Pseudoscience for profit

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.

Chemistry: an antidote to pseudoscientific thinking?

Having a basic knowledge of the principles of chemistry can help one evade the pitfalls of many pseudosciences – but it’s not infallible. This article is based on a presentation to the 2011 NZ Skeptics Conference.

2011 is the International Year of Chemistry and as such I have been involved in a number of activities to celebrate the many contributions chemistry has made to our world. It has also been a time of reflection, during which I have asked myself, can an understanding of chemistry act as an antidote to pseudoscientific thinking? But first let us start with a definition of what chemistry is.

Chemistry is the study of matter, where matter is the material in our universe which both has mass and occupies space. Matter includes all solids, liquids and gases, and chemistry explores not only the properties and composition of matter but also how it behaves and interacts. Therefore chemists also have to understand how matter and energy interact.

While in theory chemistry can be described as an isolated discipline, in its practice and application it often contributes to, and is supported by, other scientific disciplines including biology (pharmacology, molecular biology) and physics (materials science, astrochemistry).

Core Chemical Concepts

At the heart of chemistry are some central concepts which form the foundation of this discipline. Let us examine some of these.

1) Matter is made up of atoms

The most basic structural unit in chemistry is the atom. The atom itself is made up of a nucleus containing particles called protons and neutrons, around which smaller particles called electrons orbit.

2) Atoms with different numbers of protons give rise to the different elements

Atoms exist with different numbers of protons (neutrons and electrons). These different atoms afford the different chemical elements which are usually represented in the form of the periodic table (see diagram). Each element has different properties and is represented on the periodic table by a one or two- letter symbol. Ninety of the elements occur naturally and these elements can combine to form the fantastically diverse types of matter that make up our universe.

The atomic number (the number above each element) signifies the number of protons each atom has in its nucleus. You will see as you read across each row and then down the number of protons in the nucleus increases.

3) Atoms are really, really small

Atoms are so incredibly small that it can be hard to visualise how very small they are. For example, our lungs hold approximately 1,000,000,000,000, 000,000,000,000 gas atoms, while a grain of sand contains approximately 100,000,000,000,000,000,000,000 atoms.

4) Matter cannot be created or destroyed, it can however be rearranged

All of the atoms in existence were created billions of years ago in the heart of stars early in the formation of the universe. I find this an extraordinary concept – that the atoms which make up our bodies have existed for billions of years during which time some of them may have formed part of the last Tyrannosaurus rex, the first flowering plant, or occupied the bodies of various historical figures. Carl Sagan puts this more eloquently and succinctly when he explains that “we are made of star stuff.”

5)Atoms combine to form molecules

The true diversity of the matter in our universe comes from the ability of atoms to combine to form molecules. Molecules can be simple, for example water, which is made up of one oxygen atom and two hydrogen atoms, or complex, such as DNA, which can be made up of billions of atoms of the elements carbon, hydrogen, oxygen, nitrogen and phosphorus.

Molecules are also incredibly small – a single aspirin tablet contains approximately 1,000,000,000,000,000,000,000 molecules of the active ingredient, acetylsalicylic acid.

6) The shape of a molecule is key to its properties

The shapes of molecules have a fundamental effect on their properties. Water molecules, for example, have a V-shape which allows water to exist as a liquid at room temperature and to dissolve many different compounds. Without these fundamental properties, life as we know it would not have been able to evolve on Earth.

The shape of molecules is a key consideration in the development of new drugs. Many drugs work by interacting with specially shaped receptor or active sites in the body. To activate or deactivate these sites, a molecule of complementary shape must be able to fit into the site. And by making subtle changes to the shapes of such molecules it is possible to tune the effect of the drug molecule.

7) Matter moves

It may not be obvious to the naked eye or even under a microscope but all matter moves. In liquids such as water, the individual molecules move relative to each other, only fleetingly and temporarily interacting with other water molecules. This can be observed by adding a drop of food colouring to a still glass of water. The movement of the water molecules alone slowly mixes the colouring throughout the glass without any need for external agitation.

What do these concepts tell us about homeopathy?

Homeopathy was developed just over 200 years ago and is based on three principles:
a) that diseases can be treated by using substances that produce the same symptoms as the disease; b) that the greater a substance is diluted the more potent it becomes;and
c) that homeopathic solutions are ‘activated’ by physically striking them against a solid surface.

If one considers these principles against the core chemical concepts discussed so far they make little sense. How can less of a substance be more potent? How could the variable striking of water solutions have any effect on water molecules which are already in motion relative to each other, and which are therefore unable to form any collective memory of an active substance? For homeopathy to work, key chemical concepts which underlie and explain much of what we know about the physical world would have to be turned on their heads. Such a challenge to well-established chemical concepts would require extraordinary evidence.

To date, no such evidence has been provided by homeopaths. Instead, over the past 200 years, repeated attempts to prove that homeopathy works have demonstrated little more than the placebo effect and the human propensity for confirmation bias.

More Chemical Concepts

8) The Earth is a closed system in terms of mass

Apart from the launch of the occasional deep space probe, the loss of helium into space, or the addition of the occasional meteor, the Earth retains a constant mass. Thus, our physical resources are limited.

9) Matter is continuously recycled

Although we have a limited resource in terms of matter, this matter is continuously recycled as these ancient and indestructible atoms are converted from one chemical compound to another. For example, the carbon in coal when burnt is converted to carbon dioxide which may then be converted by plants into sugars. Such recycling occurs for many elements, particularly in the biosphere of our planet.

10) Chemical compounds can store and release energy

Some chemical compounds are rich in energy and this energy can be released to produce energy-poor compounds. For example, when we burn coal or oil we release energy and produce energy-poor carbon dioxide, or when we consume sugars we use the energy released in our bodies and again produce carbon dioxide. This carbon dioxide can be recycled through photosynthesis in plants to produce more sugars and other energy rich compounds for food. The same is not possible for coal or oil, and as such these are limited resources.

11) Systems are in equilibrium

The systems by which matter is continually recycled are very complex and interrelated. Such complex systems are usually in equilibrium – this means that if we change one variable the system will adjust itself to compensate. For example, as the amount of carbon dioxide has increased in our atmosphere, some of it has been removed by dissolving in the oceans.

The idea of system equilibrium is used by some to claim that an increase in carbon dioxide concentrations in our atmosphere is harmless as the system can rebalance itself. This is potentially dangerous thinking. Most systems, particularly complex ones, can only buffer a certain amount of change, beyond which the system may undergo significant change as it attempts to rebalance itself. Such changes would not necessarily be conducive to human life.

What do these concepts tell us about our environment?

Fossil fuels are a non-sustainable source of energy that also release pollutants and increase carbon dioxide levels in the atmosphere. Humanity would be better served developing alternative sources of energy which harness the power of the sun more directly, for example, through solar panels, hydroelectricity, wind turbines or biofuels. More attention needs to be paid to the effects of increasing carbon dioxide levels in our atmosphere, and its effect on the equilibrium of the Earth’s biosphere.

Chemophobia – Causes and Consequences

There are millions of different chemical compounds in existence and chemists use a standardised naming system in order to better catalogue and compare these fascinating compounds. Unfortunately, amongst non-chemists this chemical jargon can create concern and even fear. For example, most people when asked would turn down an offer to eat a mixture containing methylmethoxypyrazine, phenylacetaldehyde and b-tocopherol, at least until it is revealed that the aforementioned mixture is a chocolate bar, and all of the compounds are natural components of chocolate.

This caution or fear of the unknown is a natural instinct which has served human beings well throughout our evolution – allowing us to avoid poisonous foods and dangerous predators. However, in the modern world it can be used against us. Referring to compounds by their chemical names is a ploy used by various interest groups including alternative health gurus and anti-vaxers to try and create fear of mainstream medicines.

Furthermore, it has allowed the development of the myth of the ‘chemical-free’ product. To a chemist, the only thing that is chemical-free is a vacuum.

The term ‘chemical-free’ appears to be an invention of the marketing industry: an attempt to sell products by suggesting that if they contain only natural compounds they must be safe, healthy and/or environmentally friendly. This is, of course, very flawed reasoning. Nature produces a wide range of compounds that are toxic to humans. Tetrodotoxin from poorly prepared puffer fish, ricin from castor beans (used to assassinate a Bulgarian dissident in 1978), digitalis from foxgloves and arsenic in groundwater are all just as capable of knocking us off as any synthetic compound.

Indeed, when it comes to toxicity it is not whether something is natural or synthetic that is important. Rather it is the dose. Any substance is capable of being toxic. Consuming four litres of water in two hours can prove fatal, as can several hours’ exposure to a 100 percent oxygen atmosphere.

The idea that toxicity is dose-dependent is not new. In the 16th century the Swiss physician Paracelsus stated that “all things are poison, and nothing is without poison; only the dose permits something not to be poisonous.” However, it remains a concept that is not well understood today. Special interests groups have used this to create fear around issues such as water fluoridation, vaccines, and environmental issues. For example, when DDT started to be detected in the environment at part per million levels, the resulting knee-jerk withdrawal of DDT from the marketplace resulted in a resurgence of malaria in many vulnerable populations. Following the introduction of DDT in Sri Lanka, by 1963 the number of cases dropped to 17. A few years after DDT use was banned, the number of cases increased to 2.5 million cases in 1968 and 1969.

Another consequence of chemophobia, is that it can encourage people to embrace ‘alternative’ treatments, such as homeopathy. An example of the terrible consequences of such erroneous thinking was the death of Gloria Thomas, aged nine months, in Australia in 2002, when her homeopath father refused to treat her eczema with conventional medicine. Instead, she was given homeopathic remedies until she died of septicaemia and malnutrition.

Absurd Chemical Therapies

One of the incredible hypocrisies of some alternative medicine practitioners is that they may also embrace absurd chemical therapies. Anti-vaxers who claim autistic children are really suffering from mercury poisoning sometimes promote the use of chelation therapy. Chelation therapy involves the intravenous use of chemical agents which bind to heavy metals in the blood. It is an invasive technique which can also strip the blood of important metal ions such as calcium. Indeed, there are examples of patients who have died because too much calcium has been stripped from their blood.

Other alternative treatments have included ‘miracle mineral solution’ as a treatment for everything from Aids to Irritable Bowel Syndrome. Such wide-reaching claims are an immediate warning sign, as is the revelation that ‘miracle mineral solution’ is, in fact, a 28 percent solution of bleach! Dilute solutions of dimethylsulphoxide (DMSO), an industrial solvent, have similarly been promoted as a cure-all, supported by, of course, only vague anecdotal evidence.

When challenged, those peddling these absurd therapies will often cry ‘conspiracy’, and claim they are being victimised by the all-powerful pharmaceutical industry.

Consequences of not understanding chemistry

We live in a world where important public debates are becoming contaminated with non-science and nonsense. Knowledge of chemistry can help us identify and challenge some of the non-science and nonsense when exploring important issues such as climate change, environmental issues, water fluoridation and vaccination.

Is chemistry an antidote to pseudoscientific thinking?

At the beginning of this article I posed the question, “Is chemistry an antidote to pseudoscientific thinking?” And while I hopefully have demonstrated that knowledge of chemistry can help identifiy and challenge pseudoscientific thinking, I cannot claim that it, alone, is an antidote. I know this because there are those who despite a background in chemistry still embrace pseudoscientific beliefs. These include:

  • David Rasnick – after training as a chemist and working in medicinal chemistry for 20 years Dr Rasnick became an Aids denialist and proponent of vitamin ‘therapies’.
  • Kary Mullis, Nobel prize-winning biochemist, is an Aids denialist, a believer in astrology, and claims to have met an extraterrestrial disguised as a fluorescent raccoon.
  • Lionel Milgrom, research chemist for 30 years, is now a practicing homeopath and prominent advocate of homeopathy.

The idea that those who have trained to an advanced level in chemistry (or any other science) can go on to embrace pseudoscience has always intrigued me. I’ve often wondered how such a transition could occur, and would suggest that perhaps one or more of the following factors may be involved:

1) Frustration with science

Progress in science is often slow and frustrating. The temptation to find an easier, albeit fallacy-based career may be appealing when faced with the many frustrations of laboratory work.

2) External bias

Religious and moral beliefs may introduce bias. For example, a number of Aids denialists are blatantly homophobic.

3) No understanding of the scientific method

While most scientists pick up the principles of the scientific method during their training, few that I am aware of are explicitly taught the scientific method.

4) Need for attention/notoriety

5) Financial motives

The peddling of pseudoscience can be quite lucrative, particularly when you can use academic qualifications to lend the appearance of legitimacy to one’s claims.

I suspect that in most cases, the embracing of pseudoscientific beliefs by scientists is a gradual process, where step by small step, they move away from the scientific method until eventually they find themselves no longer bound by its philosophy and rigour.

Conclusion

While an understanding of chemistry does not necessarily provide an antidote to pseudoscientific thinking, when coupled with the tools of rational thinking, it provides the skills to critically assess many areas where pseudoscientific beliefs persist including water fluoridation, environmental science, climate change, homeopathy and alternative medicines.

“Never let yourself be diverted by what you wish to believe, but look only and solely at what are the facts.” -Bertrand Russell

An Aussie takeover?

The Letters to the Editor columns have been spilling over with irate readers concerned about yet another attack on New Zealand’s sovereignty. The cause of all the anger is the proposed Therapeutic Goods Act, which would see a trans-Tasman agency take over the regulation of therapeutic products – a term which includes not only medicines and medical devices, but also complementary medicines and dietary supplements. No one seems too concerned that the new Australia New Zealand Therapeutic Products Authority will be regulating medicines; the fuss is all about what this move will do to the alternative health industry.

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