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View Diary: The destructive consequences of junk science (graphic images) (65 comments)

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  •  You know, my parents were anti-vax nuts (5+ / 0-)

    and I got out of having to take vaccines to go to school per the "religious exemption."  I also was raised with a homeopathic doctor and several acupuncturists.  I have to say, I cannot stand homeopathy -- there is one remedy, Oscillococcinum , which ever helped me.  The rest was major fail.

    I have found acupuncture and some herbal remedies to be helpful.  I have had dental surgery without Novocaine using only acupuncture before hand and felt no pain. Yes, I know this is anecdotal, but I would not conflate all of alternative medicine into the realm of faith healing.  

    That said, even my weirdo parents would see a western doctor for something like cancer.  

    I say we dust off, nuke the site from orbit. It's the only way to be sure.

    by fearisthemindkiller on Sun May 10, 2009 at 08:53:21 AM PDT

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    •  I respect that. (5+ / 0-)

      I'm not against herbal or alternative medicines at all. But it is our job to warn about the destructive consequences of any kind of treatment. And it might be a good idea to consult a doctor when taking herbal or other alternative medicines, because of the fact of synergy. In other words, for instance, if you're taking aspirin and some kind of herbal remedy, you might wind up creating some kind of synergy that you don't want.

      •  Whatever works, you know. (3+ / 0-)
        Recommended by:
        Eternal Hope, stitchmd, esquimaux

        I think that Western Doctors should be more versed in  alternative therapies -- even if just to warn against interactions and synergies like you say.  There are also documented successes for alternative medicine.    According to this link, the state of Oregon requires that addicts must try acupuncture detox before going on methadone.  

        But as to your larger point I think you are right on.  

        I say we dust off, nuke the site from orbit. It's the only way to be sure.

        by fearisthemindkiller on Sun May 10, 2009 at 09:07:13 AM PDT

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      •  Trained practitioners (2+ / 0-)
        Recommended by:
        sberel, fearisthemindkiller

        in herbal medicine may have far more knowledge than MDs about herb/drug interactions. Despite pretenses to the contrary, Doctors don't have knowledge of the thousands of herbs that are available, thus they couldn't possibly know the interactions that might occur, which are usually minor in most cases. They look up possible interactions in manuals, just like anyone else.

        •  Good points. (2+ / 0-)
          Recommended by:
          sberel, Mia Dolan

          So, it might be an even better idea to consult a herbal practitioner who would have specialized knowledge.

        •  Not really (4+ / 0-)

          and I say this as someone that is trained in herbalism. No one knows because there hasn't been enough research.

          Most herbalists also don't extensively study pharmacology and the physiological mechanisms of their own products are poorly understood--so understanding the interactions is not really possible yet. We do know some certainly, but there is still vast numbers we don't.

          One of the problem for physicians is that many of their patients don't report they are taking herbs (either they don't think it matters or they believe there will be judgment). This makes understanding of interactions that much more difficult to figure out.

          The understanding of biochemistry, physiology and pharmacology gives many physicians a leg up on this. Many medical schools also have a course on phytopharmacology so their understanding of plant-based medicine may not be as lacking as you think.

          I'm not saying this is always the case but many herbalists also just look things up in books and prescribe using older methods that are not based on a modern scientific understanding.

          •  Just a minute... (0+ / 0-)

            Not really and I say this as someone that is trained in herbalism. No one knows because there hasn't been enough research.

            I have a doctoral degree in Chinese medicine. You're right that we don't know of every possible reaction. Nor are all the possible reactions known about inter-drug (drug/drug) reactions between the stew of drugs that doctors prescribe on a daily basis. And there are food/drug, mineral/drug, vitamin/drug reactions that are not entirely understood, and which doctors often blithely ignore completely. I know this based on reports from my patients (some of whom are MD's). What we do know is that for most herbs, the reactions are nonexistent or very minor, and generally result in slight increases or decreases in the drugs potency. Taking the herbs two hours apart from the drugs settles the issue in most cases. We are quite attentive to explaining this to patients. Now, if only we could get the doctors to monitor their own patients drug/drug interactions more attentively...it seems it's the pharmacists who constantly catch errors in doctors careless prescriptions.

            Most herbalists also don't extensively study pharmacology and the physiological mechanisms of their own products are poorly understood--so understanding the interactions is not really possible yet. We do know some certainly, but there is still vast numbers we don't.

            True, they don't extensively study western pharmacology, although in Chinese med we do take classes in the subject, including classes in herb/drug interactions. How many Western docs have taken specific classes in herb/drug interactions, much less in herbs? Few. Also, in Chinese med, we have accumulated extensive knowledge over the millenia about side effects of herbs through extensive clinical observation. But side effects of western drugs are often not known, either, and western docs often get quite defensive of their tools of the trade, despite some of the horrific results that are discovered after drugs are allowed on the market.

            One of the problem for physicians is that many of their patients don't report they are taking herbs (either they don't think it matters or they believe there will be judgment). This makes understanding of interactions that much more difficult to figure out.

            In my experience, western physicians don't take the time to look up interactions, even when they're told about herb use. Their basic approach is to scare the patient away from therapies which are often have great efficacy. That's why patients don't inform them of herb use. They have learned that they will be ridiculed by someone who has little experience, knowledge or training in therapies outside of drug interventions.

            The understanding of biochemistry, physiology and pharmacology gives many physicians a leg up on this. Many medical schools also have a course on phytopharmacology so their understanding of plant-based medicine may not be as lacking as you think.

            Oh, that's nonsense for the most part. I have worked with doctors, and I have had many patients routinely report back to me their doctor's comments. I know very well what their training is, and it doesn't include much in nutrition or herbal therapy, if any. I've taken the time to look up medical school curricula, and I have not seen the classes you refer to. Doctors are often shockingly ignorant in their comments. They spend their time in med school studying to pass other exams, and herbs are not high on the young medical student's priorities. I could write a three page essay about this, but in short, frankly, doctors are usually profoundly ignorant about herbal therapy.

            I'm not saying this is always the case but many herbalists also just look things up in books and prescribe using older methods that are not based on a modern scientific understanding.

            In Chinese med, which is my field, we keep abreast of modern findings, and have many, many, thousands of hours of training in our field. What you claim about "herbalists" may in fact be true of poorly trained individuals, most of whom I would not define as herbalists. But the same can be said of western physicians and chiropractors who delve into acupuncture with only two weeks of training, thus making a mockery of a science that takes years of training to properly implement.

            •  You both have good points. (1+ / 0-)
              Recommended by:
              fearisthemindkiller

              What we need is a holistic approach in which herbalist medicine and Chinese medicine and Western medicine are not mutually exclusive. And on top of that, we need transparency so that we can educate the public about dangerous treatments that are not safe for people. That is why I was so vehemently opposed to McCarthy getting the kind of platform she did -- here is someone who by her own admission has no scientific training, and yet is trying to scare people off of vaccines. And it works both ways -- we need laws requiring drug companies to disclose the results of their trials as well as the nature of their research. That way, we can educate the public about treatments that are effective and warn the public about approaches/treatments that are not.

              •  Yes (3+ / 0-)

                What we need is a holistic approach in which herbalist medicine and Chinese medicine and Western medicine are not mutually exclusive.

                That approach is, in fact, the way we are taught in Traditional Chinese Medicine, and in the Chinese medical system (in China) integrative medicine has been used since 1950. Integrative medicine is nothing new to the Chinese. By the way, I interned in a western hospital as part of my internship as an acupuncturist. Most people are not very aware that some of the "alternative" medical practices are becoming mainstream. The MDs I worked with were completely fine with my presence in their wards.

                The science of medicine is still developing. We must be careful of big brotherism in which some committee of industry trained professionals (google pharmaceutical industry funding of med schools) tells us what we can or can't do with our bodies. I see the issue as similar to abortion rights. In my view, no one has the right to tell me what I can do with my own body. That once was a basic right that we're rapidly losing.

            •  well (0+ / 0-)

              How many Western docs have taken specific classes in herb/drug interactions, much less in herbs?

              It is limited but increasing. I, for one, give a lecture to medical students and residents on alternative therapies. But it's a lot of ground to cover in an hour, so I wind up giving them a lot of references. It's then up to them to look it up.

              What I think a lot of people don't realize is that there are other paradigms for medical care, which you clearly know as a traditional chinese practitioner. In TCM, as well as in Ayurveda, and other alternative systems, the process of learning physiology is different, the diagnostic process is different, etc. etc. I might send you ten patients with migrains who, under your system, may come up with ten different diagnoses, and similarly I would probably make different diagnoses for patients of yours with the same diagnoses under your system.

              It's our western hubris that makes us think our system is "better." There are advantages to each system. For example, allopathic medicine does little to help with inflammation, pain and dysfunction that can't be treated with meds or surgery. But I've had lots of good outcomes for patients when I've sent them to "alternative" practitioners.

              Like many things, we would all do better if we learned more about each other, and if our minds were open to thinking differently. That's often a tall order, however.

              Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

              by stitchmd on Mon May 11, 2009 at 07:59:00 AM PDT

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        •  I say, talk to your pharmacist (0+ / 0-)

          who is often far more well versed than traditional docs with interactions with herbs, or that non-traditional docs are about interactions with "standard" meds.

          I tell my patients what I know, but I often tell them that I can't tell them details on effectiveness, because there aren't good studies for many of these agents; furthermore, the preparations are not regulated and therefore not standardized.

          I do not tell my patients to not take these agents, with the exception of warning them on some weight loss agents.

          But yeah, the best way to find out about interactions is to look it up; Google is your friend.

          Diversity may be the hardest thing for a society to live with, and perhaps the most dangerous thing for a society to be without - W S Coffin

          by stitchmd on Mon May 11, 2009 at 07:52:06 AM PDT

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    •  Accupucture has been documented and (2+ / 0-)

      tested as to giving pain relief. It does work. But one has to be careful not to fall into the hands of "accuhoaxers" as I call them. It is hard to test their bona fides.

      But aside from the often powerful placebo effect it strains credulity to accept the claims of homeopathy. You have to invent forces totally unnoticed heretofore.

      We are in a time where it is risky NOT to change. Barack Obama 7-30-08

      by samddobermann on Sun May 10, 2009 at 02:59:58 PM PDT

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