What is Skepticism: Week 4: A Skeptic’s View of Alt-Med

The Committee for the Advancement of Scientific Skepticism (CASS) at the Centre for Inquiry Canada, in an effort to educate the public about the roles of critical thinking and the philosophy of skepticism, has produced a series of articles we have entitled “What is Skepticism?”  Over  four weeks we will be presenting them on Skeptic North and welcome your comments and discussion.

In this final entry in CASS’s series What is Skepticism, Dr.Claire Trottier  and Dr. Behzad Elahi discuss the transition of a medical treatment from alternative to mainstream and the conditions under which this transition occurs.  This article first appeared in Full Comment, a blog of the National Post, on August 21, 2010.


A Skeptic’s View of Alternative Medicine

Alternative medicine is gaining popularity in Canada, especially for the treatment of chronic conditions. Many treatment modalities are endorsed by practitioners of alternative medicine: from nutritional supplements, to acupuncture, to magnetic bracelets. It is important to examine scientifically if these treatments works, and in so doing, we can see how skeptics examine the claims of alternative medicine.

For a skeptic, it is important to constantly remain open to new ideas; being skeptical does not mean dismissing ideas outright. Skepticism means carefully investigating claims to determine if they are biologically plausible, and if they are supported by evidence. When a reproducible effect is found for a new therapy, it becomes accepted as part of medicine. Incorporating new evidence is how medicine works – which is why treatments and practices change so often. Our current understanding of ulcers is a perfect illustration of the flexibility of science-based medicine.

Medical theory used to state that ulcers were caused by stress. In 1982, two Australian scientists discovered that a bacteria was in

fact responsible. There was some early resistance in the scientific community upon publication of these results. However, once these finding were reproduced, the medical community accepted this evidence. Ulcers are now successfully treated with antibiotics, and a 2005 Nobel Prize was awarded to Barry J. Marshall and J. Robin Warren in recognition for these important findings.

The American government has poured hundreds of millions of dollars annually into the study of alternative therapies through their National Center for Complementary and Alternative Medicine (NCCAM) (the 2009 budget was 121 million dollars). In collaboration with the alternative medical community, the studies undertaken at the NCCAM have not shown any evidence of efficacy for most of the treatments studied. Gingko biloba on cognitive function: no effect. Echinacea for prevention and treatment of colds: no effect. Acupuncture for back pain: no effect. In 2009, the Associated Press investigated the NCCAM and found that after a total of $2.5 billion in research funding, no new advances in medicine had been identified.

There are occasions where there are tenuous links between alternative theories and real science. Most alternative nutritional supplements are ineffective, and some have been found to contain high levels of pesticides and trace amounts of heavy metals. However, the use of certain supplements is well-supported by science: folic acid supplements prevent neural tube defects, and many physicians recommend vitamin D supplements during the winter. These supplements are not alternative, they are part of mainstream science and medicine. What sets these therapies apart from alternative supplements is that they are supported by reproducible evidence and make biological sense.

Magnets have long been believed to have healing powers, and this idea is still very popular in alternative medicine. The magnetic bracelet is a good example; it supposedly produces a magnetic field that relieves inflammation. These bracelets have been studied, and no evidence has been found to support their use. However, specific uses of magnetic fields have shown promise in depression, and a technique called Transcranial Magnetic Stimulation is currently being studied as a possible treatment. Science and medicine do not reject the potential of magnetic fields for affecting biology. The distinction between evidence and unproven pseudoscientific claims lies at the heart of skepticism.

A skeptic must have an open mind, examine biological plausibility, and review the evidence before coming to a conclusion. Skeptics are careful to avoid being swayed by personal testimonials and anecdotes. The former editor of the Journal of the American Medical Association, George Lundberg, said it best when he argued that alternative medicine does not exist: “there is only scientifically proven, evidence-based medicine supported by solid data, or unproven medicine, for which scientific evidence is lacking”. When it comes to health, skeptics separate the wheat from the chaff and only support therapies that have been shown to work.

Author bio’s

Claire Trottier has a Ph.D. in Microbiology and Immunology, and is currently working in biomedical science education as a Postdoctoral Fellow.  She is a CFI science adviser and lives in Montreal, Quebec.

Behzad Elahi grew up in Iran in an intellectual family of skeptics and physicians.  He received his M.D. degree from Tehran University of Medical Sciences, Iran in 2005. Since 2008 he has been working on his PhD in University of Toronto, department of Neurology and Neurosurgery. Behzad holds Canadian Institute of Health Research (CIHR)scholarship  in the field of dystonia and has grown special interest in brain plasticity and movement disorders especially Parkinson’s disease and dystonia.

About the Committee for the Advancement of Scientific Skepticism (CASS) and the Centre for Inquiry Canada (CFI): CASS is a national, fast response team which critically engages with scientific, technological and medical claims made in public discourse. We address factual inaccuracies and misinformation in public debates by promoting evidence-based science. CASS is a subset of CFI. CFI is the leading freethought organization in Canada promoting reason, science, secularism and freedom of inquiry. CASS can be followed on Twitter @CFICASS, or on Facebook on the CASS fan page.

7 Responses to “What is Skepticism: Week 4: A Skeptic’s View of Alt-Med”

  1. Ben says:

    So what is the current state of affairs regarding hookworms to treat auto-immune diseases? I have heard loads of anecdotal evidence, and have even seen a few corroborating reports that deal with the Hygiene Hypothesis. I know it is firmly in the Alt-Med category for now, mostly because few health practitioners cotton on to the idea of intentionally inflicting parasitic infections on people without reasonable justification.

    Most of the hits I get on search queries seem to be of the “OMG MIRACLE CURE THAT BIG PHARMA WANTS TO HIDE FROM YOU!” bent which always sets off warning flags with me, however, unlike other forms of alt-med treatment, it seems to be getting some reasonable attention by researchers. Do you know of any recent studies that have looked into this?

  2. Claire Trottier says:

    Hi Ben – yes there is a very interesting literature on the possible links between lack of helminth (and other parasitic) infections and immune disorders such as autoimmunity and allergy. I know of a small fringe group of altmed people who advocate infecting people with parasites as treatment for these issues, but no credible scientists would suggest something like that at this point!

    There is a good review from 2009 in Immunology on this topic (Immunology. 2009 Jan;126(1):18-27) and one from 2010 in Nature Reviews Immunology (Nat Rev Immunol. 2010 Apr;10(4):278-84. Epub 2010 Mar 12). Unfortunately you need institutional access to read them. If you enter “helminth AND allergy” or “helminth AND autoimmunity” in pubmed you will be able to read lots of abstracts. This is definitely a legitimate scientific interest in this question, but we’re a long way from giving people hookworms to treat asthma :)

  3. Paul Paddon says:

    I’m new to your blog and I’m curious about the bias of the writers.

    In this article it is stated:

    “In 2009, the Associated Press investigated the NCCAM and found that after a total of $2.5 billion in research funding, no new advances in medicine had been identified.”

    I follow the link provided and it turns out that this is not correct simply based on that article (which itself is not primary source at all!)

    “After spending $2.5 billion, the disappointing answer seems to be that almost none of them do.”

    This in the first paragraph! Further, the AP article states in addition that therapies have been found to help relieve pain, anxiety and fatigue.

    Is this not a clear example of mis-representing “data” in denialist fashion?

    • Art Tricque says:

      If one reads the AP article, and the Skeptic North article through, I believe that your argument is rather clutching at semantic straws, and a rather transparent concern troll attempt at conjuring a false equivalence.

  4. R Horrowitz says:

    You are trying to re-write the dictionary here, guys! By virtue of the fact that it favours the closed-world assumption, skepticism is an inherently unscientific and inefficient way of exploring the physical universe.

    Moreover, the word simply does not mean what you would like it to mean. The closed-world assumption (that a claim is false until it is proven to be true) is no different from the open world assumption (that a thing may be assumed to be true until it is shown to be false). In fact, both assumptions are, by symmetry, equally unscientific. Skepticism is properly defined as a *mental attitude*, not a method of acquiring and analysing data. It is certainly distinguishable from science, which is a method, not a belief system or an attitude.

    The work of gathering and data can go on, quite happily, without requiring either world assumption to be in place. Likewise, when the time comes to interpret the data, one need only pick the theory that is most consistent with it. The prevailing theory often changes over time as the data set is filled out. No assumptions are required. Leave your attitude at the door.

    ‘Plausibility’ (which describes the *superficial* appearance of worth or truth) is not just irrelevant, it is perhaps the exact opposite of how good science works. The explanation that fits the data best slowly gains acceptance. Explanations or theories that do not fit the data begin to fade away. ‘Plausibility arguments’, being based on superficial appearances, seldom convince irrational people to become more rational. (Consider if you will, the homeopaths). Data however, can be compelling.

    The value you are espousing in this article (albeit unevenly) is agnosticism, not skepticism. Skepticism is more than ‘uncertainty’. It is uncertainty plus doubt.

    And doubt, along with its twin faith, are two evil fruits from the same evil tree.

    • Kim Hebert says:

      Speaking of rewriting the dictionary, it may surprise you to learn that your strawman definition of something is not THE definition.

      Yes, I know it’s a shock. Sit down and take a few deep breaths.

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  • Michael Kruse

    Michael is an advanced-care paramedic in York Region, just north of Toronto, Ontario. A semi-retired theatrical lighting designer as well, he re-trained in 2005 as an EMT-PS at the University of Iowa and as an ACP at Durham College, and is currently working towards a B.Sc at the University of Toronto. Michael is a founder and the chair of the board of directors of Bad Science Watch. He is also the recipient of the first annual Barry Beyerstein Award for Skepticism. Follow Michael on twitter @anxiousmedic. Michael's musings are his own and do not necessarily represent those of his employer or Bad Science Watch.