean he has transformed the cells to cancer cells. The cells in Figures 3-6 of the patent do not show evidence of malignancy, despite the author claiming that they do. After he added zeolite, they ended up undergoing osmotic lysis; evidently zeolyte did not lyse normal buccal cheek cells. However, he does not describe what happened to his saccharinized cells if he did NOT add zeolite. This would not pass muster as a high school science project.

The patent also includes an animal study involving a total of ten mice divided into three groups. The zeolite was actually injected into the animal's chests, at the identical sites into which the cancer cells had been introduced. It did not cure any cancer, which is a damning observation given the previous claims, but the cancers did grow slower, especially at the beginning. However, in the treatment group, the microcrystalline rock was actually injected INTO the cancer. Since minerals introduced into the body's tissues attract macrophages and cause inflammation, it is not surprising that this slowed down the tumor growth.

The advertising is only semi-literate but makes grandiose claims to be taken purely on trust. For example, "Harvey Kaufman, researcher, scientist and creator of the product, has just completed a study on End IV (sic.) cancer patients. These are basically patients further treatment (sic.) He is in the process of writing up the results and is hoping to have them published in The American Medical (sic.) Waiora cannot make any claims, it can provide coincidental anomalies. All 65 patients started NCD 15 months ago, their cancers given less than 6 weeks to live. As of today 51 are alive and cancer free." Evidently they are responding far more dramatically than the mice did. It's no wonder that the ad provides no details that would allow independent confirmation, because the story is inconsistent with the realities of today's medical research. Without an animal model, no institutional review board would allow someone to do a real study of zeolite on human beings. Without IRB approval, the Journal of the American Medical Association won't touch a paper. Anybody smart enough to get a patent knows this. If the patent-holder merely gave his powder to people who presented themselves to him as having been told they were in the final stages of cancer (and there are no criteria for saying that death must be six weeks away -- another sign that somebody isn't being straight-up), then he would not have been in a position to confirm the accuracy of the diagnoses.

The manufacturer is now claiming to have performed a study at Duke University. There is of course no publication. An internet search (June 2006) shows that some students were given zeolite and their urine tested for something. Nobody says what. An announcement of results was promised in March 2006. I'm unable to find it. Chances are this was an undergrad class project.

I am not making any of this up.

Since this is a multi-level marketing scheme, the person who sells you the zeolite is probably sincere, well-intentioned and nice. I predict that the ringleaders will be prosecuted successfully.

Before you spend money on the product or join a marketing program, considering bringing a copy of the patent to a professor of cell biology or someone else who does real bench cancer research at your favorite college. Find out what he/she thinks.

Follow-up: October 2007. I was actually pleased to see that Liquid Zeolite responded to some of my concerns. They took down the page "www.liquidzeolite.org/criticism-pathguy.html" in March, 2008... sorry you won't get to see it. (Instead, you get a disclaimer... "Zeolite is not a medicine, and is not intended for the treatment or prevention of disease.") As I've stated above, many (if not most) of the people involved in these promotions are sincere, decent, and even altruistic. I also regret some of my language, which I've changed. So far, their reply is principally "Absence of evidence is not proof of no effect", and I sensed perhaps a willingness to collaborate. I cannot agree that someone offering a cancer remedy to the public does not have a substantial burden of proof. I also can't justify this as an animal project for me to initiate, but if these are still underway, I'm available as histopathologist -- and I could support their work by distinguishing tumor destruction through nonspecific inflammation and the true tumor cell death caused by an agent truly effective against cancer. Nothing would please me more than to see a major new success against cancer and a radical scientific paradigm shift based on some real work. I stand by the statement, as a pathologist, that the "cancer cells" in figures 3-6 of the patent are normal cells from the inside of somebody's cheek, not turned cancerous but instead damaged by incubation in a hostile medium. (If you're really curious -- for example, the "blebs" noted in the text are typical of cells dying by many different means, especially apoptosis.) We'll wait and see. The burden of proof is on these people. I'm sure you understand.

If you are promoting zeolite yourself, and are assuring others that it is toxic to cancer but harmless to normal cells, think about whether you're ready to inject a syringeful into the soft tissues of your own face.

If you are considering becoming involved with the marketing of zeolite, please consider this. In making the statement that the "cancer cells" illustrated in the patent are not cancer cells, and making the illustrations readily available, I am exposing myself to the scrutiny of every honest, practicing pathologist in the world. We are the doctors charged with the accurate diagnosis of cancer. If I am wrong, I have lost all credibility with the peers on whom my career depends. In turn, I have nothing to gain from keeping this page online except ongoing character attacks and the satisfaction of knowing that I'm keeping you from doing something that you, as a decent human being, may very well regret in the end.

Jonathan Campbell, the healthy-eating guy, recognizes Zeolite as a scam and advises possible victims of their legal rights, including a warning that because it is being distributed by a limited-liability corporation, "you can't sue them." Cancer Compass message board on zeolite. "If there are people out there that are desperate enough to throw their money at quack cures, why shouldn't I be the one to catch it?"
Cancer Compass update; the holders of Harvey Kaufmann's patent are suing Waiora. Includes an account of a family member's visit to Harvey Kaufmann; not surprisingly, he seems to be a perfectly good and decent guy. Many "independent thinkers" are driven by a real desire to be of service to humankind.

Follow-up, May 2009. Waiora zeolite is still available for sale online "at a discount" for $58 for a eyedrop-sized bottle of suspended clay. However, the high-pressure multi-marketing scheme seems to be dead. I am proud of the role this page played in helping well-intentioned people avoid becoming involved in it. To their credit, the site http://discount-zeolite.com/ posts a link to Prof Courtney Bartholemew's "Science Report", an overwhelming unfavorable assessment of "alternative medicine." "Indeed, much of what today is called alternative medicine is, at best, effective placebos, and, at worse [sic.], fraud, and I feel a professional and perhaps cultural obligation to speak out, even if I run the risk of being unfashionable." He cites an unreferenced Norwegian multi-centre study: "The study revealed that death rates were 30 per cent higher in alternative medicine users than in those who did not use alternative medicine. The use of alternative medicine seems to predict a shorter survival from cancer was the study's conclusion [sic.]" Does anyone have the reference?

Anthony G. Payne -- alternative practitioner and internet friend. His fine site has been up for well over a decade.

This site was mostly written in 1999. I'll keep adding as I'm able.

What's the Harm -- tries to measure the damage done by various antiscientific ideas and practitioners

Natural Standard is a site that supposedly evaluates standard and alternative-complementary medicines objectively and impartially. You might find it helpful. However, the writers are reluctant to identify obvious quackery as such. ("There is currently limited available data supporting iridology as a tool for cancer diagnosis. Additional study is needed." More money thrown away on something that obviously doesn't work? Ditto for drinking urine to cure liver cancer -- "additional studies are needed" -- and so forth. Get real. Further: "It remains unclear if antineoplastons are effective, or what doses may be safe. Until better research is available, no clear conclusion can be drawn." This despite an infamous, huge study in which the old phony cancer treatment did nothing but cause brain damage. See Mayo Clin. Proc. 74: 137, 1999.) By contrast, they'll mention, but not reference, studies of dubious remedies in which somebody suggests something being peddled to the confused public might work on rats.

Follow-up, July 2006

Letter received from herbalist David Hoffman:

Dear Dr. Friedlander:

Just a quick note to thank you for such a clear and rational site. I'm a UK trained clinical phytotherapist and I now find myself teaching phytotherapy to a whole range of people from beginning herbalists to MD's, pharmacists and veterinarians.

I am constantly amazed at the gullibility (and desperation) of people drawn to 'alternative medicine'. Your site, which I only discovered just now, is a cornucopia of insights that I intend to direct both students and practitioners to.

If I can ever be of any help with my background in botanical medicine, please do not hesitate to contact me.

Your sincerely,

David Hoffmann BSc, FNIMH
Medical Herbalist
Traditional Medicinals
4505 Ross Road
Sebastopol, CA 95472

There's a single site focused on evidence-based medicine (as they put it, "separating the wheat from the chaff") as it applies to botanicals and particularly aromatherapy. Martin Watt's entire site's a good read. Click here for the list of dangerous botanical oils used by unethical practitioners.

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