Detoxes, herbalism debunked

[dorisbonkers]

Hello all. I’m glad I found this site. It’s like finding an oasis. I saw a reference on Richard Dawkins’ site and I’ve spent good few days reading the some of the posts -- particularly the mammoth Mannion ‘non-evasive psychic surgery posts, as well as the traditional Chinese medicine ones (I am from the UK but currently work in Singapore so it’s prevalent here – I’m also pregnant and the Chinese confinement rules I’ve come to learn are off the scale…)

I thought I’d leap straight in with a subject that really bugs me – detoxes – and maybe you can help me formulate a response to a discussion I’m having with someone on a pregnancy board.

My father’s friend was a top oncologist and I remember years ago having a discussion about detoxes and what a load of quick-fix snake oil they were. As I understand it from him, the liver and kidneys work, or they do not (in which case you’re in serious trouble and seeing a doctor anyway. You can eat healthily and cut back on alcohol and caffeine and get plenty of sleep and exercise. That will help you feel better after a period of living unhealthily. Unfortunately that’s not a quick fix like downing 4 pints of wheatgrass decoction a day and eating nothing but alfafa sprouts for a week. Anyway, I think we may all be singing from the same hymn sheet on this subject.

I had a discussion with a woman asking about Gillian McKeith’s (yes, the hunchback poo quack) 24 hour (now THAT IS a quick fix promise) detox and I advised against all detoxes and told the lady to eat healthy food, drink enough water, do some light exercise and get plenty of sleep AND spend the 20-30 quid she would’ve handed over to that old crone on a treat for herself.

The woman who runs the site challenged me (although to be fair, she’s no fan of McKeith)

The reason I feel driven to answer is that while the view seems perfectly reasonable at first, thinking about it, I feel it’s the thin end of the wedge and can be harmful in that it doesn’t encourage critical (enough) thinking about an important subject – one’s health – and also allows complementary therapists to get away with dubious claims and rip us off.

Plus there’s the old canard about evil Big Pharma vs non-profit (ha) complementary therapy.

I should add that I don’t believe in complementary therapy, only medicines and treatment that have been proved to work (of which some may be derived from plants, like aspirin) and those that haven’t.

Here she starts:

“Well if you stop drinking and take milk thistle, for instance, that may help to cut down "fatty liver" and improve other liver conditions. Although the tests on milk thistle have not yet been rigorous or extensive enough, that does not cancel out the effects that have been shown.”

She provided two sites (I can't post them as I've not reached the posting limit)

But the first one is just a summary of some research, saying no results have been conclusive, while the second explicitly states: “Clinical efficacy of milk thistle is not clearly established.”

So should I hand over my 10 pounds to the makers of milk thistle (for some reason this is viewed as less pernicious than handing over 10 pounds to big Pharma) on the basis of very little?

And besides, how in God’s Holy Trousers do I know I have a “fatty liver”. A doctor would surely need to diagnose alcoholic or non alcoholic steatohepatitis? And surely in that case I’m in better, more qualified hands (than myself and some herbalist) to proceed with possible treatment.

Then she says this:

“And, of course, there are no large pharma companies pushing a product that is available to everyone, and perhaps falsifying or nudging studies into it. Plenty of "standard" drugs have somewhat dubious, exaggerated or insufficient research behind them.”

Ah, evil pharma. I’m not sure what standard drugs that have insufficient research are – she doesn’t name them, but of course I concede that there have been some drugs whose side effects were eventually deemed too hazardous post approval (I’m a reporter and used to cover healthcare). But generally, medicine and science has an open mind and uses the testing methodology to continually reassess and refine. It’s called progress. I’m not sure we’re getting that here with exhortations to swallow spoonfuls of liquid we’re not sure works. And being satisfied with that.

Besides, it raises the question, if it’s been used to improve liver function since Greco-Roman times, wouldn’t doctors have pounced on it, tested it rigorously, and if it worked, prescribed it widely?

The last comment is:

"Eating sensibly" is not always the only way to improve our body's function.”

But surely if I was eating healthily and getting sleep and had cut back on booze and FELT ILL, I’d seek medical advice rather than randomly dose myself up with products that still COST money. Plus don’t illnesses and feeling ropey often just come and go? If all I relied on was my own anecdotal evidence that I somehow recovered because at the same time I was drinking some tonic, I’d be doing myself a disservice.

Also contained in this is a spurious idea that you can somehow improve on the normal function of an organ and create a super-organ running on absolutely all cylinders. Surely a responsible doctor/scientist with qualifications, experience and years of testing would desire that. But they generally don’t (the discussion over doctors prescribing complementary treatments is another area) think this way because the organs either work or they don’t, and if they don’t you have a problem, which may or may not go away of it’s own accord, but should be looked into by a trained professional.

Perhaps I’m being churlish. I’d certainly like to know more about how self-suggestion works and placebos and how seemingly taking charge of one’s health can help a patient recover.

Thanks for listening, and sorry for such a lengthy first post.

[filippo lippi]

Don't apologise, some of my posts run to two or three lines ;)

[Pebble]

The main problem with debunking detoxification diets, is that diet manipulation has been touted by the medical profession from the time of Hippocrates. When one thinks about it most medicines are administered orally, and a lot have origins in or are related to plant extracts. Even to this day we continue to experiment with low carbohydrate, low fat, high roughage diets. Most of this is not well supported by evidence (though the low carbohydrate diet is better than most (NEJM last week). The result is to some extent criticising the woo mongers then becomes a case of the pot calling the kettle black.

Where the departure occurs is that we at least try to construct clinical trials to test the ideas out, and avoid hyperbole (such as accusing the colon of being a known source of toxins - evidence not provided). Even in the detox area there are some attempts to understand what might be going on - see below:

Br J Nutr. 2008 Apr;99(4):883-92. Epub 2007 Sep 21.

A short-term intervention trial with selenate, selenium-enriched yeast and
selenium-enriched milk: effects on oxidative defence regulation.

Ravn-Haren G, Bügel S, Krath BN, Hoac T, Stagsted J, Jørgensen K, Bresson JR,
Larsen EH, Dragsted LO.

Department of Toxicology and Risk Assessment, National Food Institute, Technical
University of Denmark, Mørkhøj Bygade 19, 2860 Søborg, Denmark. grh@food.dtu.dk

Increased Se intakes have been associated with decreased risk of cancer and CVD.
Several mechanisms have been proposed, including antioxidant effects through
selenoproteins, induction of carcinogen metabolism and effects on the blood lipid
profile. In a 4 x 1 week randomised, double-blind cross-over study, healthy young
men supplemented their usual diet with selenate, Se-enriched yeast, Se-enriched
milk or placebo (Se dose was 300 microg/d for selenate and Se-enriched yeast, and
about 480 microg/d for Se-enriched milk) followed by 8-week washout periods. All
Se sources increased serum Se levels after supplementation for 1 week. The effect
of the organic forms did not differ significantly and both increased serum Se
more than selenate. Conversely, thrombocyte glutathione peroxidase (GPX) was
increased in the periods where subjects were supplemented with selenate but not
in those where they were given Se-enriched yeast or Se-enriched milk. We found no
effect on plasma lipid resistance to oxidation, total cholesterol, TAG, HDL- and
LDL-cholesterol, GPX, glutathione reductase (GR) and glutathione S-transferase
(GST) activities measured in erythrocytes, GPX and GR activities determined in
plasma, or GR and GST activities in thrombocytes. Leucocyte expression of genes
encoding selenoproteins (GPX1, TrR1 and SelP), and of electrophile response
element-regulated genes (GCLC, Fra1 and NQO1) were likewise unaffected at all
time points following intervention. We conclude that thrombocyte GPX is
specifically increased by short-term selenate supplementation, but not by
short-term supplementation with organic Se. Short-term Se supplementation does
not seem to affect blood lipid markers or expression and activity of selected
enzymes and a transcription factor involved in glutathione-mediated
detoxification and antioxidation.

Toxicon. 2007 Sep 1;50(3):339-48. Epub 2007 Apr 22.

The effect of feeding piglets with the diet containing green tea extracts or
coumarin on in vitro metabolism of aflatoxin B1 by their tissues.

Tulayakul P, Dong KS, Li JY, Manabe N, Kumagai S.

Graduate School of Agricultural and Life Sciences, University of Tokyo, Yayoi
1-1-1, Bunkyo-ku, Tokyo 113-8657, Japan.

To clarify whether enzymes involved in aflatoxin B1 (AFB1) metabolism in pigs
respond to antioxidant agents, the effect of feeding piglets with diets
containing green tea extracts (Sunphenon) and coumarin on in vitro AFB1
metabolism by their liver and intestinal tissues was studied. The results showed
that coumarin reduced AFB1-DNA adduct formation by both liver and intestinal
microsomes, while Sunphenon did not have any effects. Both coumarin and Sunphenon
enhanced the glutathione S-transferase (GST) activity to conjugate AFB1 to
glutathione GSH in the intestine, although no effects were noted in the liver.
Changes of the expression of mRNA of GSTA2 and GSTO1 were not in parallel with
the observed changes of GST activity, suggesting that other GST subtypes are
involved in the GST activity toward AFB1. As for lipophilic-free AFB1
metabolites, coumarin reduced the liver microsomal conversion of AFB1 to
aflatoxin M1 (AFM1) and aflatoxin Q1 (AFQ1), but Sunphenon exerted no effects.
Both coumarin and Sunphenon enhanced the conversion of AFB1 to aflatoxicol in the
liver. All the results suggest that feeding with a diet containing coumarin
affects AFB1 metabolism to enhance AFB1 detoxification through the suppression of
P450 enzyme activity in the liver and the enhancement of GST activity in the
intestine. Feeding with a diet containing Sunphenon enhances AFB1 detoxification,
but the effects are noted mainly in the intestine.

Cancer Epidemiol Biomarkers Prev. 2000 Aug;9(8):787-93.

Modulation of human glutathione S-transferases by botanically defined vegetable
diets.

Lampe JW, Chen C, Li S, Prunty J, Grate MT, Meehan DE, Barale KV, Dightman DA,
Feng Z, Potter JD.

Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center,
Seattle, Washington 98109-1024, USA. jlampe@fhcrc.org

Glutathione S-transferases (GSTs) conjugate activated xenobiotics with
glutathione; thus, GST induction may improve detoxification and excretion of
potentially harmful compounds. Using a randomized cross-over design, we tested
the hypothesis that, in humans, serum GST-alpha concentration (GST-alpha) and GST
activity increase with vegetable consumption and that this effect is GSTM1
genotype dependent. Twenty-one men (10 GSTM1-null and 11 GSTM1+) and 22 women (15
GSTM1-null and 7 GSTM1+), nonsmokers, 20-40 years of age and not on medications,
ate four 6-day controlled diets: basal (vegetable-free), and basal supplemented
with three botanically defined groups of vegetables (i.e., brassica, allium, and
apiaceous). Fasting blood samples, collected on the last 2 days of each feeding
period, were analyzed for GST-alpha, serum GST activity [against
1-chloro-2,4-dinitrobenzene (CDNB) and 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole
(NBD-Cl)] and peripheral-lymphocyte GST-mu activity (against trans-stilbene
oxide). The brassica, but not allium or apiaceous, vegetable diets (relative to
the basal diet) increased GST-alpha by 26% (P = 0.005) and GST (NBD-Cl) activity
by 7% (P = 0.02) in the GSTM1-null individuals, particularly the women. Apiaceous
vegetable supplementation decreased GST-alpha in the GSTM1+ men (P = 0.03). Among
the GSTM1+ women, both brassica and the allium diets increased GST-mu activity by
18% (P = 0.02) and 26% (P = 0.001), respectively. The vegetable diets had no
effect on GST (CDNB) activity, irrespective of GSTM1 genotype or sex. These
results demonstrate that GSTM1 genotype has a significant effect on GST responses
to diet and that brassica vegetables are most effective at inducing GST-alpha,
whereas both brassica and allium vegetables induce GST-mu. GST responses were
more pronounced in women than men, but it is not clear from this study whether
this is a dose-per-body-weight or a sex-specific effect.

Carcinogenesis. 1995 Sep;16(9):2125-8.

Effects of consumption of Brussels sprouts on intestinal and lymphocytic
glutathione S-transferases in humans.

Nijhoff WA, Grubben MJ, Nagengast FM, Jansen JB, Verhagen H, van Poppel G, Peters
WH.

Department of Gastroenterology, University Hospital St Radboud, Nijmegen, The
Netherlands.

A high intake of glucosinolate-containing cruciferous vegetables, such as
Brussels sprouts (Brassica oleraceae), has been linked to a decreased cancer
risk, but the underlying mechanism is still unclear. The aim of this study was to
reveal possible modulating effects of consumption of Brussels sprouts on
duodenal, rectal and lymphocytic (i) glutathione S-transferase (GST) enzyme
activity, (ii) GST isozyme levels and (iii) glutathione (GSH) content. Ten
healthy non-smoking volunteers were randomly assigned to two groups in a
cross-over design. Five persons started on a glucosinolate-free diet (control
period), while the other five consumed 300 g/day cooked Brussels sprouts, at the
expense of 300 g glucosinolate-free vegetables (sprouts period). After 7 days the
regimen was changed for a further week. At the end of both periods blood samples
and duodenal and rectal biopsies were taken. Mean GST activity showed marked
differences between duodenal, rectal and lymphocytic cytosols (737 +/- 54, 321
+/- 29 and 154 +/- 14 nmol/min/mg protein respectively), but was uninfluenced by
the dietary regimen. Isozyme distribution varied greatly between the tissues. In
duodenum GST-alpha, -pi, and -mu isozymes were expressed in considerable amounts
(8441 +/- 1365, 3002 +/- 223 and 536 +/- 248 ng/mg protein respectively). Rectal
biopsies also contained above three GST classes, but here GST-pi was the most
pronounced expressed isozyme (2849 +/- 246) followed by GST-mu (495 +/- 242),
while GST-alpha was only present in minor quantities (149 +/- 31). In lymphocytes
only GST-pi (755 +/- 96) and GST-mu (83 +/- 54) could be detected. As a result of
the dietary regimen rectal GST-alpha and -pi levels were slightly increased at
the end of the sprouts period, by 30 and 15% respectively. GSH contents were
uninfluenced by the dietary regimen. In conclusion, consumption of
glucosinolate-containing Brussels sprouts for 1 week results in increased rectal
GST-alpha and -pi isozyme levels. We hypothesize that these enhanced
detoxification enzyme levels may partly explain the epidemiological association
between a high intake of glucosinolates (cruciferous vegetables) and a decreased
risk of colorectal cancer.

[dorisbonkers]

Thank you Pebble for an exhaustive reply.

Of course many medicines are derived from plant extracts. Like humble aspirin.

I suppose I'm questioning whether drinking herbal concoctions not yet proved to be effective is a particularly good idea, especially as they aren't free.

I remember writing a story a few years about on a study that found milk thistle to be ineffective in treating liver disorders, so I was interested in what this woman had to say about it (very little it seems)

She's basically saying if you have a fatty liver (do I?) then drinking milk thistle (whose effects even she admits are inconclusive) may help reduce the fatty deposits.

It just sounds bunk and why should I had over my money to the so called nice end of the healthcare market (herbalists) as opposed to seeing a doctor for a supposedly fatty liver and possibly pay evil Big Pharma for any eventual treatment if I needed it (which may end up being derived from plants, or may not)

But she then goes on to say that big pharma have falsified/rejigged their research (although she doesn't give examples) so why trust them, you might as well trust the milk thistle advocates.

This is not the way I approach my healthcare.

[Cuddles]

But she then goes on to say that big pharma have falsified/rejigged their research (although she doesn't give examples) so why trust them, you might as well trust the milk thistle advocates.

Yeah, it's the standard fall back of those who don't actually have anything to fall back on. "Sure you've got all those fancy facts and studies, but they're all faked so I'll carry on believing my nonsense anyway." Of course, pointing out that selling quack remedies is just as big business as selling real ones, and therefore all the claims about "big pharma" would apply just as much to their quackery of choice, never seems to get through to them.

[Matt]

An instinctive rule of thumb that we've all noticed is that if it's fun it's bad for you and if it's nasty it's good for you.

Thus cigarettes, alchohol and rich foods are bad for you. Fresh air, water and unprocessed foods are good for you.

It seems to work but it leads to a sort of self flagilation. If cutting down on junk food is good for you, how much better for you is subsiting on raw broccoli?

As it happens randomly adopting the latest bizarre food fad is unlikely to be any better for you than simply stopping doing bad things. There's nothing very wrong with meat, two veg and a dollop of mashed potato. A little research finds that steaming the veg retains the most nutrients and grilling the meat reduces the fat content for very little difference in tha taste of the meal. A little peek at the nutritional infomration tells you when a tasty snack is actually loaded with you're day's allowance of fat and should be considered a rare treat. It's in these moderate changes that most of the health benefits can be found, and such moderate changes are more likly to become lasting changes in habits with long term benefits.

However what to do if you've just had a major blowout. New Year and the Party season are over and it's a time for self reflection. How many mince pies? A whole pot of brandy butter, and I can't even remember what happened Saturday night. Well the sensible thing to do is to simply return to a life of moderation and limited indulgance. The damage has been done and the body will recover as best as it can so long as you odn't continue the abuse. However we feel bad, guilty. We want to do more than simply return to sensible habits. We want to do something to undo the damage we've done. To purge ourselves of this guilt.

That's where detox comes in. It offers harsh unforgiving penetence. A regime that nobody could keep up long term but a perhaps if I deprive mysel of anything enjoyable for a month, or subsist of something disgusting and repetative for just a week that will be punishment enough to counteract the enjoyment I've had recently.

Whatever this does for our state of mind in alietiating our guilt the benefits over straight forward sensible eating are minimal if they exist at all. At some extremes these untested unregulated miracle detox diets can actually be very harmful.

As for big pharma suppressing research. Alt medicine is nearly as big (about a third the size if I remember Ben Goldacre correctly). We tend to think of small independent sandal wearing hippies as the force behind Alt medicine. In fact it's a multi national industry worth billions of dollars influenced by all the same factors of corporate greed as so called big pharma. Except unlike big pharma, there's limited or no regulation in place to keep these captialst forces in check.

If the claims of alternative medicine are true then they should be easily proven by quality trials that the international nutraceutical manufacturers and huge health food chains could easily afford.

Yes Big Pharma has it's flaws. Firstly that's as irrelevent as the school yard excuse of a boy who's been caught fighting "he started it". however it is worth pointing out that the fact that we know so much about their flaws is because they're tightly and transparently regulated so that flaws are detected early and halted. Whereas alt medicine is subject to all the same capitalist temptations but none of the checks and balances, no requirement to demonstrate effectiveness, no system to gather evidence of side effects or interactions once on the market and even if without looking for problems doubts are raised, no requirement to withdraw a product.

It's like pointing out isolated cases of corruption within a police force and suggesting that the answer is chaotic vigilantism.

[dorisbonkers]

Cuddles, thank you

Matt, and you. A great post and you've helped crystallise (ooh, I can feel the positive energy vibrations from a smokey quartz...) my thoughts.

I should know better, this woman's site has a whole section on Astrology.

It's easy to dismiss the far-out stuff, far more insidious is the mainstream belief in natural stuff (because it's natural) without proof to back it up.

Thanks chaps

[Admin]

Dorisbonkers *sniggers* - great name!!!

Welcome to UKS. O0


I thought I’d leap straight in with a subject that really bugs me – detoxes – and maybe you can help me formulate a response to a discussion I’m having with someone on a pregnancy board.

To be honest, trying to argue rationally with people who've formed irrational beliefs for irrational reasons is like trying to nail blancmange to the ceiling. They tend to believe things for idealistic and emotional reasons and are impervious to things like facts and evidence.

I notice you say it's on a pregnancy forum. Perhaps you can use emotional arguments in return (fight fire with fire)? Herbal and unproven products are bad enough to take at the best of times as no one has much idea of what's in them thus no idea of their possible side effects. But taking drugs (because if they work that's what they are!) during pregnancy is always risky.

You could try asking what effect milk thistle has on developing babies' livers or other organs.

If they say it's 'natural therefore safe' then there's plenty of examples where 'natural is lethal'.

So what I'm saying is - the rational approach doesn't always (in fact very rarely) work and sometimes you need to tackle such arguments differently - like using appeals to emotion or appeals to fear - just like they do!


She's basically saying if you have a fatty liver (do I?) then drinking milk thistle (whose effects even she admits are inconclusive) may help reduce the fatty deposits.

That's actually a completely meaningless statement!

If you have a fatty liver (how would you know if you did, how would you know if the treatment had changed it?) then milk thistle may help reduce fatty deposits.

'May', of course, being a weasel word that renders the claim meaningless.

Pointing out the absurdity of such statements might (weasel word!!!) help others to see through the claims.

It's difficult and I don't think there's a really good answer for how to deal with such arguments. People's beliefs are amazingly resilient and can stand up to seemingly endless refutation. People believe what they want to believe and nothing much can change it.

[FarSideOfTheMoon]

If you go to www.skeptoid.com (http://www.skeptoid.com), you should find a fairly recent podcast episode on detox. I can't link directly from work, but there will be a transcript as well.

The guy that does the podcasts is very good at spending 10 minutes covering the main issues, without going into too much detail and leaving the paths open for further research.

My wife was/is a big user of ivillage when she was pregnant, I was kind of shocked how much wooly thinking there was out there concerning pregnancy. Not an awful lot of bogus stuff that would do people harm, but a lot of misconceptions and myths.

[dorisbonkers]

Thanks. And I hasten to add the milk thistle thread came about not in a discussion on pregnancy. I've given up posting on pregnancy once someone told me "I hope you die on the operating table, you vain b&tch" when I posted I was having a planned c-section.

Here's her the gist of her reply

1. She's not anti Big Pharma - her OH has made a lot of money consulting for them - and she does not blindly accept anything. However the rigorous testing is not done on widely available remedies, such as milk thistle, because testing costs money and it's not in anyone's interest to do it to the levels

2. With the amount that she has drunk over the last few years she is fairly sure that her liver needs all the help it can get,


3. She likes the anecdotal and medical results on milk thistle.

4. There is a camp that says "all natural stuff is good", there is an equivalentally knee-jerk camp that says "all natural, non-medical stuff is pointless and you are a naive dupe for taking it".

5. Silymarin has been shown to work - but it needs more studies.

6. She is not convinced by my assertion that all detoxing is pointless and one only needs to eat better. She finds it inconceivable that all herbal, non-medical ingredients are useless and that there is no way to improve the running of my body except by eating a "balanced diet". A balanced diet may be lacking in many nutrients - essential fatty acids, for instance.

7. She is positive that her body can be helped to rid itself of all the unnatural crap that modern life and habits have thrown at it.

All this reeks of belief system rather than rational thought.

Thanks for the welcome John, my name is from Private Eye - the only two fans of Neasden FC.

[puzzlebobble]

1. She's not anti Big Pharma - her OH has made a lot of money consulting for them - and she does not blindly accept anything. However the rigorous testing is not done on widely available remedies, such as milk thistle, because testing costs money and it's not in anyone's interest to do it to the levels
There's a lot of money being spent on alternative therapies. Only a tiny fraction would need to spent to improve the standard of evidence.

2. With the amount that she has drunk over the last few years she is fairly sure that her liver needs all the help it can get
Firstly the liver has lots of extra capacity (in living donor liver transplants only 1 lobe is transplanted). If she does not already have signs of liver failure and stops drinking it is unlikely to be problem.
Secondly the liver cells can divide (slowly) and so can regenerate themselves. As far as I am aware nothing has been shown to be of benefit (except stopping drinking/other hepatotoxins).

4. There is a camp that says "all natural stuff is good", there is an equivalentally knee-jerk camp that says "all natural, non-medical stuff is pointless and you are a naive dupe for taking it".
I don't think many people would say there is nothing good to be found from herbs etc. You mentioned aspirin from willow bark yourself. What I don't get is people who wouldn't want to extract the active ingredient from the natural product.

Her criticisms are either against strawmen or don't stand up to criticism.

To be honest I think JohnJackson is right when he suggested she might already have fixed beliefs. I don't think I've ever managed to convince someone that far gone. There's always going to be some more skeptical people in the peanut gallery though- so maybe having an argument with them does some good.

[Admin]

Thanks. And I hasten to add the milk thistle thread came about not in a discussion on pregnancy. I've given up posting on pregnancy once someone told me "I hope you die on the operating table, you vain b&tch" when I posted I was having a planned c-section.

How pleasant!

People who hold rational beliefs that are justified and who hold a naturalistic world view tend to do so in a calm manner. Those whose beliefs are irrational and unjustified tend to get very passionate, even fanatical, about them.

I bet the person who made the vile comment above thought of themselves as a wonderful person, in harmony with nature and goodness etc.


All this reeks of belief system rather than rational thought.

That's what these things boil down to. It's a world view based on idealism and ideology rather than evidence and reason.

[Admin]

You mentioned aspirin from willow bark yourself. What I don't get is people who wouldn't want to extract the active ingredient from the natural product.

This one is actually a good illustration between 'natural' medicine and the scientific approach to it.

Many people believe that Aspirin comes from willow bark. It's 'natural' and therefore this validates all of herbal medicine.

But it's not quite like that. The active ingredient in willow bark extract is Salicylic Acid. This is what reduces fever, relieves pain, etc. However, it causes a lot of problems with the stomach - gastral bleeding etc.

Scientists, after isolating the active component (Salicylic Acid), made some analogues of this compound and the one that showed similar medicinal properties but with much reduced side effects was Acetyl-Salicylic Acid - this is what's now known as Aspirin.

So yes, there is a compound in willow bark that had medicinal properties (and strong side effects) but science has used it to develop a similar, but much more usable, compound in its place.

So Aspirin is not found in willow bark - it was developed from a similar compound that was found in willow bark.

And that's how science uses 'natural' chemicals.

There are paralysing compounds in snake venom. Scientists looked at them, worked out which one was the most effective, altered the structure slightly to see if they could improve things further and such compounds are used to paralyse muscles in things like neurosurgery (where a twitch could be disastrous). They don't use 'natural' snake venom - they use compounds derived from it.

That's how science works with things that are produced in nature.

[Matt]

I've given up posting on pregnancy once someone told me "I hope you die on the operating table, you vain b&tch" when I posted I was having a planned c-section.

Isn't the internet great. people feel so free to say the things that would get them knocked on their arse if they said them in person.

I doesn't matter to me one jot but was your c section planned for reasons of vanity e.g. avoiding the worst of the strech marks? Or was the vain bitch comment doubly inappropriate?

[Mongrel]

As for big pharma suppressing research. Alt medicine is nearly as big (about a third the size if I remember Ben Goldacre correctly). We tend to think of small independent sandal wearing hippies as the force behind Alt medicine. In fact it's a multi national industry worth billions of dollars influenced by all the same factors of corporate greed as so called big pharma. Except unlike big pharma, there's limited or no regulation in place to keep these captialst forces in check.

Not forgetting that a few of the big Alt-Med companies are actually subsidiaries of Big Pharma companies

[JJM]

{snip} Many people believe that Aspirin comes from willow bark. It's 'natural' and therefore this validates all of herbal medicine.

But it's not quite like that. The active ingredient in willow bark extract is Salicylic Acid. This is what reduces fever, relieves pain, etc. However, it causes a lot of problems with the stomach - gastral bleeding etc.Umh, there is not much salicylic acid (SA) in willow bark (SA is found in significant amounts in some other plants e.g., meadowsweet). The active component in the bark is salicin which is digested, absorbed and converted into salicylic acid. I am not sure when that was worked out; but I suspect it was after the development of aspirin.

For some reason, doctors were treating some inflamation with SA in the late nineteenth century (I am not sure if they isolated it from a natural source, it is easy to make). Aspirin was developed in the lab to get around the unpleasant side effects of SA.

If anyone can fill in the blanks I mentioned above, I would appreciate it. I have Diarmuid Jeffreys' book "Aspirin" (Bloomsbury, 2005) which does not go into the chemical details that I seek. Nonetheless, it is an interesting read.

[JJM]

{snip} I thought I’d leap straight in with a subject that really bugs me – detoxes – and maybe you can help me formulate a response to a discussion I’m having with someone on a pregnancy board. {snip}You can read about detox nonsense at many places including:
www.quackwatch.org
http://scienceblogs.com/insolence/
http://www.sciencebasedmedicine.org/

As for milk thistle, a pretty good (free) source of information is found here:
http://www.mskcc.org/mskcc/html/11570.cfm

One must be wary of that source, however, because they freely cite the "German Commission E" monographs on herbs. The Commission E relied too heavily on unpublished claims from herb manufacturers. Unpublished information is no better than anecdote. Published information can be wrong; but, al least, we have the opportunity to evaluate it.

[Admin]

Umh, there is not much salicylic acid (SA) in willow bark (SA is found in significant amounts in some other plants e.g., meadowsweet). The active component in the bark is salicin which is digested, absorbed and converted into salicylic acid. I am not sure when that was worked out......

Yes I know it's a more complex picture than I painted but I'm just getting the point over that it's not science versus nature but that if something can be shown to work from nature then science will not only use it, but also quite often improve on it.

I did these examples on my OU course (Chemistry) many years ago but I don't know where the books are. The chemical changes from one form to another are relatively simple as shown here: http://www.miracosta.edu/home/dlr/211exp3.htm

But, I must admit, I don't know a great deal more and I haven't seen the explanation of how salicin is converted to salicylic acid. As it's over a decade since I last studied any chemistry, I could probably understand the explanation but no longer have a clue how to work out a synthetic route.

[JJM]

Yes I know it's a more complex picture than I painted but I'm just getting the point over that it's not science versus nature but that if something can be shown to work from nature then science will not only use it, but also quite often improve on it. {snip}I understand that. It is a minor, but common, misconception (willow and salicylic acid) of little consequence in most people's lives. I opened my post with "Umh" hoping to suggest that it was not a big deal.

I taught introductory, organic and advanced chemistry courses in university; and I only recently learned these facts about aspirin. If I did not know it, you certainly can't be expected to do. Yet, I figure if we know the correct story we should spread it. My post was meant as a clarification, not a remonstration.

[Admin]

My post was meant as a clarification, not a remonstration.

Oh yes, I realise that and you were right to post it. O0

I agree that this one is a good example of how a widely-held belief (that Aspirin comes from the bark of willow trees) is in fact false and it's not an example of Mother Nature providing a tailor-made medicine for us - science had to improve on it to make it widely usable.

I think you're right also that Aspirin was discovered independently - i.e. it wasn't a direct result of improving on salicylic acid. Although it was purposely used to replace it as it dealt with the side effects problem:


In 1897, scientists at the drug and dye firm Bayer (http://en.wikipedia.org/wiki/Bayer) began investigating acetylsalicylic acid as a less-irritating replacement for standard common salicylate medicines. By 1899, Bayer had dubbed this drug Aspirin and was selling it around the world

Aspirin

[puzzlebobble]

I think I used to know that about aspirin but had forgotten:-[

I'm just trying to think of a drug that has definitely come directly from a plant as it's quite nice to have an example of a drug which is in use which comes from a herb/plant to show in arguments that medicine doesn't automatically dismiss herbalism. Any suggestions?

The things which keep popping into my head come from bacteria like streptomycin and penicillin but not plants.

[Pebble]

Just to get back to fatty liver. This is not a diagnosis to be thrown around and managed in ignorance (with herbal guesswork). The diagnosis requires both blood tests and liver ultrasound, then the cause should be sought (diabetes, obesity, alcohol, pregnancy, hypothyroidism spring to mind) extreme cases are serious and need aggressive treatment.


Clin Sci (Lond). 2008 Sep;115(5):141-50. Links
Non-alcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations.

Preiss D, Sattar N.
British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, Scotland, U.K.
The global increase in the prevalence of obesity has heralded a rise in associated liver injury namely NAFLD (non-alcoholic fatty liver disease). It is estimated that 20-30% of adult populations in developed countries have NAFLD and, although high quality data is currently lacking, the condition is clearly increasing in children also. NAFLD should be suspected in those with commonly available simple clinical signs and biochemistry consistent with insulin resistance. A small number of individuals with NAFLD, often considered a relatively benign condition, will progress to more severe stages of liver disease including NASH (non-alcoholic steatohepatitis) with or without fibrosis, cirrhosis and occasionally hepatocellular carcinoma. NAFLD is also commonly associated with an increased risk of developing Type 2 diabetes and treatable features of insulin resistance such as dyslipidaemia and dysglycaemia. Histological examination of liver tissue remains the only proven method to distinguish between simple steatosis and NASH, a condition far more likely to progress to cirrhosis. Identification of an imaging technique or non-invasive marker to achieve this distinction is therefore much sought after and would allow larger clinical trials and better clinical assessment. Case series and pilot studies of lifestyle advice, insulin sensitizers and other medications have shown improvements in liver histology and serum liver enzymes but robust randomized controlled studies are needed. Furthermore, the cost/benefit ratio of any new therapies, and any potential harms, must be evaluated carefully before being clinically advocated.

[Pebble]

I think I used to know that about aspirin but had forgotten:-[

I'm just trying to think of a drug that has definitely come directly from a plant as it's quite nice to have an example of a drug which is in use which comes from a herb/plant to show in arguments that medicine doesn't automatically dismiss herbalism. Any suggestions?

The things which keep popping into my head come from bacteria like streptomycin and penicillin but not plants.

Coumadin (warfarin): from sweet clover.
Digoxin: derived indirectly from foxglove
Taxol: ?Yew tree
THC : Cannabis plant
Opium: Poppy

[JJM]

{snip} I'm just trying to think of a drug that has definitely come directly from a plant as it's quite nice to have an example of a drug which is in use which comes from a herb/plant to show in arguments that medicine doesn't automatically dismiss herbalism. Any suggestions? {snip}An instructive case comes from the antimalarial artemisinin. More than 100 "antimalarial" herbs from traditional Chinese medicine were tested before that was found http://www.ncbi.nlm.nih.gov/pubmed/16722826?ordinalpos=21&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum (http://www.ncbi.nlm.nih.gov/pubmed/16722826?ordinalpos=21&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_RVDocSum)
It illustrates the poor reliability of studies of ethnic uses of herbs. More particularly, it points up the variability in herbs because, for Artemisia species- artemisinin is only found in the herb when it is grown under specific conditions.

Foxglove (e.g., digitalis and digoxin) products for heart disease were an early success for herbal medicine; but it was also a success for pharmacology- isolating and quantifying the dose of active ingredients; which could kill in overdose. The cinchona alkaloids (quinine, etc.) are further examples.

Taxol is an excellent example of an herbal, anti-cancer drug that was unknown to ethnic tradition.

[JJM]

{snip} For some reason, doctors were treating some inflamation with SA in the late nineteenth century (I am not sure if they isolated it from a natural source, it is easy to make). Aspirin was developed in the lab to get around the unpleasant side effects of SA. {snip}I have re-examined Jeffreys' book "Aspirin" (which I had only skimmed, previously). On p. 40, he makes it clear that salicylic acid (SA) was isolated from meadowsweet and found to be the active ingredient.

[Pebble]

Just a thought on detoxification: Medicine loved detoxification by a number of means for a very long time, it proved useless through bitter experience and has therefore never been formally disproven by scientific methodology. I wonder if this extract from the death of Charles II should be compulsory reading for those in the detox industry.


"When Charles II* of England lay dying from a convulsion which attached him while shaving, the medicos of that day left no stone unturned in helping him along to the Great Beyond. First, he was bled of a pint of blood. Then his shoulder was cut and eight ounces more of blood was extracted by cupping.

Then followed an emetic, a purgative and another purgative. Next, an enema in which they used antimony, sacred bitters, rock salt, mallow leaves, violet, beet root, camomile flowers, fennel seed, linseed, cinnamon, cardamom seed, saffron, cochineal and aloes. This enema was repeated. In two hours, another purgative was given.

The King's scalp was then shaved, and a blister raised on it. They gave him next sneezing powder of hellebore root; they sought to strengthen his brain by giving him powder of cowslip flowers.

The cathartics(reference to medical practices of the 1800s) were frequently repeated. He was given drinks of barley water, licorice, sweet almonds, white wine, absinthe, anise seed, extracts of thistles, rue, mint and angelica. When these did not cure him, they gave him a plaster of burgundy pitch and pigeon dung, to be applied to his feet.

More bleeding, more purging; they added melon seeds, manna, slippery elm, black cherry water, extracts of flower of lime, lily of the valley, peony, lavender and dissolved pearls. When these did not do the trick, they went at it with gentian root, nutmeg, quinine and cloves. When this failed, he was given forty drops of extract of human skull. Then they forced down his throat a rallying dose of herbs and animal extracts. Then some powdered bezoar stone.

Alas, after an ill fated night His Serene Majesty was so exhausted that all the physicians became despondent. And so, more active cordials, and finally pearl julep and ammonia, were forced down the royal patient's throat.

Then he died."

Morris A. Bealle 1939

[puzzlebobble]

Thanks for the excellent suggestions Pebble and JJM.

Just a thought on detoxification: Medicine loved detoxification by a number of means for a very long time, it proved useless through bitter experience and has therefore never been formally disproven by scientific methodology.
would you not consider desferoxamine chelation therapy for iron overload a form a detoxification?

[Pebble]

Thanks for the excellent suggestions Pebble and JJM.

would you not consider desferoxamine chelation therapy for iron overload a form a detoxification?

Touche. However, hardly a detox diet, and in liver disease there is good evidence for low protein diets as part of the treatment of encephalopathy or in those with diabetes insipidus restriction of water effectively detoxifies. That however is science in action , not woo diet advice. My point being that in the past medicine was very similar to alternative medicine today, the excuse being that no one knew any better then.

[JJM]

Just a thought on detoxification: Medicine loved detoxification by a number of means for a very long time, it proved useless through bitter experience and has therefore never been formally disproven by scientific methodology. {snip} the most horrific "detox" procedures were abandoned in the nineteenth century; but less violent laxatives and enemas continued till about 80 years ago. At that time, advances in anatomy and physiology rendered the notion of "retained toxins" to the rubbish bin of medicine. It has been formally disproven.

[Pebble]

the most horrific "detox" procedures were abandoned in the nineteenth century; but less violent laxatives and enemas continued till about 80 years ago. At that time, advances in anatomy and physiology rendered the notion of "retained toxins" to the rubbish bin of medicine. It has been formally disproven.

Good to see: source of evidence ?

[JJM]

Thanks for the excellent suggestions Pebble and JJM.

would you not consider desferoxamine chelation therapy for iron overload a form a detoxification?One must distinguish between real toxins, and the imaginary sort suggested by quacks. Yes, one can require detoxification from exposure to a variety of environmental contaminants (e.g., lead) or addictive drugs.

The detox promoters want you to think that an ordinary diet results in accumulated toxins in your body. Read the references I cited, above. The detox promoters are vague about what the "toxins" are or, where named, they do not offer real evidence that the customer has that problem.

Moreover, let's assume for a moment that you actually harbor some "toxin." There is no evidence that the sCAMs these people promote will actually rid you of the problem.

[dorisbonkers]

JJM, Pebble. Interesting stuff, and thanks for the link between old treatments and new quack detoxes. The detox industry today would not like to be compared so unflatteringly to the purgatives of yesteryear.

Thanks.


I doesn't matter to me one jot but was your c section planned for reasons of vanity e.g. avoiding the worst of the strech marks? Or was the vain bitch comment doubly inappropriate?

Hello Matt, I have no problem answering you.

I was raped when I was a student in Russia. I think on balance I have handled it well (that's a whole other story though). While I don't have a problem with sex or being examined by any number of male doctors, I do seem to have developed an irrational fear of childbirth. This has been borne out with me being fine with non painful gynaecological exams and procedures and painful ones. I have fainted and had panic attacks the minute I feel pain and am in that position.

I've thought long and hard in the 6-1/2 months being pregnant so far. I'm not a wimp and at one stage almost forced myself into the decision of natural -- because I'm a tough old boot and intellectually I think I could handle it. But should I really put myself in the position of possibly having a panic attack if the labour doesn't progress or things go wrong? That wouldn't do anyone any good. I made myself watch a labour video and I had a panic attack.

I should also add I'm less caught up in the mystical idea of childbirth as an event so awe-inspiring and magical that I am in some way doing my child and myself and my husband a big disservice in not having a natural birth. I'm not trying to reduce the amazing experience people no doubt have, it's just not my number one priority.

The life of my child is the really important thing, not the birth. Plus I am happy to have my husband with me for a section (I've told him not to look in the reflection of the lights!) as I wouldn't be happy having him attend a natural birth. Again, this may seem a little odd to you normal people.

You should also bear in mind that a section doesn't prevent stretchmarks, since you either get them from 6 months on or not. (Luckily I've not got them). Plus you will also get an scar, so the idea that it is vanity escapes me.

I think the 'vanity' comment relates to the idea that people request c-sections to preserve vaginal tightness. While it may be a small factor in someone's decision making, I think you'd be pretty hard pressed to find someone who requested a major operation that entails scarring for this reason alone. It's certainly not on my list of reasons.

A planned section is usually scheduled for a week to 10 days before the due date, so you don't escape stretchmarks if you're genetically predisposed, but you do escape the last final days of what can be uncomfortable symptoms, such as urinary incontinence and sciatica. But again, that wouldn't drive someone's decision making, since you may have already put up with 8 months of discomfort (I know I have, I've had vomiting six months in, as well as nosebleeds and sciatica)

I've not decided 100 percent on whether to go for a section and I am going to let the baby's position (currently breech) and size (she's very tall and big at the moment) be a factor in my final decision.

I'm in Singapore, where all healthcare is private and sections are very common. But my doctor is actually an advocate of natural birth but he completely agrees that in my circumstances I have the right to go for a section. I also have a condition called Ashermans (caused by a D&C after a miscarriage in the UK on the NHS) and a section can be advised in some cases.

The midwife-led ante-natal care in the UK seems to be so heavily against medical intervention that this has suffused the whole debate on women's forums. It has almost taken on a mystical element, which I find very offputting. It's the same post birth, with many midwives pro-attachment parenting -- a method once at the fringe of child rearing seems now mainstream.

People will even push to have vaginal birth in breech presentation (why?), or post previous sections (that I can understand better...)

Of course I realise I go against the grain of what women in the UK want (or think they want). But what underlying antagonism drives someone to not wish you the best, even though they themselves may do it differently, but to wish you ill. I'm stumped on that one.

I was even told I was ridiculous seeing a doctor for every prenatal visit instead of a midwife and that the number of scans I was having (every three weeks as the Ashermans placed me at a higher risk of miscarriage) was harming the foetus.

[Pebble]

the most horrific "detox" procedures were abandoned in the nineteenth century; but less violent laxatives and enemas continued till about 80 years ago. At that time, advances in anatomy and physiology rendered the notion of "retained toxins" to the rubbish bin of medicine. It has been formally disproven.

Looking through your links have not come up with anything specific yet. A thought crossed my mind, 80 years ago (1930s) they would not have known what toxins to look for and had not yet developed the methodology for rigorous clinical trials - so in what fashion has it been formally disproven?

[JJM]

Looking through your links have not come up with anything specific yet. A thought crossed my mind, 80 years ago (1930s) they would not have known what toxins to look for and had not yet developed the methodology for rigorous clinical trials - so in what fashion has it been formally disproven?What they determined, back then, was that there was no crud accumulating in the digestive tract. The contents of the intestines are inexorably swept out, completely.

As for modern "detox" offered by alties, they cannot tell you what the toxins are. Sometimes they apply bogus tests to "identify" them. Their detox schemes are never shown to work.

A particularly egregious detox consists of an electrified foot-bath. One adds some salt water, puts in the feet, and turns on the current. the bath rapidly fills with a reddish sludge, said to be toxins drawn out of the body. This is easily debunked- just run it with your feet in it, the same sludge develops. The electrodes in the bath are made of iron and they generate, and shed, rust due to the electric current.

The bottom line is that the onus is on the alties to reliably demonstrate the existence of toxins and the efficacy of their treatments. They have not done that.

[Pebble]

What they determined, back then, was that there was no crud accumulating in the digestive tract. The contents of the intestines are inexorably swept out, completely.

As for modern "detox" offered by alties, they cannot tell you what the toxins are. Sometimes they apply bogus tests to "identify" them. Their detox schemes are never shown to work.



Agreed, no problem with any of that. But I think you would agree that the concept is not disproven, just never shown to work and counter intuitive. This is precisely the hunting ground of woos.

[seren]

dorisbonkers I was horrified by that quote: "I hope you die on the operating table, you vain b&tch". Was that from a woman? Jesus christ!

The "natural and home-birth" crowd are one of my pet hates (along with homeopaths). This idea that left to itself birth naturally "goes right" most of the time because women are "designed" to do it really annoys me, and just isn't borne (pardon pun) out by the figures. A good proportion of women who choose "natural" home birth end up having to come to hospital anyway. It's painful, and messy and risky.

With an aversion/borderline phobia like yours I can't believe someone would say that to you. Actually I can't believe anyone would say that full stop. The internet is the backside of the world.

But it's all part of a wider trend- there are women who are made to feel shamed because they cannot breastfeed, people with cancer berated for not "thinking positively", people told they bring on their own suffering with their thoughts. This idea that nature wants us to be happy, that we're all in this natural state of "abundance", popping out babies whilst singing The Sound of Music, it's all such nonsense. I've started ranting now, sorry.

[JJM]

Agreed, no problem with any of that. But I think you would agree that the concept is not disproven, just never shown to work and counter intuitive. This is precisely the hunting ground of woos.You are sounding too much like a lawyer. As I said, the concept that stuff accumulates in the digestive tract has been disproven.

Other than that, we agree.

[Pebble]

You are sounding too much like a lawyer.


No. But from a skeptical standpoint I'll take that as a compliment.

[Pebble]

As I said, the concept that stuff accumulates in the digestive tract has been disproven.



Another thought, what about 'blind loop syndrome' initally associated only with surgery on the bowel, causing malabsorption, but now recognised as occurring in other groups and causing bloating, discomfort etc, even appears to occur in 'normal' controls. Of course colonic irrigation etc and usual detox regimes would be useless, but is due to relative slow GI transit times.

Am J Gastroenterol. (http://javascript%3Cb%3E%3C/b%3E:AL_get%28this,%20%27jour%27,%20%27Am%20J%20Ga stroenterol.%27%29;) 2008 May;103(5):1257-62. Epub 2008 Apr 16.Links (http://javascript%3Cb%3E%3C/b%3E:PopUpMenu2_Set%28Menu18422815%29;)
Small intestinal bacterial overgrowth in patients suffering from scleroderma: clinical effectiveness of its eradication.

Parodi A (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Parodi%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Sessarego M (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Sessarego%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Greco A (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Greco%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Bazzica M (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Bazzica%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Filaci G (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Filaci%20G%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Setti M (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Setti%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Savarino E (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Savarino%20E%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Indiveri F (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Indiveri%20F%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Savarino V (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Savarino%20V%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Ghio M (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Ghio%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Di.M.I. Unit of Gastroenterology, University of Genoa, Genoa, Italy.
OBJECTIVES: After the skin, the gastrointestinal tract is the second most common target of systemic sclerosis (SSc). AIM: Our aims were to investigate orocecal transit time (OCTT) and the presence of small intestinal bacterial overgrowth (SIBO) in SSc as a cause of intestinal symptoms. METHODS: Fifty-five SSc patients and 60 healthy controls, sex and age matched, entered the study. Enrolled subjects completed a questionnaire for intestinal symptoms and a global symptomatic score (GSS) was calculated. OCTT and the presence of SIBO were assessed by a lactulose breath test (LBT). Patients with SIBO were treated with rifaximin 1,200 mg/day for 10 days. Finally, a second questionnaire and LBT were performed 1 month after the end of therapy. RESULTS: The prevalence of SIBO was higher in SSc patients compared with controls (30/54 vs 4/60, respectively, P < 0.001). OCTT was significantly slower in SSc patients compared with controls (150 min, 25-75th percentile 142.5-165 vs 105 min, 25-75th percentile 90-135, respectively, P < 0.001). In patients with SIBO, the median GSS score was 8 (25-75th percentile 3.25-10.75). Eradication of SIBO was achieved in 73.3% of patients, with a significant reduction of symptoms in 72.7% of them (GSS score 2, 25-75th percentile 1-3, P < 0.05). CONCLUSIONS: These data suggest that SIBO occurs more frequently in SSc patients than in controls. Intestinal symptoms in these patients may be related to this syndrome and its eradication seems useful to improve clinical features. OCTT is significantly delayed in SSc patients, suggesting an impairment of intestinal motility, a further risk factor for the development of SIBO.

[dorisbonkers]

Seren - I agree and thanks for the

I think having a sceptical and practical disposition can really help in coming to terms with difficult times or life-changing events, such as childbirth and parenting. One's brain is in the best position it can be to deal with those times and adapt, as well as sorting through the noise out there.

Most people will of course be shocked by a 'you deserve to die' comment. But when the dust has settled instead of being angry I understand it's her (yes, it was a woman) who has issues, not me.

Thanks.

[JJM]

Another thought, ...The defense will stipulate that A) an impacted or strangulated intestine will accumulate crud behind the site of obstruction. 2) Abnormal transit time does not lead to "accumulation" in the long run. III) SIBO does not fit the ordinary definition of accumulated "toxins."

[Pebble]

The defense will stipulate that A) an impacted or strangulated intestine will accumulate crud behind the site of obstruction. 2) Abnormal transit time does not lead to "accumulation" in the long run. III) SIBO does not fit the ordinary definition of accumulated "toxins."

In which case the prosecution will enter in evidence Roux-en-Y procedures, - no obstruction, simply a blind end loop with clear evidence of 'retained crud' and associated bacterial overgrowth leading to malabsorption. In SIBO there is clear evidence of consequent bacterial overgrowth, and while no overall accumulation, the 'toxic' implications are the same, just less dramatic.

[Cuddles]

6. She is not convinced by my assertion that all detoxing is pointless and one only needs to eat better. She finds it inconceivable that all herbal, non-medical ingredients are useless and that there is no way to improve the running of my body except by eating a "balanced diet". A balanced diet may be lacking in many nutrients - essential fatty acids, for instance.

No, it really may not. A balanced diet has enough of everything you need but not too much of anything, by definition. If it's lacking in any nutrients, it's not balanced. I can just about understand how people can be suckered in by talk of toxins and so on, but I really can't understand how they can make such obviously self-contradictory claims.

[dorisbonkers]

I can just about understand how people can be suckered in by talk of toxins and so on, but I really can't understand how they can make such obviously self-contradictory claims.

Because they're thick?

[Matt]

Because they're thick?

A tempting solution however if wrong it encourages those who think they're intelligent to suspect they're immune. It encourages those who are less confident in their intelligence to accept the views of thers based upon their intelligence.

In fact we often find intelligent people falling fowl of common biases. Even those of us who have made a concious effort to educate ourselves about such biases woefully absent from most edudcational curricula may find that we still fall to such biases.

I suspect the reason is twofold. An unwillingness or inability to skeptically examine thier beliefs and pride in beliefs leading to intransience in the face of rational argument.

[dorisbonkers]

A tempting solution however if wrong it encourages those who think they're intelligent to suspect they're immune. It encourages those who are less confident in their intelligence to accept the views of thers based upon their intelligence.

Oh I know Matt, I was being flippant.

But I happen to know that that particular woman labours under the illusion she is more intelligent than she is.

[JJM]

In which case the prosecution will enter in evidence Roux-en-Y procedures, - no obstruction, simply a blind end loop with clear evidence of 'retained crud' and associated bacterial overgrowth leading to malabsorption. In SIBO there is clear evidence of consequent bacterial overgrowth, and while no overall accumulation, the 'toxic' implications are the same, just less dramatic.How is a "blind end" not an obstruction? I am reasonably bilingual (British and American) but I may be confused. I live on a "dead end" street which means you can pass us on the highway; but you cannot go very far if you go up our road, the end is obstructed by trees and boulders and such.

The prosecution must establish that there are identifiable toxins due to SIBO. The mere presence of bacteria is insufficient proof. The defense moves for dismissal on the grounds that no such reasonable connection has been made.

[Cuddles]

Because they're thick?


A tempting solution however if wrong it encourages those who think they're intelligent to suspect they're immune. It encourages those who are less confident in their intelligence to accept the views of thers based upon their intelligence.

In fact we often find intelligent people falling fowl of common biases. Even those of us who have made a concious effort to educate ourselves about such biases woefully absent from most edudcational curricula may find that we still fall to such biases.

I suspect the reason is twofold. An unwillingness or inability to skeptically examine thier beliefs and pride in beliefs leading to intransience in the face of rational argument.

To be honest, I kind of agree with both of you. As Matt says, there are many different biases people can fall foul of, and even the most intelligent people are vulnerable, although I would argue they are less likely to do so, especially if they understand what the biases are. However, I've mentioned before that I see a worrying tendency among skeptics, to take this too far and ignore the simple explanation that some people really are just stupid.

Take a look at most woo's writing and you will see an incredible lack of spelling and grammar, and usually of maths and science as well. Often they barely have the ability to string together a coherent sentence, and tend to make statements that directly contradict others, sometimes even in the same sentence. These are not the hallmarks of an intelligent person. Yes, it's not their fault and yes, intelligent people also fall for various biases, but many skeptics seem to go out of their way to deny the fact that many people are just plain stupid, and that they seem to be overrepresented among the believers of woo.

[FarSideOfTheMoon]

To be honest, I kind of agree with both of you. As Matt says, there are many different biases people can fall foul of, and even the most intelligent people are vulnerable, although I would argue they are less likely to do so, especially if they understand what the biases are. However, I've mentioned before that I see a worrying tendency among skeptics, to take this too far and ignore the simple explanation that some people really are just stupid.

Take a look at most woo's writing and you will see an incredible lack of spelling and grammar, and usually of maths and science as well. Often they barely have the ability to string together a coherent sentence, and tend to make statements that directly contradict others, sometimes even in the same sentence. These are not the hallmarks of an intelligent person. Yes, it's not their fault and yes, intelligent people also fall for various biases, but many skeptics seem to go out of their way to deny the fact that many people are just plain stupid, and that they seem to be overrepresented among the believers of woo.

I'm in agreement. Intelligence is no guarantee of common sense, but the failure of our education system and the general intelligence level of people, stops them being exposed to science, and the critical thinking and logical thought processes that follow.

[Julia]

It may be hard to believe, but even the most intelligent and best-educated people are capable of shutting down their bullshit detectors when it comes to the type of woo they want to believe. A former fan of Sylvia Browne over on www.stopsylviabrowne.com (http://www.stopsylviabrowne.com) actually taught a course on critical thinking whilst she was under the Taloned One's spell!

[Pebble]

The defense will stipulate that A) an impacted or strangulated intestine will accumulate crud behind the site of obstruction. 2) Abnormal transit time does not lead to "accumulation" in the long run. III) SIBO does not fit the ordinary definition of accumulated "toxins."

Here is the issue: A blind ended loop is not an obstruction or strangulation, rather an out-pouching in which there is stasis, the general flow is unaffected. It is not obstructed as the contents can easily flow into the main stream of GI contents at any time. That the consequent malabsorption is due to bacterial overgrowth is well shown.

In respect of SIBO, the presence of bacterial overgrowth is readily confirmed by hydrogen breath testing, and the symptomatic link has been repeatedly shown by the response to antibiotic therapy. Trials have confirmed this though I don't know if they were double blind, will have a look.

[JJM]

Here is the issue: A blind ended loop is not an obstruction or strangulation, rather an out-pouching in which there is stasis, the general flow is unaffected. It is not obstructed as the contents can easily flow into the main stream of GI contents at any time. That the consequent malabsorption is due to bacterial overgrowth is well shown.Typical lawyerly ducking and dodging. "They could not have been cornered because they could have escaped via the highway." They could have been cornered, it remains to be proven if they were.


In respect of SIBO, the presence of bacterial overgrowth is readily confirmed by hydrogen breath testing, and the symptomatic link has been repeatedly shown by the response to antibiotic therapy. Trials have confirmed this though I don't know if they were double blind, will have a look.I am certain that hydrogen is not a toxin. I resubmit my plea that the case should be dismissed for lack of evidence; especially inre the normal intestine. Abnormal intestines are,well, abnormal.

I am all too familiar with the tactics of Law 1) If you can't argue the law- argue the facts.
2) If you can't argue the facts- argue the law.
3) If you can't argue either- just argue.

[Pebble]

Typical lawyerly ducking and dodging.

You obviously missed the post where I stated that I am not a lawyer, and indeed never had anything to do with law.


am certain that hydrogen is not a toxin.
[/QUOTE]

No but it is produced by bacteria, and is the method of choice for demonstrating the presence of bacterial overgrowth in the GI tract.

[JJM]

You obviously missed the post where I stated that I am not a lawyer, and indeed never had anything to do with law.No offense intended. I thought it was an amusing approach. FYI, I am a chemist and I respect lawyers (like my late father).


No but it [hydrogen] is produced by bacteria, and is the method of choice for demonstrating the presence of bacterial overgrowth in the GI tract.As far as I know, bacterial growth does not equate to the production of "toxins." E. coli is the most common bacterium in our intestines; yet, it is only a couple percent of the total found there. None of those bacteria produce significant "toxins." That is, one must prove a bacterium makes a toxin, it is not enough to show a bacterium is there.

[Pebble]

As far as I know, bacterial growth does not equate to the production of "toxins." E. coli is the most common bacterium in our intestines; yet, it is only a couple percent of the total found there. None of those bacteria produce significant "toxins." That is, one must prove a bacterium makes a toxin, it is not enough to show a bacterium is there.

E Coli does produce toxins. We are generally tolerant of those we live with, but intolerant of forgein strains:

As for the other residents, I would have to do some work to determine which do and which do not.



Lancet. (javascript:AL_get(this, 'jour', 'Lancet.');) 2008 Jun 14;371(9629):2019-25.http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--linkinghub.elsevier.com-ihub-images-01406736-TL.gif (http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3048&itool=AbstractPlus-def&uid=18554712&db=pubmed&url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(08)60839-9) Links (javascript:PopUpMenu2_Set(Menu18554712);)

Use of a patch containing heat-labile toxin from Escherichia coli against travellers' diarrhoea: a phase II, randomised, double-blind, placebo-controlled field trial.

Frech SA (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Frech%20SA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Dupont HL (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Dupont%20HL%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Bourgeois AL (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Bourgeois%20AL%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), McKenzie R (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22McKenzie%20R%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Belkind-Gerson J (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Belkind-Gerson%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Figueroa JF (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Figueroa%20JF%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Okhuysen PC (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Okhuysen%20PC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Guerrero NH (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Guerrero%20NH%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Martinez-Sandoval FG (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Martinez-Sandoval%20FG%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Meléndez-Romero JH (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Mel%C3%A9ndez-Romero%20JH%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Jiang ZD (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Jiang%20ZD%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Asturias EJ (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Asturias%20EJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Halpern J (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Halpern%20J%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Torres OR (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Torres%20OR%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Hoffman AS (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Hoffman%20AS%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Villar CP (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Villar%20CP%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Kassem RN (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Kassem%20RN%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Flyer DC (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Flyer%20DC%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Andersen BH (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Andersen%20BH%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Kazempour K (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Kazempour%20K%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Breisch SA (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Breisch%20SA%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Glenn GM (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Glenn%20GM%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
IOMAI Corporation, Gaithersburg, MD, USA.
BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) is a major cause of travellers' diarrhoea. We investigated the rate of diarrhoea attacks, safety, and feasibility of a vaccine containing heat-labile enterotoxin (LT) from ETEC delivered to the skin by patch in travellers to Mexico and Guatemala. METHODS: In this phase II study, healthy adults (aged 18-64 years) who planned to travel to Mexico or Guatemala and had access to a US regional vaccination centre were eligible. A centralised randomisation code was used for allocation, which was masked to participants and site staff. Primary endpoints were to investigate the field rate of ETEC diarrhoea, and to assess the safety of heat-labile toxins from E coli (LT) delivered via patch. Secondary endpoints included vaccine efficacy against travellers' diarrhoea and ETEC. Participants were vaccinated before travel, with two patches given 2-3 weeks apart. Patches contained either 37.5 mug of LT or placebo. Participants tracked stool output on diary cards in country and provided samples for pathogen identification if diarrhoea occurred. Diarrhoea was graded by the number of loose stools in 24 h: mild (three), moderate (four or five), and severe (at least six). Analysis was per protocol. The trial is registered with ClinicalTrials.gov, number NCT00516659. FINDINGS: Recruitment closed after 201 participants were assigned patches. 178 individuals received two vaccinations and travelled and 170 were analysed. 24 (22%) of 111 placebo recipients had diarrhoea, of whom 11 (10%) had ETEC diarrhoea. The vaccine was safe and immunogenic. The 59 LT-patch recipients were protected against moderate-to-severe diarrhoea (protective efficacy [PE] 75%, p=0.0070) and severe diarrhoea (PE 84%, p=0.0332). LT-patch recipients who became ill had shorter episodes of diarrhoea (0.5 days vs 2.1 days, p=0.0006) with fewer loose stools (3.7 vs 10.5, p<0.0001) than placebo. INTERPRETATION: Travellers' diarrhoea is a common ailment, with ETEC diarrhoea illness occurring in 10% of cases. The vaccine patch is safe and feasible, with benefits to the rate and severity of travellers' diarrhoea.

[JJM]

E Coli does produce toxins. We are generally tolerant of those we live with, but intolerant of forgein strains:

As for the other residents, I would have to do some work to determine which do and which do not. {snip}You are demanding that I cross every I and dot every T. Under normal circumstances in the United States of America, on Earth, in the twentyfirst century- intestinal flora are not toxic. Toxic bacteria are not the subject of detox quacks.

Even when the detox quacks cite real "toxins," they usually have no evidence of their (toxins) presence, and no evidence that their detox methods are effective even if the toxin is there. I think you know that.

I will leave you to amuse yourself from now on.

[Pebble]

You are demanding that I cross every I and dot every T. .

The point of skepticism is to question rigorously whether a proposition stands up to scrutiny or not.

[JJM]

The point of skepticism is to question rigorously whether a proposition stands up to scrutiny or not.If you want to teach me the basics, you are about 50 years late. When high school resumes in the fall, join your debate club (sometimes called a forensics club). You could learn a lot, if you lose the adolescent megalomania.

[Pebble]

if you lose the adolescent megalomania.

I gave up trying to escape adolescence over 30 years ago. Always felt maturity was grossly over-rated.

[puzzlebobble]

I've slightly lost the thread but we seem to be discussing GI detox's now. There are some examples which may actually work- for example multiple dose activated charcoal for various poisons. Eg:
cardiac glycosides (http://www.ncbi.nlm.nih.gov/pubmed/17054261?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=3&log$=relatedarticles&logdbfrom=pubmed)
So the theory of being able to remove a toxin by ingesting a substance is not that crazy. Isn't the basic flaw in the woo's application of this logic that they simply don't realise how good the liver/kidney etc. do this already? (and that you've got to know what the toxin you are trying to remove is/how your detox thing works)

[Mongrel]

Partially, the other part is they never specify the 'toxin'.

Anyone who's had to read safety documentation will realise that - for ingested chemicals some require dilution, some require buffering, some require expulsion whilst others may have specific remedies. When you get carted off to the hospital you don't get treated for 'toxin' damage you get treated for drinking bleach or oven cleaner.

[Pebble]

Isn't the basic flaw in the woo's application of this logic that they simply don't realise how good the liver/kidney etc. do this already? (and that you've got to know what the toxin you are trying to remove is/how your detox thing works)


Spot on. There is no question that toxins are absorbed in substantial amounts on a daily basis from the gut. The absorption only through the portal system ensures that the liver has the chance to detoxify this efficiently in most. However in liver failure, or bypass (portal hypertension) this can result in confusion, encephalopathy, high out put cardiac failure, pulmonary hypertension, hepato-pulmonary syndrome etc. The level of hepatic bypass is usually quantified by measuring ammonia levels in the blood. Excess of local toxic agents (bacterial overgrowth) causes malabsorption and gaseous discomfort, but as long as the liver is working does not cause systemic symptoms.

Kidney failure is slightly different, generally the kidneys deal with toxins produced in the body, but in renal failure limiting protein intake can limit the impact of added sources of urea, uric acid, phosphates etc.

The assumption (unproven) of the woos is that this occurs at a lower level in most people, and is unrecognised by conventional medicine. Nice theory, and very lucrative. Disproving this is like proving that angels are not responsible for moving the planets about. There is of course not a shred of supportive evidence.

[Tim the Mage]

herb manufacturers.

As a gardener surely you mean growers?

[Mongrel]

As a gardener surely you mean growers?

No, most manufacturers don't grow their own.

[Tim the Mage]

No, most manufacturers don't grow their own.

To be pedantic and precise...

I understand therefore that you mean 'manufactuers of herbal medicines' rather than 'herb manufacturers'. After all the herbs (like the ones in my garden) grow and presumably the herbs these manufacturers are using to make their herbal medicines do likewise. Even if a nice friendly organic farmer is growing them rather than the wicked manufacturers themselves.

[Mongrel]

To be pedantic and precise...

I understand therefore that you mean 'manufactuers of herbal medicines' rather than 'herb manufacturers'. After all the herbs (like the ones in my garden) grow and presumably the herbs these manufacturers are using to make their herbal medicines do likewise. Even if a nice friendly organic farmer is growing them rather than the wicked manufacturers themselves.

Pedantry noted and accepted, although -5 points for a typo :smiley:

Although I'd be astonished if the plants used by the manufacturers were organic, I can't recall a "From organic sources" on any supplement (and they're just the sort of people who would so they can squeeze every last penny from you.

[Lazyike67]

Hello all. I’m glad I found this site. It’s like finding an oasis. I saw a reference on Richard Dawkins’ site and I’ve spent good few days reading the some of the posts -- particularly the mammoth Mannion ‘non-evasive psychic surgery posts, as well as the traditional Chinese medicine ones (I am from the UK but currently work in Singapore so it’s prevalent here – I’m also pregnant and the Chinese confinement rules I’ve come to learn are off the scale…)

I thought I’d leap straight in with a subject that really bugs me – detoxes – and maybe you can help me formulate a response to a discussion I’m having with someone on a pregnancy board.

My father’s friend was a top oncologist and I remember years ago having a discussion about detoxes and what a load of quick-fix snake oil they were. As I understand it from him, the liver and kidneys work, or they do not (in which case you’re in serious trouble and seeing a doctor anyway. You can eat healthily and cut back on alcohol and caffeine and get plenty of sleep and exercise. That will help you feel better after a period of living unhealthily. Unfortunately that’s not a quick fix like downing 4 pints of wheatgrass decoction a day and eating nothing but alfafa sprouts for a week. Anyway, I think we may all be singing from the same hymn sheet on this subject.

I had a discussion with a woman asking about Gillian McKeith’s (yes, the hunchback poo quack) 24 hour (now THAT IS a quick fix promise) detox and I advised against all detoxes and told the lady to eat healthy food, drink enough water, do some light exercise and get plenty of sleep AND spend the 20-30 quid she would’ve handed over to that old crone on a treat for herself.

The woman who runs the site challenged me (although to be fair, she’s no fan of McKeith)

The reason I feel driven to answer is that while the view seems perfectly reasonable at first, thinking about it, I feel it’s the thin end of the wedge and can be harmful in that it doesn’t encourage critical (enough) thinking about an important subject – one’s health – and also allows complementary therapists to get away with dubious claims and rip us off.

Plus there’s the old canard about evil Big Pharma vs non-profit (ha) complementary therapy.

I should add that I don’t believe in complementary therapy, only medicines and treatment that have been proved to work (of which some may be derived from plants, like aspirin) and those that haven’t.

Here she starts:

“Well if you stop drinking and take milk thistle, for instance, that may help to cut down "fatty liver" and improve other liver conditions. Although the tests on milk thistle have not yet been rigorous or extensive enough, that does not cancel out the effects that have been shown.”

She provided two sites (I can't post them as I've not reached the posting limit)

But the first one is just a summary of some research, saying no results have been conclusive, while the second explicitly states: “Clinical efficacy of milk thistle is not clearly established.”

So should I hand over my 10 pounds to the makers of milk thistle (for some reason this is viewed as less pernicious than handing over 10 pounds to big Pharma) on the basis of very little?

And besides, how in God’s Holy Trousers do I know I have a “fatty liver”. A doctor would surely need to diagnose alcoholic or non alcoholic steatohepatitis? And surely in that case I’m in better, more qualified hands (than myself and some herbalist) to proceed with possible treatment.

Then she says this:

“And, of course, there are no large pharma companies pushing a product that is available to everyone, and perhaps falsifying or nudging studies into it. Plenty of "standard" drugs have somewhat dubious, exaggerated or insufficient research behind them.”

Ah, evil pharma. I’m not sure what standard drugs that have insufficient research are – she doesn’t name them, but of course I concede that there have been some drugs whose side effects were eventually deemed too hazardous post approval (I’m a reporter and used to cover healthcare). But generally, medicine and science has an open mind and uses the testing methodology to continually reassess and refine. It’s called progress. I’m not sure we’re getting that here with exhortations to swallow spoonfuls of liquid we’re not sure works. And being satisfied with that.

Besides, it raises the question, if it’s been used to improve liver function since Greco-Roman times, wouldn’t doctors have pounced on it, tested it rigorously, and if it worked, prescribed it widely?

The last comment is:

"Eating sensibly" is not always the only way to improve our body's function.”

But surely if I was eating healthily and getting sleep and had cut back on booze and FELT ILL, I’d seek medical advice rather than randomly dose myself up with products that still COST money. Plus don’t illnesses and feeling ropey often just come and go? If all I relied on was my own anecdotal evidence that I somehow recovered because at the same time I was drinking some tonic, I’d be doing myself a disservice.

Also contained in this is a spurious idea that you can somehow improve on the normal function of an organ and create a super-organ running on absolutely all cylinders. Surely a responsible doctor/scientist with qualifications, experience and years of testing would desire that. But they generally don’t (the discussion over doctors prescribing complementary treatments is another area) think this way because the organs either work or they don’t, and if they don’t you have a problem, which may or may not go away of it’s own accord, but should be looked into by a trained professional.

Perhaps I’m being churlish. I’d certainly like to know more about how self-suggestion works and placebos and how seemingly taking charge of one’s health can help a patient recover.

Thanks for listening, and sorry for such a lengthy first post.


So Phen Phen, Vioxx, Fenfluramine & others like them are 100% safe to use because No Drug company would EVER produce harmful drugs & in all the years not one Drug Company has EVER lied.

Anyone want to buy a Bridge in New York City? I'm selling cheap? Honest My backer is a Pharmaceutical Company. And remember folks ONLY drugs sold in the United States is 100% guaranteed to be sold untainted like those sold in the UK where they don't care what is in their drugs.

Ike

[Pebble]

So Phen Phen, Vioxx, Fenfluramine & others like them are 100&#37; safe to use because No Drug company would EVER produce harmful drugs & in all the years not one Drug Company has EVER lied.

Anyone want to buy a Bridge in New York City? I'm selling cheap? Honest My backer is a Pharmaceutical Company. And remember folks ONLY drugs sold in the United States is 100% guaranteed to be sold untainted like those sold in the UK where they don't care what is in their drugs.

Ike


Unclear whether you are generally suspicious of corporations or have a specific beef here.

Remember all drugs are poisions. If they do not interfere with metabolism in some way they are inactive (i.e. a placebo). The same is true of alternative 'medicines' if they work (not much evidence here) then by definition they can cause harm. So that is why care is needed in use, and when that care is inadequate harm may follow.

As to corporate ethics, the checks and balances in place usually prevents harm and robustly punishes those caught out. Not so much through the court system as the consequent media attention that hugely devalues companies that misbehave in this area. Fenfluramine was highlighted as a drug to be watched very carefully for possible cardiac side effects from the beginning, so the signals were picked up quite early. The vioxx story is quite complicated, certainly the company has suffered hugely as a result. But the interpretation of how robust the meta-anlaysis data that was used retrospectively to discredit the agent is not as clear as some would like, really it was the few 'excluded' deaths that did for the company.

No such checks operate in the 'black market' of alternative medicine.

Given the above, your recommended way forward is?

[Matt]

So Phen Phen, Vioxx, Fenfluramine & others like them are 100% safe to use because No Drug company would EVER produce harmful drugs & in all the years not one Drug Company has EVER lied.


What a silly thing to say. It's completely irrelevent to this disccussion no-one has suggested any such thing.

Since you're new around here I'll take time to explain. The straw man fallacy describes the rhetorical equivalent of instead of engaging your opponent, building a man a straw to engage, which might have a superficial likeness but is infact designed by you to have inherrent weaknesses which you'll then exploit.

No-one has said that any system is perfect. However it is undeniable that the system in place to test and licence pharmaceutical medications both in this country and abroad is detailed, evidence based and has had great measurable sucesses despite the occasional accidental or corrupt slip up. The same cannot be said of so called alternative medicine which continues to promte products despite there being no evidence base to support their efficacy and sometimes when clear evidence shows them to be either ineffectual or even harmful.