2,5 Billion(!) dollars spent on search for alternative therapies...

Often when I debate alternative therapies or remedies with people they claim that there is no evidence in favor of alternative methods and therapies because no one bothers to investigate (and find the amazing effects), or that no money is given to investigators who want to test these remedies i.e. that the grant managers are against alternative therapies. These excuses are now no longer valid since the American government has spent 2,5 Billion dollars testing alternative therapies.

As was known and not unexpected from my point of view is that some alternative therapies do show minor benefits. Acupuncture works for certain things, yoga helps you relax which also results in other spin off effects. However a large majority of the therapies tested proved to be no better than placebo (if you think that placebo is "good enough" read my post here).

Also remarkable is how easy it seems to be to get a grant if you wan't to study alternative therapies (which by definition do not have a solid scientific theory behind them). In one instance 2 million dollars were given to study whether accupressure could help people loose weight. Now this large sum of money was given despite the fact that a pilot study on 60 participants had failed. The grant was given even though no scientist have ever found any evidence of meridians (in accupressure you are supposed to press on these meridians). I could go on, but the essence of the matter is that these 2 million dollars were given to a study that, judging from the evidence, had extremely low plausibility - I would even go as far as to say that if accupressure would prove to have an effect (beyond placebo) we would face a paradigm shift in biology.

There are of course some positive aspects of this endeavour. I suppose that it is normally good to test whether a really popular type of therapy works. However, the question is whether the people using a particular therapy cares about the outcome of a scientific study - my guess is that they will only care if it gives them a positive results, otherwise it is just biased scientists. I also have trouble seeing where to put the line, there are some really crazy ideas out there and if we would start to research everything that is getting popular we would end up spending huge amounts of money on evaluating pure nonsense.

I would personally prefer that grants are given to those who have good reasons for studying whatever it is they want to study, today that is not the case...

See also orsakverkan (swe)

Popular fallacies of alternative and complementary medicine

In the most recent issue of the magazine "Skeptic", Harriet Hall, also known as "SkepDoc" writes about three fallacies that you will encounter very frequently if you engage in discussion about alternative or complementary medicine. I will of course not plagiarize Hall's article, but what I am writing here is her article, filtered through my brain (I have written about related matters here and here)...

The fallacies that you will inevitably hear are the following three;
(1) It is "natural" (and hence better for you)
(2) It has been used for a long time (and if it didn't work people would have stopped using it)
(3) It works for me (or a friend or a spouse or a friend of a friend...)

So natural is good by default ehh? In this form the statement sound very categorical, and hence, put in this fomr, the claim can be falsified by a single unambiguous counter-example, and there are plenty... Curare, a compound extracted from nature (and thus a natural compound?) will paralyze you and hence is not recommended unless you need to be still during a surgery. There are many different, naturally growing mushrooms, which will kill people who try to eat it. There is also the fen-phen scandal where a product which was advertised as an alternative medicine was later shown to have severe side effects, despite the fact that the active ingredient was "natural".

Ok, sure, there are a few extreme counter-examples, but still, isn't natural products better in general? Well this is certainly debatable and I would not jump to verdict just yet, however, the evidence to date actually tells the opposite story, namely that natural is often worse than "synthetic" (or whatever you won't to call it). Plants which are sprayed with pesticides are protected from potential predators and therefore they can use all their energy to grow. Now that I think of it, it is rather similar to us humans, in peacetime we can spend our energy on building schools and being nice to children and that sort of stuff... Plants which are not sprayed are not given their protection and therefore they have to use allot of energy on chemical warfare (or the plant-equivalent thereof). Basically they produce chemicals which will make the predator (us), sick.

But don't synthetic pesticides make you sick too? In large quantities they might (just like natural pesticides). However, pesticide control is rather strict and the chemicals used are tested so that they are of minimal danger to us... I have written more about this issue here.

The second argument says that if something has been used for a long time then it is because it is good. Again there are many counterexamples. Some people persist in using astrology even though it has been falsified over and over again. Astrologers cannot do what they claim to be able to do, and add to that the fact that their quackery is based on an astronomical model that is very out-dated. Still people are still using it… If we would have strictly gone by the "old is good" rule we would still be drilling holes in people's head to relieve headaches (here you can buy your own drill kitJ), and what about all new techniques and medicines that are developed? Are we to discard them because they are new? The fact of the matter is that we cannot rely on tradition. The way to test whether a therapy is good or bad is to do a proper, scientific test where it is possible to isolate the effect of the medicine from other factors such as placebo.

The last argument (it works for me), is the one that I have most sympathy for. In my opinion we should have respect for individual differences as well as the power of people's belief to cure them or at the very least make them feel better. If someone starts taking extra vitamins to bolster their immune system and then they do not get sick for a long time then everything is great (as long as they don't overdose which could be dangerous). Similarly, when I tell people that I am studying the brain I am often told about some therapy or mental training that I have never heard about before but which has changed their life. In those cases I normally just say that I am happy for them. However, the mistake that is often made is to assume that just because you have experienced miracles everyone else will too. Even with most conventional medicines which have a proven effect that is greater than placebo, it doesn't work for everyone. The point is that what works for you might not work for other people. Most alternative therapies have not been tested (or they have been tested with no effect). The responsible policy if you ask me is that doctors advocate therapies which have a proven effect, but do not prevent people from spending their money on other therapies (as long as they are not harmful)…

Medical myths

Rational as I may be I sometimes engage in superstitious behaviors because of advice I have heard a long time ago and then stuck. For example, when I have a flu I usually overdose on C-vitamin. I believe that this piece of advice was made famous by Nobel prize winning scientist Linus Pauling who asserted that C-vitamin could cure the common cold. According to other sources that I trust more on this particular issue, such as Harriet Hall, also know as the "Skep Doc", a C-vitamin overdose will at best shorten the common cold for a day, and that is for people who do not eat a lot of C-vitamin in the first place (I am one of them why I may perhaps benefit somewhat), at worst a C-vitamin overdose can make you quite sick.

Two other behaviors which I sometimes engage in is drinking coca cola when my stomach is upset, and eating garlic when I have the common cold. Quick google searches did neither prove or disprove the efficiency of these two questionable treatments. Perhaps someone out there know something about it (in which case I hope you will share your knowledge).

What I really wanted to write about in this post is an article published in the British Medical Journal in which widespread myths, often reinforced by doctors were punctured. Some of these myths I believed in firmly until I saw the article. For example I have thought for a long time that reading in dim light is bad for your eyes. Now, becuase of this article, I know that there is no good evidence to back this claim. I had been wrong, but now I have changed my provisional world model to fit the new data (I stand corrected to put that more simply).

However, I am proud to say that I never bought into the myth that you only use 10% of your brain. Then again, I am a brain researcher so perhaps I cannot brag to much about this accomplishment. The idea, though popular in books such as Uri Geller's "Little Mind Power Book", is completely absurd. Would evolution allow 90% of our brain just sit there and do nothing, I think not. By the way, the claim can be easily disproved by sending a person into an FMRI and watch how the entire brain lights up which is an indication of energy expenditure (maybe with the exception of people like Uri Geller). Furthermore, in contrast to predictions of the "we only use 10% of our brain" hypothesis, removal of almost any part of the brain will result in clear symptoms,


The entire list of medical myths which are debunked in this nice article are as follows. Take a look at the article if you are not willing to take my word for it (there are nice references as well).

1. People should drink at least 2,5 litres of water per day
2. We only use 10% of our brains
3. Hair and fingernails continue to grow after death
4. Shaving hair causes it to grow back faster and be coarser
5. Reading in dim light ruins your eyesight
6. Eating turkey makes people especially drowsy
7. Mobile phones cause electromagnetic interference in hospitals

Complementary and alternative medicine - Spontaneous recovery from disease

Alternative and complementary medicine refers to products and practices which are not part of the standard medical procedure that you get when you go to a hospital. Though the terms are often used interchangeably, alternative refers to when a practice aspires to replace standard medical care whereas complementary practices only aspire to complement standard medical procedure. For sure, for sure, medical research is far from a complete understanding of the physiology and anatomy of humans, and there are almost certainly many effective remedies which are not a part of the standard repertoire today. In the future we will no doubt see many advances in science and in consequence, new therapies to treat disease.

Having said this, complementary and alternative medicine suffers from what I consider to be a much more serious problem. First of, many of the techniques and practices used in alternative and complementary medicine have never been tested, or have not gained any support, in controlled studies and hence they have never proved to have any "real effect" (as opposed to placebo effect which they probably do have). Even more serious, because alternative therapies have often not been tested properly, it is hard to tell whether they have any serious side effects. What is almost certain is that if a particular substance has any effect at all, then it is more than likely to have side effects as well (see table at bottom of this article).

Sometimes alternative practices turn out to be effective and when they do they are eventually assimilated into standard medical practices. To be fair, this assimilation process can sometimes be agonizingly slow and some doctors are probably too conservative, however, the essence of the matter is that when an alternative treatment or therapy has gained enough support in studies it will cease to be "alternative" and become "standard". This is to some extent true for acupuncture, which is now used occasionally as a treatment for various conditions even though it has long been controversial. However, importantly, the mechanism that makes acupuncture work seems to be different from what has been claimed by those who have used this procedure in the past. No meridians have ever been demonstrated. Instead it seems that acupuncture stimulate pain sensing nerve endings. These nerve endings in turn exercise a form of lateral inhibition meaning that they block other pain sensing nerve endings around them, thus preventing the patient from experiencing pain in that area.

Complementary and alternative practices can often give the illusion of being effective because we recover spontaneously from diseases. We have an impressive immune system, which deals with seemingly limitless pathogens in an extremely efficient and competent manner. I am making up the numbers here, but say that after taking a certain herb 90% of all people recover from the flue within a week. Wow, surely there must be something to it then? But wait a minute. Almost everyone (say 90%) recovers from the flue within a week if they just stay home in bed. Suddenly these herbs do not seem that fantastic, and they seem even less attractive if you take into account the often excessive price tags.

Back pain is another example that deserves mention, and these figures I am not making up (they come from a lecture I attended recently). Nine out of ten (90% that is) cases of acute back pain will go away after one week. Combine this with the fact that 60-80% of all individuals will experience back pain sometime in their lifetime and what you get is an awful lot of cases of back pain that goes away in one week. Not surprisingly, at least not to a cynic like me, there are a huge number of alternative or complementary therapies for back pain, and they all seem really successful as long as you do not compare them to no treatment at all…

Here is my advice, my alternative therapy if you like. If you experience back pain, and don't have any other serious symptoms such as your vertebrae penetrating your back muscles (in which case I would advice going to a doctor), don't spend your money on all sorts of alternative/complementary therapies, rather relax for one week and see if the pain simple goes away (in most cases it will). Once you have recovered, use the money you would have spent on a therapy on something nice, such taking your girlfriend to a cozy restaurant. If the pain does not go away after one week, go see a doctor and have your back checked up…

Writing about alternative medicines is something that really warms my heart. I have written about homeopathy here, here and here, and here I have written about the role of the placebo effect.