By Chet Yarbrough
The Skeptics’s Guide to Alternative Medicine
By: Steven Novella MD
Great Books Lecture Series
STEVEN NOVELLA (AMERICAN CLINICAL NEUROLOGIST, ASST. PROFESSOR AT YALE UNIVERSITY SCHOOL OF MEDICINE)
Many listener/readers will be disappointed, if not outraged, by Steven Novella’s criticism of alternative medicine and medical treatments. He notes that many such treatments are untested by properly conducted experiment, and replication. He notes many alleged medical treatments and cures either fail clinical tests or are not tested at all.
The significance of Novella’s argument strikes at the heart of anecdotal evidence used to advertise unproven cures for minor, as well as major medical conditions. With freedom of advertising, unproven claims of miracle cures are fed to the public. Their claims are to improve health for everything from fatigue, to joint pain, to erectile dysfunction.
Over the counter supplements and game playing are alleged to improve health and memory. Their only proof is anecdotal experience. Some advertisements of the OTC’ treatments claim to improve memory, abate Alzheimer’s, and reduce the negative effect of dementia. Support in the media comes from anecdotal stories from users of these alleged remedies.
One of the most heavily advertised health supplements for brain health today is Prevagen. Prevagen is dosed with a protein found in jelly fish.
Novella takes on the vitamin and herbal industry by noting vitamin supplements, plant and animal extracts are an unregulated industry. The FDA gives free reign to manufacturers, advertisers, and sellers of supplements which:
- 1) vary dramatically in their alleged ingredients, and
- 2) have no clinically proven benefits.
Novella explains (and most have heard this) that a balanced diet is the best prescription for healthy living. Novella notes the only exception is when there is a vitamin deficiency revealed in a blood test.
Many OTC drugs are supported by lab-coat wearing and white-shirt-and-tie actors. No reputable clinical trials are required to sell Ginkgo Biloba, Ginseng, Echinacea, and other herbal medicines.
Next, Novella takes on the Chiropractic and Acupuncture industry. Novella argues these two industries have never had clinically proven benefits. Novella implies Chiropractors talk of “vertebral subluxation” as a cause for disease that can be cured with manipulation of the body. He suggests that is quackery. Novella implies this is junk science foisted on an unwary public. No clinically reproducible experiments of this Chiropractic diagnosis and treatment have proven such a claim. Novella attacks the validity of acupuncture with the same argument. His conclusion is that any positive results are from the placebo effect, not from clinically reproduceable tests.
The body naturally fights disease with one’s own immune system. People get better and feel better because their immune system cured them. Novella explains feeling better after taking a herbal supplement may be a result of the placebo effect. Feeling better is reinforced by testimonials of those who say it worked for him or her. The obvious risk of the placebo effect is that someone who needs medical treatment will choose an alternative medicine that delays proper treatment by a qualified medical professional.
Novella suggests feeling better is not a measure of efficacy. Feeling better may be from getting over an illness.
The public is forearmed by Novella’s critique of alternative medicine. Be skeptical about what your friend, an acquaintance, a mother, a sister, a brother suggests is a remedy for your malady. Be particularly skeptical of an industry unsupervised by the FDA. Everyone should be wary of unqualified medical treatment, prescribed medicines, vitamins, and herbs. Companies in the field of alternative medicine are not in the business for your health. They are in the business of making money.
It seems prudent to suggest one should reserve a measure of skepticism for all purveyors of cures, even medical professionals. As is true of all humans, medical professionals can be seduced by the desire for money, power, and prestige–even at the expense of those who seek care.
After listening/reading Novella’s book, it seems prudent to be skeptical of all who prescribe cures for mental and physical illness.