Proponents of alternative therapies often throw around charges of vested interest when challenged. But often their own interests don’t bear scrutiny.
As this is the first of what I hope will be a regular column in the NZ Skeptic, I thought I would take the opportunity to tell you all a little bit about who I am and what has motivated me to write this column (besides David twisting my arm…). I am a research scientist with two obsessions: bioluminescence (the production of light by living organisms – think glow worms and fireflies), and nasty microbes. I feel immensely privileged to have made a career out of combining these two passions: in a nutshell, I make bacteria glow in the dark for a living.
After many years working in the UK, I was awarded a fellowship from the Health Research Council of New Zealand and relocated to the University of Auckland. Shortly after arriving in Auckland I joined Skeptics in the Pub and a fellow skeptic lent me a copy of Trick or Treatment. This fantastic book, written by Dr Simon Singh and Prof Edzard Ernst, reviews the evidence for the effectiveness of complementary and alternative medicine. I’m sure I don’t need to tell this audience that despite very little evidence for their success, these treatments are widely used.
In the final chapter, Singh and Ernst list some reasons why this might be. Surprisingly, scientists are on their list. Singh and Ernst argue that alternative health practitioners are highly vocal and many of their claims go unchallenged. They believe scientists have a responsibility to make their voices heard too. I found Singh and Ernst’s call to arms inspirational and took up blogging and writing letters to the editor as a result.
A very rich source of ire comes from a free monthly 150-page glossy A4 advertising magazine called the Ponsonby News, distributed to over 16,000 homes and businesses in Auckland. The Ponsonby News has a couple of ‘health correspondents’: John Appleton, who has a website selling vitamin and other supplements, and ‘Dr’ Ajit, an Ayurvedic practitioner with a couple of spas in Auckland. For those unfamiliar with Ayurvedic ‘medicine’, it is a system of traditional medicine that originated in India. Mr Ajit’s column is usually pretty funny, like urging people with hay fever not to eat stodgy food in winter for fear it will clog them up.
But John Appleton’s column usually worries me. A couple of months ago, he was inspired by an article he read in the Listener assessing the risks and benefits of hormone replacement therapy, which advised readers to avoid the internet and talk to their doctors instead. Unsurprisingly, Mr Appleton was somewhat horrified by this suggestion having “found the internet to be a fabulous resource” for researching topics like hormone replacement therapy.
Indeed, what he went on to write about was ‘bio-identical’ hormones which he implied are a safe and effective alternative to hormone replacement therapy. I wrote a letter to the editor to point out that the benefits of ‘bio-identical’ hormones were at best overhyped and at worst pseudoscientific nonsense1, which prompted a reply both through his column and in person. In it, I was accused of being part of the medical establishment, locked away in my ivory tower, only interested in “science for profit”, unlike those in the complementary and alternative medicine field, who he believes are doing “science for people”. He has since sent me an envelope full of reading material to show me just how bad evidence-based medicine is.
It was really interesting to read the propaganda material which has shaped Mr Appleton’s views on evidence-based medicine and the medical establishment. Needless to say, they are all non-peer reviewed articles posted on natural health websites.
I found one article in particular quite fascinating, as it trumpeted Andrew Wakefield, the disgraced gastroenterologist who insists there is a link between autism and the measles-mumps-rubella (MMR) vaccination. As a microbiologist, I am very familiar with Wakefield’s work, which is just plain old bad science (see NZ Skeptic 100). But Wakefield continues to be held up as a shining example of how a good doctor trying to do the best for his patients has been vilified by the medical establishment. If this kind of material is what Mr Appleton is using as his evidence base then I’m definitely alarmed!
I am left contemplating Mr Appleton’s concept of “science for profit” versus “science for people”. I have never thought of myself as doing science for profit. True, I make a decent living being a scientist but it is nothing like the money I imagine some of those involved in alternative medicine make. It is worrying that the alternative health field has successfully propagated the belief that it is purely motivated by improving people’s health and wellbeing, completely glossing over the fact that it is an extremely lucrative industry.
Indeed, one of the pieces of evidence that Mr Appleton used to back up the claims he made about ‘bio-identical’ hormones was a review paper written by a medical doctor called Kent Holtorf and published in an obscure peer-reviewed journal. Interestingly, Dr Holtorf declared no conflicts of interest despite the fact that he is founder of the Holtorf Medical Group which has offered ‘bio-identical’ hormone therapy for over 10 years. Science for people? More like ‘pseudoscience for profit’, if you ask me.
1‘Bio-identical’ was a phrase coined to describe plant-derived molecules believed to be identical to human hormones. No evidence has ever been presented to verify this. Many of the conventional treatments include similar plant-derived molecules. The difference is that the conventional therapies have been studied over many years so doctors know what the side effects and risks associated with them are. There is no evidence that ‘bio-identical’ hormones are safer or more effective; it is likely they have the same side effects and risks. As for it being pseudoscience, ‘bio-identical’ hormone treatment often involves blood or saliva testing to determine which hormones are deficient and hence tailoring treatment to the individual. While this sounds like a good idea, there is no scientific basis or indeed evidence that such a strategy is useful or relevant. In fact, hormone levels in the blood and saliva vary from day to day and are unlikely to reflect the actual biological activity in specific tissues.