Tuesday, September 3, 2013

Accredited Naturopathic Schools - Article 2

In a recent exchange, http://rosemary-jacobs.blogspot.com/2013_08_01_archive.html, a student at an accredited naturopathic school in Canada told me that his school is considered a medical school because the students there get an education comparable to that of medical doctors. Since he had previously stated, “…NDs do not have the same privileges as MDs in Canada, not even close,” I asked him why if NDs have an education comparable to that of MDs, they aren’t given the same privileges that MDs have. He didn’t respond. If any of you knows the answer, please tell me. I’d love to know. 

Anyone with a degree from an accredited naturopathic school in either the US or Canada can be licensed as a naturopath, ND, in any and all of the states and provinces that license them meaning that the educations they get in all their accredited North American schools are considered to be the same, http://www.cnme.org/. I know of several NDs with degrees from Canadian schools who are practicing in the US. 

Based on my investigations and personal experience with NDs who hold degrees from accredited ND schools, I am quite certain that their educations are not the equivalent of an MD’s, not even close, http://rosemaryjacobs.com/naturopaths.html 
and I’m not the only one who has looked into the matter who has arrived at that conclusion. 

NDs who constantly insist that they get the same education in their 4-year accredited schools that MDs get in their 4-year institutions usually fail to add that most NDs start practicing when they finish school whereas MDs are required to do hospital residencies which for those going into primary care, the area NDs claim to specialize in, is a minimum of three additional years. In other words medical doctors spend a minimum of 3 more years after earning degrees from 4-year medical schools getting a hands-on education as they work under the supervision of experienced doctors in hospitals. http://www.aanmc.org/education/comparing-nd-md-curricula.php. Evidently, their 4 years of study in medical school isn’t considered sufficient to prepare them to treat patients but 4 years of study of what NDs claim is the equivalent of that education in an ND school is? I don’t think so, but that’s just part of the problem.

While a few NDs are starting to do residencies now because jurisdictions who license them are beginning to require it, they are usually doing one year residencies and they are usually doing them in clinics or private naturopathic practices not hospitals. http://www.np-ga.com/currentresidencies.html. Heck, unlike MDs, NDs don’t have hospitals. Unlike MDs, they haven’t opened hospitals or been doing surgery and caring for the acutely ill in them since the founding of naturopathy in 1902 when they were called “drugless healers”. And even today where naturopaths are licensed in several jurisdictions as primary care physicians, they aren’t permitted to do anything but minor surgery. They can’t do invasive procedures in which people are cut open. So, yeah, they may learn anatomy in their schools by dissecting cadavers, but they don’t gain experience observing or working on the anatomy of living human beings laying opened on the operating table. Neither do they observe and care for people in serious crises and emergency situations. I think that most anyone who has ever been a patient in a hospital or spent time visiting one will tell you that what you see there is very different than what you see anywhere else. My guess is that anyone who has ever been a hospital patient or visited one realizes the huge difference between seeing and treating very sick people and those with minor complaints or chronic illnesses. 

But even without taking into account medical residencies, how can NDs possibly learn all the same scientific disciples in their 4-year accredited schools that MDs learn in theirs in the same depth as MDs do when in addition to courses labeled as basic medical sciences that medical doctors take naturopaths must also take courses that teach and prepare them to practice so many additional modalities like homeopathy, botanical medicine, physical therapies, counseling, and nutrition? http://www.scnm.edu/academics/nd-degree/nd-scope-of-practice. Are there really enough hours in the day during a 4-year course of study to cram in all that MDs, psychologists, registered dietitians, physical therapists, homeopaths and herbalists learn in order to practice their specialties? How could there be? Do the math.

And at 4-year accredited naturopathic schools located in places where NDs are not permitted to prescribe or use drugs, while they may take a course called “pharmacology”, how can they get practical experience with pharmaceuticals when neither they nor their ND professors are permitted to use them? And why is it that NDs who have degrees from ND schools where they are not permitted to use prescription drugs are permitted to use them if and when they become licensed in a state that permits NDs to use pharmaceuticals? That sounds very dangerous to me. 

Maybe I’m not the only one who has investigated and concluded that NDs most certainly do no get an education equivalent to that of MDs in their schools. Maybe that is why NDs in Canada aren’t granted the same privileges that MDs have there.

Wednesday, August 21, 2013

Evidence vs The Evidence

In a comment after an article about naturopathy,  http://rosemary-jacobs.blogspot.com/2013_08_01_archive.html, I wrote, “NDs terrify me. They routinely use products that have never been evaluated for safety or efficacy. One or more of these substances could be totally useless but as lethal as cigarettes. By the time that is discovered, it will be too late to save many from premature deaths. http://rosemary-jacobs.blogspot.com/2012/05/deadly-folk-medicine.html”. The link was to an article I had written about deadly folk medicine that included references supporting my claim about the dangers of natural remedies and why they had to be  rigorously tested and evaluated for safety and efficacy before being used routinely. 

A student at an accredited naturopathic school who realized I was referring to NDs, naturopaths, with degrees from 4-year accredited schools like the one he attended replied, “The stats say ZERO deaths from natural products - that is the evidence.” He offered this reference, http://orthomolecular.org/resources/omns/v06n04.shtml

My response was that his reference wasn’t ‘the’ evidence. It was a piece of the evidence. As such, it had to be checked and verified and then reviewed in the context of all the other available evidence relevant to the topic.

As soon as I clicked on the student’s link to the orthomolecular medicine site and saw the title of the article, “No Deaths from Vitamins, Minerals, Amino Acids or Herbs”, I knew that something had to be wrong because it contradicted the evidence I already had. It contradicted the evidence presented in my article above as well as with all the other numerous well documented reports of deaths caused by supplements like ephedra and the laxative teas. It contradicted what I had learned when I had spoken with survivors of two of the dead victims and some of the lawyers who had represented them.

So what was the problem? How had the authors and the student missed those deaths?  Well if you read the article, you will find that the authors based their conclusion that supplements are safe and haven’t killed anyone on just one piece of evidence, reports of deaths received by US Poison Control Centers in one year, 2008. 

But would anyone with an ounce of common sense who wanted to know the facts draw a conclusion based on that one report alone? I doubt it. I think most people, would say, Wait a minute. Were there any natural product deaths reported to the US Poison Control Centers in any other years? Were there any reported to it in the last 20 years? Were there any natural product deaths reported anywhere else such as to the FDA?Were there any supplement deaths reported in the medical literature or in the press? And even if a thorough investigation couldn’t find any, would rational people conclude that there couldn’t be any in the future? I doubt it. I think they’d understand the cigarette analogy. They’d understand that some substances take decades to kill their victims. 

But if readers discovered what I already knew, that supplements have already killed people, do you think they’d wonder why the site and the student excluded those death reports; why out of several reports they had chosen only one - the one that supported the conclusion that the products they promote are safe? Do you think that they’d ask themselves if anyone actually looking for factual information on the lethalness of supplements would exclude pieces of evidence that showed they had killed people? 

If you review the entire orthomolecular medicine site, not just the page the student linked to, you’ll find additional claims not supported by objective evidence. For instance, look at what the ortho site has to say about Max Gerson, MD and his Gerson Therapy, http://orthomolecular.org/history/index.shtml. Compare that to what the American Cancer Society says about him and his Therapy. http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/dietandnutrition/gerson-therapy. Notice specifically what it says about adverse reactions including deaths associated with coffee enemas which are a part of Gerson Therapy.

Also look at what the ACS has to say about orthomolecular medicine. http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/orthomolecular-medicine. Specifically, under the heading “overview”, “Available scientific evidence does not support the use of orthomolecular therapy for most of the conditions for which it is promoted.”  

But that isn’t the end of the story. In addition to death reports, there are many documented cases of injuries natural products used as remedies have caused. Look at what Consumers Union has to say about their safety even during the period that included 2008 when the ortho site said there were no deaths caused by them. http://foodpoisoningbulletin.com/2013/consumers-union-endorses-dietary-supplement-labeling-act/#comments

I personally also know that there are many documented cases of argyria, skin discolored by silver, caused by oh so natural silver “dietary supplements” that CU never mentioned. I predicted these back in 1995 when I learned that silver was being sold as a supplement, a “natural antibiotic”. It is the very thing that got me to investigate supplements and natural “remedies” and to discover the deaths and injuries they have caused and may possibly cause in the future. I have spoken to and seen some of the silver victims, their lawyers, doctors, friends and families. I’ve read of other cases of argyria in medical journals and in the media. I’ve been interviewed by the same journalists who interviewed Paul Karason and Stan Jones. I’ve reported extensively on the problem. Here’s just one example, http://rosemaryjacobs.com/naturopaths.html

“Evidence” is a word used professionally by scholars like historians and economists as well as by cops, lawyers, prosecutors, judges, journalists, scientists, and doctors who practice evidence-based medicine (EBM). They take courses to learn what specifically constitutes reliable evidence in their fields. They all learn that you can’t “cherry-pick” evidence, you can’t selectively choose that which  supports your views while excluding that which does not.

But the concepts of evidence and proof aren’t alien to the guy in the street who uses them intuitively to varying degrees in his daily life. When he wants to buy a car, he asks his friends if they like theirs and probably checks magazines that he considers unbiased and reliable like Consumers Report to see what their investigations have uncovered and to see if they verify the claims that salesmen make. If he sees a news report about a local businessman accused of sexually harassing a female employee, he doesn’t draw a conclusion based on that report alone. He considers everything he knows about the situation and the guy and the gal. If he knows many women who have worked with the man over the years who respect and admire him and if he knows that the woman has a history of making false accusations against people, he doubts her claim. Intuitively he knows that one piece of evidence isn’t ‘the’ evidence. He knows that it can’t be viewed in isolation but only as a part of all that a good investigation uncovers. He knows that all the relevant facts have to be independently verified and that the sources providing them have to be considered to see if they have a financial, philosophical or emotional interest in the topic which could make them prone to either unconscious bias or to deliberately lie or deliberately mislead people. 

Life doesn’t come with guarantees but if we want to stack the odds in our favor the best thing we can do is learn where to find and how to weigh and evaluate evidence, the whole body of relevant evidence, so that we can make truly well informed decisions about the things that are important in life like drugs and therapies.

Scholars have recently recreated the view that General Robert E. Lee had of the Gettysburg battlefield and concluded that it is very likely that he lost there because his battle plan and the decisions he made were based on very incomplete evidence. They were based on the number and location of Union troops seen by him and his scouts who used high parts of buildings like the cupola atop the Lutheran Seminary as lookout posts as well as reports from cavalry reconnaissance troops. Unfortunately for them they didn’t see the large numbers of enemy soldiers who were blocked from view by the hilly terrain. Not seeing the superior number of Union forces, not obtaining all the facts, had dire consequences for the Confederates. 

Of course, there are times in life, especially in war and emergency situations when we simply have to make a quick decision, times when we have to choose from several options even though we don’t have all the relevant facts. At those times, we cross our fingers and go with the evidence we have and our intuition knowing that there are serious consequences to whatever we decide even if it is to do nothing at all. 

However, most situations we face in life aren’t like that - something people in most professions know very well, especially scientists and those who practice evidence-based medicine. That is why medical scientists study drugs and therapies before they are used routinely. It is why those who practice EBM routinely use approved drugs that have been well studied. It is why medical scientists devise ways to test drugs and therapies scientifically, as unbiasedly as possible, to obtain the facts, the body of evidence, that enables them to make treatment decisions that increase the odds of helping not harming patients. 

That doesn’t mean that no one will ever be injured or killed by a well studied drug or therapy. It just means that by limiting our routine use of drugs and therapies to those that have been well studied that we will greatly increase the chances of our benefiting from them rather than being harmed by them. It will decrease the odds of our playing Russian roulette with our lives and health. It will reduce the guesswork and the risk that involves. This I believe is all we can reasonably hope for in life. This is why I believe in scientific or EBM and why the unscientific naturopathic alternative terrifies me.  

A Naturopathic View

I recently had a fascinating exchange on a Canadian site with a fellow named Dave who says he is a student at a Canadian naturopathic school. I think that Dave provided a wealth of information on what licensed NDs believe and are taught in their schools. 

In my other blogs I’ve been careful to limit my comments about what licensed NDs with degrees from their 4-year accredited schools believe and do to what representatives of their profession state themselves either in person or on sites of organizations that represent them, like the sites of their schools and their state and national associations. 

While I don’t know if the views Dave has expressed are representative of the profession, they certainly are consistent with the representative views I am familiar with. 

Although Dave is being educated in a Canadian naturopathic school, the degrees granted by the Canadian and American schools are recognized by the same jurisdictions so that in states and provinces that license NDs with degrees from 4-year accredited ND schools, it doesn’t matter if the degree is from a Canadian or an American institution. For that reason I conclude that the instruction offered in both countries is the same.

As far as I’m concerned, everything Dave has said further confirms what I’ve stated repeatedly. Whether they know it or not, NDs neither learn, understand nor appreciate evidence-based medicine (EBM) itself or even the most basic medical sciences like pharmacology and toxicology. I hope to explain that further in future blogs using the wealth of material Dave has provided. 

But please don’t take my word for any of this. Read the exchange for yourself and draw your own conclusions. 

Whether or not you agree with me or with Dave, doesn’t matter in the least to me. What matters is that if this is a topic that interests you that you review all the relevant material for yourself and draw your own conclusions.

Tuesday, July 23, 2013

Naturopaths & Alternative Or Naturopathic Pharmacology

Once more an anonymous person who says s/he is an ND has told me that naturopaths are trained in pharmacology and the use of prescriptions drugs just like primary care MDs are. 
For starters let me make it clear that I have no reason to doubt that s/he has earned a degree from an accredited ND school. In fact everything s/he has said to me sounds as if that assertion is true but I have no way to verify it. 
I believe that s/he and many others who write to me anonymously saying they are licensed NDs and that they are trained in pharmacology and the use of prescription drugs really believe it. However, everything I know about naturopaths and everything they say makes me conclude that they are terribly and dangerously mistaken. Let me try to explain.
When I first developed argyria, I researched dermabrasion, a procedure in which the top layer of skin is literally sanded off, but I and the dermatologists I consulted dismissed it because we knew that silver was bound up so deep down in my skin that it couldn’t be sanded off. For that reason, we assumed that dermabrasion could not effectively treat argyria. Roughly twenty years later, I noticed that I had thin light lines on my skin which resembled scratch marks. While I’ve always been around dogs, cats, puppies and kittens, I didn’t remember ever being scratched. Any scratches I had gotten were so minor that they never bled. Suddenly it hit me. For twenty years I’d assumed that dermabrasion couldn’t help me, but IN MEDICINE YOU DON’T ASSUME. YOU TEST. 
I felt like the world’s biggest fool thinking that maybe I had been discolored all those years when I could have been “normal”. What if the silver could have been removed with dermabrasion? Just because the dermatologist couldn’t sand off enough skin to reach it with his little electric sander didn’t mean that the procedure wouldn’t cause a chemical reaction that would have an effect on the silver. For instance, the inflammation the dermabrasion caused might possibly result in forcing the silver out of my skin to a place where the body could eliminate it or where it wasn’t visible.
I knew I had to have a test patch done, something I should have had done 20 years before because IN MEDICINE YOU DON’T ASSUME. YOU TEST. 
Medical doctors who practice evidence-based medicine and scientists like pharmacologists know this exceedingly well. The years they spend doing and following research drills the lesson into them. They know that when you are dealing with a complex organism like a living human being that all kinds of unknown things take place inside the organism that can effect the person’s health and the way that drugs, therapies and toxins affect him. While many of these effects are predictable, many are not and experience has shown scientists time and time again that ASSUMPTIONS HAVE TO BE TESTED OBJECTIVELY TO SEE IF THEY ARE ACCURATE. Naturopaths who have only very recently been exposed to scientific or evidence-based medicine and who still aren’t engaged in scientific research haven’t learned this yet. They have over 100 years of catching up to do. A great many don’t even want to catch up. They are still very weary of scientific medicine and even afraid of it which is exactly why they want to use “natural” alternatives. 
But back to the little light lines on my gray skin. 
After calming down and thinking rationally, I decided to have a test spot on my skin dermabraded. However, by then I realized full well that even if it worked it wouldn’t help me because I would never let anyone sand my upper and lower eyelids so that if the silver were removed from the skin on the rest of my face I’d wind up looking like a raccoon, but by golly, by then the experiment wasn’t about curing me.  It was about seeing what effect dermabrasion has on argyria. Something I really wanted to know.
This urge to experiment to learn and to objectively test your suspicions to see if they are true is the most integral part of science, including scientific or evidence-based medicine and all the medical sciences like pharmacology, yet it is the very need to test rather than assume that drugs and therapies are safe and effective that separates naturopaths from scientists and medical doctors who practice evidence-based medicine. 
While I have no doubt that ND schools teach a subject that they label  “pharmacology”, that perhaps they even have people who have earned PhDs in pharmacology teaching the course and that they may even use pharmacology textbooks that medical scientists state are reliable, I don’t think that NDs are taught, understand or appreciate the medical science of pharmacology or any other science for that matter. If they did, they wouldn’t fail to comprehend the need to objectively test their assumptions and beliefs about natural drugs and therapies before routinely using them.
Here are just a few examples of NDs, as a profession rather than just a few individuals, routinely assuming that their assumptions are correct without ever testing them or checking to see if anyone else has.
Over 200 naturopaths licensed in the state of VT assumed that silver taken internally or put in the eye was safe and offered benefits. Why else would they have included it in their VT sanctioned Naturopathic Formulary?  http://rosemaryjacobs.com/naturopaths.html (Scroll to the bottom to see the formulary.)
Over 200 naturopaths licensed in VT assumed that cobalt, nickel and tin offered benefits when administered IV. They included them in their formulary too. 

I am not an MD or a medical scientist and was not about to take the time to research those items, but the idea of anyone shooting cobalt, nickel or tin into someone’s vein sounded really weird and dangerous to me, which is why I asked the newly appointed VT official charged with regulating licensed NDs in the state about the practice and expressed my concerns to him. 
(Scroll down to # 12, the letter from VT Health Commissioner, Harry Chen, MD, the VT NDs’ state regulator.) Specifically notice his statement:
“Tin is sometimes administered by naturopaths who believe tin can be used to treat baldness based on a few studies involving mice. The efficacy of this treatment has not been demonstrated in the medical literature. Tin is not an essential nutrient.”

As far as I’m concerned that is totally insane. No one trained in pharmacology will assume that something that has an effect in mice will have the same effect in humans or that it will be safe to use in humans. Scientists, or anyone who knows anything about the history and development of drugs, knows that you can’t  assume that a substance that works in a test tube will work and be safe in humans. Heck, they’ll even know that what is safe and effective in one species like a mouse may not be safe or effective in another species like dogs, cats or humans. That is why drugs aren’t approved simply based on studies that show they work in a test tube or that they are safe and effective in an animal model like mice. Everyone who knows diddle about evidence-based medicine and pharmacology knows that, but NDs don’t. That tells me that they know nothing about science or the science of pharmacology which is why I would label any pharmacology naturopaths learn in their accredited schools as Alternative or Naturopathic Pharmacolgy, something which is the opposite of the science of pharmacology.

Using tin intravenously to treat baldness in humans because of a few studies showing it worked in mice, even assuming the mice studies were good, without ever testing it in humans is totally irresponsible and crazy especially when baldness is not a disease and especially when it would be so very easy for naturopaths to conduct tests to determine if their assumption about it is correct. It would be so simple, easy and cheap to do experiments to determine if their assumption was true. Heck, I even know a few NDs who would be perfect test subjects. 

Dr. Chen did not address cobalt or nickel in his letter to me yet if you check the Memorandum at the bottom of this page, http://rosemaryjacobs.com/naturopaths.html, you will see that on his advice, in the interest of patient health and safety, they were removed from the formulary along with colloidal silver, silver and tin, and quite frankly I’m very certain that none of those things would have been removed if I hadn’t so aggressively pursued the matter. 

Including untested substances in their formulary certainly didn’t bother any of the NDs licensed by the state of VT all of whom have degrees from accredited naturopathic “medical” schools. Apparently it never occurred to them to test the things they included in their formulary to see if their assumptions about them were true or to even review the medical literature to find out if they had already been tested and found to be useless and/or toxic by scientists.  Worse yet, when I expressed my concerns, they didn’t investigate to see if I was right. They simply brushed me off. All of this convinces me that, contrary to what naturopaths believe, they know nothing about pharmacology, toxicology, science or evidence-based medicine.

In addition to learning something about prescription drugs in their “medical” schools, naturopaths are taught about classical homeopathy, botanical drugs and dietary supplements (natural medicines) and are expected to incorporate them all into their practices. Most NDs also sell these “natural remedies” to their patients. 

There is no objective evidence to support the use of any classical homeopathic remedy, and if there were, chemistry as we know it would be flushed down the drain because such remedies don’t contain active ingredients. They are well shaken sugar or water that homeopaths and naturopaths believe, but have never objectively demonstrated, have curative properties. It isn’t just pharmacologists, medical doctors who practice scientific medicine, and medical scientists who you will find rolling on the floor with laughter when they hear NDs claim that homeo remedies are medicine, chemists too find it so outlandish as to be preposterous. It is the antithesis of science. The antithesis of chemistry. Classical homeopathic “remedies” are things that people who understand chemistry or pharmacology, a very specialized branch of chemistry, simply would never use except as a placebo, a sugar pill the doctor knows is useless but which he gives a patient he can’t help to make him “feel better”. But NDs don’t use homeo remedies as placebos. NDs are taught and most believe that they really are medicine. If they understood pharmacology, they would never believe that.

Except for a very few diseases which are treated with specific vitamins, there is no evidence that crude botanical drugs and supplements offer benefits and lots of evidence that they cause harm. http://www.theatlantic.com/health/archive/2013/07/the-vitamin-myth-why-we-think-we-need-supplements/277947/. Yet they are an integral part of the practice of naturopathy. Why? Because NDs assume that Mother Nature offers cures but they never test the substances objectively to see if that assumption is true. What they do is mine scientific data bases to find studies showing that the natural drugs and therapies they believe in and assume are safe and effective are. They compile the results along with lists of the natural chemicals found in specific botanical remedies and mistake the results for pharmacology when what it really is is a smorgasbord of isolated study results. That’s called “cherry picking” - pulling together things that prove your claim without any regard to the accuracy or quality of the studies you cite or whether or not they are relevant to the claim you are making - are they lab studies, mice studies or human studies - all the while excluding anything you find that shows that your claims are wrong. While lawyers and naturopaths may get away with that. Scientists like pharmacologists can’t. They are required to present a large body of evidence - many good quality studies - that consistently give the same results before they can draw a conclusion. 

Here’s another example of what I call “Alternative” or “Naturopathic Pharmacology” taken from Textbook of Natural Medicine, 1999, 2nd edition, Pizzorno & Murray, which Bastyr, the naturopathic “medical school”, calls, “the gold standard in science-based natural medicine.” 

What follows are excerpts interspersed with my comments.

p. 775
Hydrastis canadensis (goldenseal) & other berberine-containing botanicals

The pharmacology of these plants is primarily discussed in terms of the activity of berberine. 

p. 776
Berberine has demonstrated antibiotic, immunostimulatory, anticonvulsant, sedative, hypotensive, uterotonic, cholerectic, and carminative activity. Berberine’s pharmacological activities support the historic use of berberine-containing herbs. 

Berberine has shown antimicrobial activity against bacteria, protozoa, and fungi,…

[Comment: Ten references are given. None look as if it is to a study done in humans. Several of the publications are obscure. One is a book about herbs for the general public. NDs may mistake these references for evidence. Scientists never would. Scientists require a large body of solid studies that consistently give the same results, not a few obscure ones, some or all of which are of questionable quality, and when drugs are concerned, the studies have to be done in humans with a standardized substance.]

p. 778
It appears that berberine is effective in treating the majority of common gastrointestinal infections. The clinical studies have produced results with berberine comparable to standard antibiotics in most cases. In fact, in several studies results were better.

p. 779
Berberine has been shown in several clinical studies to stimulate the secretion of bile (cholerectic effect) and bilirubin. In one study of 225 patients with chronic cholecystitis, oral berberine doses of 5-20 mg three times a day before meals caused, over a period of 24-48 hours, disappearance of clinical symptoms, decrease in bilirubin level, and an increase in the bile volume of the gallbladder. 

[Comment: Cholecystitis is an inflammation of the gallbladder. I don’t see a citation to the study mentioned. They also recommend goldenseal for the treatment of trachoma, an infectious eye disease, cirrhosis of the liver and cancer. p.778-779.] 

The dosage should be based on berberine content. As there is a wide range of quality in goldenseal preparations, standardized extracts are recommended...

Now lets compare what the naturopaths’ gold standard textbook says about the pharmacology of Hydrastis canadensis to a few sources Mr. Google found.

University of Maryland. Accessed July 2013:

Goldenseal (Hydrastis canadensis) is one of the most popular herbs in the United States, often combined with echinacea and sold to treat or prevent colds. But there's no evidence that it works. In fact, there's very little scientific evidence that goldenseal works to treat any condition… A substance in goldenseal, called berberine, does kill some kinds of bacteria and fungus in test tube studies. But scientists don't know if goldenseal would kill any germs in people.

NCCAM, the US government agency setup by Congressmen who were strong proponents of “alternative” medicine and “dietary supplements” and wanted the government to conduct studies they thought would show that their pet remedies and therapies were safe and effective.  Accessed July 2013:

Few studies have been published on goldenseal’s safety and effectiveness, and there is little scientific evidence to support using it for any health problem.
Clinical studies on a compound found in goldenseal, berberine, suggest that the compound may be beneficial for certain infections—such as those that cause some types of diarrhea, as well as some eye infections. However, goldenseal preparations contain only a small amount of berberine, so it is difficult to extend the evidence about the effectiveness of berberine to goldenseal.
NCCAM is funding research on goldenseal, including studies of antibacterial mechanisms and potential cholesterol-lowering effects. NCCAM is also funding development of research-grade goldenseal, to facilitate clinical studies.

The Mayo Clinic on inflammation of the gallbladder or cholecystitis. Accessed July 2013: 

Now if you think that maybe UM, the NCCAM or the Mayo Clinic simply didn’t find the studies the NDs found, you’d be wrong. The scientific medical literature which includes things like drugs and natural products is indexed. Searching it and finding studies relevant to a particular topic is what medical doctors and scientists do all the time. It is what many of the people who posted the material on the 3 sites above do for a living.

Medical scientists like pharmacologists have and continue to study all kinds of plants and substances found in nature looking for active ingredients that offer benefits. They study them in the lab, in animals and in humans. They find many that have active ingredients, describe the ingredients chemically (most people have seen chemical diagrams of molecules) and explain what they discover those chemicals do, but they don’t assume that they are safe and beneficial or routinely use them as medicine until they have a large body of evidence consisting of many solid studies done in humans that consistently show that they offer benefits and are safe. In other words SCIENTISTS DON’T ASSUME. THEY TEST. That is the essence of science. The essence of pharmacology. The essence of scientific or evidence-based medicine. It is the very essence that NDs totally miss. 

I suspect that naturopaths learn a lot of chemical names as well as the chemical components of plants and drugs and what those chemicals do in test tubes and mice and erroneously assume that they do the same thing in people. I also suspect that they assume that when they learn all that that they are learning pharmacology, but that assumption is wrong. They completely miss the fact that until there are many good studies in humans consistently giving the same results that there is no pharmacology to learn other than their alternative, naturopathic pharmacology which is based on assumption not experiments. 

naturopaths, pharmacology, science, medicine, licensed naturopaths, naturopathic schools

Saturday, June 22, 2013

Silver Added To Antibiotics

What follows are my thoughts on this article, http://www.latimes.com/news/science/la-sci-antibiotics-silver-20130620,0,6215677.story, which was written by Monte Morin and published in the Los Angeles Times on June 20, 2013 with the title, “Silver found to increase effectiveness of antibiotics”. The article reports that James Collins, a microbiology professor at Boston University, has found that silver, “when added to antibiotics in trace amounts makes the drugs as much as 1,000 times more effective in treating mice…” I have not yet obtained and read Dr. Collins’s study but am blogging on the LAT report because of the attention I am sure that it will get.

This is very exciting and promising. I hope that further studies, especially studies in humans, consistently confirm the results. If so, I will certainly endorse using silver this way and suspect that drug companies will want to add it to antibiotics and that before doing so they will do studies that show under what conditions it is beneficial, the amount that is beneficial and the amount that is toxic to the average person taking it. 

However, assuming the Times article accurately reports the original research, there are some very important things to note.

The study didn’t use colloidal silver. It used silver nitrate. Silver nitrate was used before the advent of antibiotics. It didn’t work when taken internally although it did cause many cases of argyria, gray skin. When silver was studied back then, researchers discovered that mice don’t get argyria. 

The Times reports that, “In one experiment, researchers induced peritonitis in mice by injecting them with E. coli cells. Of the mice treated with silver and vancomycin, 90% survived…Half of the mice that got silver died, along with 90% of the mice treated with antibiotics.” That sounds as if: silver nitrate and vancomycin very effectively treated E. coli peritonitis in mice; silver nitrate alone was effective in half the cases; and, vancomycin was effective in 10% of the cases. However, without knowing more details, I can’t conclude anything other than that the combination of silver nitrate and vancomycin sounds very promising indeed and should be studied further. Without knowing things like how long the animals were kept alive and monitored after the study, I have no idea whether or not any of the treatments cured them or just slowed the progression of their disease.  

The story also notes that bacterial resistance to silver has been reported. That is true. It has been seen with approved topical silver drugs that have been used extensively to treat wounds, especially serious burns usually in hospitals burn units. 

I find this study very relevant to this blog on naturopathic medicine because it strongly reinforces my entire point which is that the difference between the evidence-based or scientific medicine espoused by MDs, medical doctors, and the belief-based system of medicine embraced by NDs, naturopaths, is that MDs believe that the only way to evaluate drugs and therapies to see if they are safe and effective is to study them extensively and objectively before using them routinely. NDs on the other hand, believe in trying anything they think or hope may work either because it is natural and their philosophy holds that natural = beneficial or because, based on their own personal experience or testimony from someone else about his, they conclude that it works. 

Additionally, scientists who develop drugs and therapies believe that the only way to do that is by doing exactly the kind of objective studies that Dr. Collins has done here progressing one step at a time whereas naturopaths and other alts jump right in using whatever suits their fancy playing Russian roulette with your life and health. See why naturopaths terrify me?

silver, antibiotics, drug resistance, naturopaths, colloidal silver, silver nitrate