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More on “integrating” pseudoscience with science

Naturopathy is at least 99% woo. That has to be said at the outset. Naturopaths might brag about all the science they take in naturopathy school, claiming that it’s as much as MDs take. Even if that were true, the question is not how many hours of basic science naturopaths take, but rather what’s taught in those hours and, more importantly, what’s taught in the clinical hours. For instance, given that you can’t have naturopathy without homeopathy, it implies that what’s taught in basic science classes in naturopathy school allows room for the incredible magical quackery that is homeopathy to be not just plausible but a standard of naturopathic care. As long as that is true, naturopaths are deluding themselves (and deceiving the public) when they claim that naturopathy is based on science. Indeed, the only complaint I’ve ever heard from naturopaths about homeopathy is that it’s either too complicated or that naturopathy schools teach it wrong, not that homeopathy is superstitious thinking based on ancient principals of sympathetic magic.

Of course, it’s not just homeopathy that makes naturopathy by and large a hodge-podge of beliefs and treatments that range from the mundane science-based, such as recommending the same things that “conventional doctors” recommend, such as losing weight and exercising, to the questionable, such as as recommending all manner of supplements, to hokum like traditional Chinese medicine, acupuncture, and various forms of “energy healing,” to pure quackery, like homeopathy. When taken as a whole, naturopathy is a system of medicine that fetishizes anything it views as “natural” and as a result is heavily weighted towards pseudoscience and quackery.

All of this is why one of the more disturbing developments in quackery lately is the move for naturopaths to market themselves as primary care practitioners. It is a role for whyc they are woefully untrained., their delusions otherwise notwithstanding. Unfortunately, they are having some success legislatively, not only gaining licensure in a number of states but gaining prescribing privileges and the right to do primary care in some. They do through a combination of savvy marketing, appeals to “health freedom,” and, of course, the co-opting of science.

Once again, when it comes to trying to convince people that naturopathy is good medicine and that, contrary to reality, “integrative medicine” doesn’t represent “integrating” quackery with real medicine, that wretched hive of scum and quackery, The Huffington Post, excels. So does our old friend John Weeks, propagandist for pseudoscientific medicine of all stripes and, above all, “integrating” quackery into science-based medicine. This time around, he’s done it in an article, How Naturopathic Doctors Are Proving the Value of Integrative Medicine. In it, Weeks tries to argue that not only isn’t naturopathy science-based, but that integrating naturopathy with science-based medicine improves outcomes.

I’m not impressed.

I’ll show you what I mean. Weeks starts by seemingly magnanimously thanking conventional medicine for providing the scientific basis for the Textbook of Natural Medicine the consumer-focused counterpart the Encyclopedia of Natural Medicine , because many of the studies they referenced were “gleaned from conventional medical literature.” No doubt. Of course, it’s how such bodies of studies are interpreted where naturopaths fail, inevitably ascribing near magical powers any positive evidence they could cherry pick in support of their favored woo. However, I suppose that, in a way, it is rather chivalrous of Weeks to give credit where credit is due in doing the research they could not and that they could use for their own propagandistic purposes.

Unfortunately, it’s only a prelude to patting oneself on the back for “paying conventional medicine back”:

Now it looks like present day naturopathic researchers may be paying back this debt — at least as far as their medical doctor colleagues in integrative medicine are concerned.

A recently-published study of naturopathic treatment for diabetes and a review of 13 outcomes studies of “whole practice” naturopathic treatment each support the value in the multiple modality, individualized approach that is also favored by integrative M.D.s.

The study Weeks is touting is this one, Adjunctive naturopathic care for type 2 diabetes: patient-reported and clinical outcomes after one year. I am underwhelmed. First, it’s a small study, only 40 patients with type 2 diabetes, a hemoglobin A1c level between 7.5% adn 9.5%, and at least one other cardiovascular risk factor, such as hyptertension. Second, and more importantly, it’s for all intents and purposes uncontrolled. Yes, there is a control group, but it’s a more or less useless control group. Basically, it’s a control group (the “usual care cohort”) constructed from the medical records of patients who, we are told, were potentially eligible to join the “adjunctive naturopathic care” (ANC) cohort but were not invited. Although the study was prospective, there was no randomization, and the groups were not treated as close to identically as possible. Basically, this was an observational cohort study in which one cohort was never seen by the investigators. Thus, the ANC group got a letter, came to see the naturopath several times, and knew they were taking part in a study.

Also, contrary to what was claimed in the abstract, the ANC and usual care cohorts had a number of notable differences. The ANC cohort was younger, had a higher A1c (and thus more room for improvement), and lower blood pressure. Interestingly, more of the ANC group used metformin (80% versus 20%), which suggested that they had more severe diabetes and, therefore, more room for improvement:

Use of oral medications and insulin increased in the ANC cohort during the 12-month observation period, with three patients starting on sulfonylureas, three patients starting on metformin and six patients starting on basal insulin. The total number of prescription refills also increased in the ANC cohort on average during the observation period from 4.7 ± 2.2 per year during the year prior to baseline compared to 5.9 ± 2.7 per year during the ANC observation period, whereas refills did not change in the usual care cohort (i.e., 4.2 ± 3.0 refills/year during the prior year compared to 4.0 ± 3.2 refills during the ANC observation period).

Did these patients get worse and require more medication or was their compliance improved? Who knows? If it was improved compliance, did it have anything to do with naturopathy? Given that the control group wasn’t treated the same way or observed in any way other than by reviewing medical records, improvements observed in the ANC group could well be due to the study effect, also sometimes called the Hawthorne effect. This is a well-known confounder of clinical trials in which subjects improve or modify an aspect of their behavior that’s being experimentally measured simply because they know they are being studied, not because the experimental manipulation worked. In fact, if I were intentionally trying to maximize the Hawthorne effect, I would be hard-pressed to come up with a better study design than this one. Consistent with this, although there were a lot of statistically significant improvements in hard clinical parameters (such as HbA1c) at six months, by twelve months the observed improvements were no longer significant while the subjective measures remained improved.

In other words, this study shows little. Interestingly, there were also adverse events reported in the ANC group, nearly all due to adverse reactions to supplements.

Next up on the quackademic medicine hit parade directed by weeks is a poster presentation. I kid you not. He’s referencing a poster presentation:

The poster presentation was entitled “Systematic Review of Outcomes Studies of Outcomes Studies of Whole Practice Naturopathic Medicine.” The poster team, led by Erica Oberg, N.D., MPH and Carlo Calabrese, N.D., MPH, acknowledged that “formal whole practice studies in naturopathic medicine are a recent phenomenon.”*

All of the naturopathic studies were on chronic conditions. “Some degree of clinical benefit” was found in each, “sometimes quite strong.” Eight of the 13 used quality of life measures with all showing improvements. While noting many “methodological weaknesses,” the team concluded that the review “provides evidence of effectiveness and cost savings in chronic diseases in the observed or validly-modeled practice of trained and licensed naturopathic doctors.”

Here’s a description of the study. You know what they say about meta-analyses: Garbage in, garbage out. Oddly enough Weeks didn’t link to the actual poster; so I will. It’s right here. It’s even more underwhelming than the first study. It pools twelve studies of widely varying conditions. Given how many different conditions were examined (tendonitis, temporomandibular joint problems, low back pain, hypertension, multiple sclerosis, and menopausal symptoms, among others) I find it hard to believe how one could legitimately pool the results in any meaningful way, much less to conclude that naturopathic interventions are beneficial and cost-effective. This is particularly true given that only six of the studies were actually randomized clinical trials; the rest were observational or retrospective.

None of this stops Weeks from exulting:

Such research is of most value to real world decision makers. The aim is not to show that X therapy caused Y response under controlled conditions. Rather, these help stakeholders — whether employers, individuals, hospitals, or accountable care organization leaders — understand what may happen if a given population of patients is cared for by a set of integrative practitioners. These specifically help answer whether naturopathic doctors will be helpful if included in care teams or benefit plans.

Evidence like this will answer no such question. It’s too low quality to answer much of any question. But this is the sort of evidence what Weeks and the naturopaths whose “integration” with science-based medicine he promotes use to make their case, which makes his claim that soon doctors will be soon borrowing the results of research carried out by naturopaths for anything.

Naturopaths and their apologists trumpet that naturopathic care should be “integrated” into conventional medicine because their nostrums add something unique and valuable. In reality, anything science-based that they add is nothing that physicians don’t know already anyway (eat a good diet, get enough sleep, and exercise). What they add that is unique is something that shouldn’t be “integrated” with conventional medicine: magical thinking, pseudoscience, and quackery. To paraphrase Mark Crislip, “integrating” feces with ice cream doesn’t make the ice cream better; it just contaminates it with feces.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

324 replies on “More on “integrating” pseudoscience with science”

It is “funny” how the ScienceBlogs website choose its random adverts. Currently the ad I see is about “Shockingly accurate insights” from a psychic (Norah) who offers free readings if you click on her ad. Maybe Orac can somehow persuade the Powers that be not to allow such ads that go so completely against what this site is about?

Maybe Orac needs to add a new Friday column “weird stuff Google adds served us this week”.
As for ND licensing, I’m still hoping the trial lawyers will put an end to it. Just too much potential for serious conditions not recognized or treated with magic water to not be seen as an income source.

I actually missed the psychic ad. Never saw it, fortunately for my blood pressure.

Personally, I used to be irritated by the ads, but these days I’m amused to think that advertisers are paying money, however little per click-through, to appear on blogs where the readers are, for the most part, completely hostile to their nostrums. Sometimes things do go beyond the pale and I complain, but as long as we use an ad service that uses search terms to match ads to content, this sort of thing will happen from time to time. We’re not alone, either. I’ve noticed the same thing at other skeptical blogs, including Freethoughtblogs and even Skepchick. Basically, these days I pick my battles, complaining about the most egregious offenses (ads for homeopathy, for instance) and leaving the rest alone. It’s an unending struggle, as I’ve found out over the years. As soon as the Powers That Be block one ad, another woo ad appears.

Sometimes I even have fun with it, intentionally sprinkling my posts with words that I think will bring a certain kind of add and then seeing if I’m right.

But enough about advertising. Let’s stick with the content of this post. I would prefer that this thread not be derailed by a discussion of Sb advertising policy.

The total number of prescription refills also increased in the ANC cohort on average during the observation period from 4.7 ± 2.2 per year during the year prior to baseline compared to 5.9 ± 2.7 per year during the ANC observation period

The change is about half the quoted error bar. Either their error calculation is off, or this change is not statistically significant. And given the study design issues mentioned in the post, these options are not mutually exclusive.

Stranger @0709: The pre-NG incarnation of ScienceBlogs had a similar issue; I recall one post in which Orac complained about a Suzanne Somers ad appearing together with a previous post applying his Respectful Insolence to whatever woo Ms. Somers was pushing that year. Or search the archives for mentions of Asian mail-order brides, which were advertised along with posts opposing the practice. It’s a known long-standing issue with Google Ads.

At the risk of incurring Orac’s wrath for a silly post…

Orac’s link to Jann Bellamy’s blog on SBM details new legislation in Vermont that has allowed Naturopaths to be designated as Primary Care Physicians…for insurance purposes.

http://www.sciencebasedmedicine.org/index.php/legislative-alchemy-2012-5/

“Unfortunately, a much-needed counterweight to Vermont’s expansion of naturopathic practice did not make it out of committee. A bill would have required a state pharmacologist to approve the naturopathic formulary. Alarmingly, the current formulary includes colloidal silver preparations, to treat eye infections, and silver, which can be administered intravenously, both dangerous substances which no physician in his right mind would ever use as a treatment.”

Which immediately brought to mind this…

http://www.youtube.com/watch?v=t0aT0GXW8jw

( I promise to post a serious comment, shortly)

Are there any naturopaths whose practices are not riddled with pseudoscience and quackery?

For a case in point, I give you John Ruhland N.D., whose website notes that he has taught at Bastyr University (an ND school which prides itself on research). This guy promotes homeopathy, “toxin” removal, treating “yeast overgrowth”, “alternative perspectives on causes and treatments of viral infections such as Hepatitis and AIDS”, and “a comprehensive look at alternatives to vaccination.”

Quite the collection of woo, plus evident denialist nonsense about AIDS and antivax foolishness.

Oh, and he’s into coffee enemas (at least for his patients). His rationale is brilliant:

“Coffee enemas are a good treatment for elimination of toxins. During WWII, the German army had run out of pain killers and used coffee enemas to successfully reduce pain. These two facts provide the rationale for their use in advanced chronic diseases.”

Remember, you must use only organically-grown ground coffee, NO INSTANT!”

ht_p://drruhland.com/

I’ve seen the bit about the Nazis using coffee enemas for pain. Aside from the aptness of this “treatment” (“You vill talk, or it’s more Folgers up the butt for you“), is there any evidence to back up the fantasy that German medics, once they ran out of morphine, carried coffee enema kits to successfully treat pain from battlefield injuries?

It’s hard for those who actually read the research that’s published on medicinal plants to dismiss all of TCM as “hokum” when one traditional recipe after another after another shows efficacy in double-blind placebo-controlled trials. It must pain you to see so many scientists ignoring the dictates of the great god Science by testing such quackery, far less having the temerity to publish their unacceptable results. (I am sure you will respond that ancient Chinese physicians believed in qi, which doesn’t exist, and therefore all herbal remedies discovered by them must be Worthless. Since the ancient Greeks et al. who discovered opium believed in humors, please let us know when you stop prescribing opiates in order to apply this criterion in a culturally unbiased manner.)

One nitpicky point: I wouldn’t shriek too much about the fact that a web article cites a poster abstract of research too newly completed to have been published yet. (This one is from a May 2012 conference, so if it were really important, which it doesn’t seem to be, it would be “breaking news.”) Even in scientific writing in many fields, it is considered acceptable to cite an abstract under such circumstances, rather than fail to mention someone else’s relevant work. Of course, you point out that it is “work in progress” or a “preliminary report.” Half the news articles on MedPage Today tout the latest pro-intervention results from presentations at conferences, so I will not easily be convinced that public discussions of unpublished research are verboten in medicine.

FWIW, I pretty much share your opinion of naturopaths. The average naturopathic graduate knows less about physiology and pharmacology than an MD and less about herbal medicine than a traditional herbalist or shaman who’s been practicing for more than a few years. I think it is because they waste so much of their time studying genuinely dubious stuff like homeopathy and iridology, ending up jacks of all trades and masters of none. Worse, I have encountered a couple who do not realize this to be the case and think that the fact they have a sheepskin with “Doctor” on it proves they know all there is to be known about certain subjects.

It’s hard for those who actually read the research that’s published on medicinal plants to dismiss all of TCM as “hokum” when one traditional recipe after another after another shows efficacy in double-blind placebo-controlled trials.

[citations needed] that it’s “one traditional recipe after another.” Anyway, what you describe is a completely standard part of scientific medicine (albeit with a vastly lower success rate than you imply), called pharmacognosy. It doesn’t validate TCM in the slightest that on occasion it gets lucky; without doing the science there’s no way to tell which times were lucky and which weren’t!

It must pain you to see so many scientists ignoring the dictates of the great god Science by testing such quackery, far less having the temerity to publish their unacceptable results.

As mentioned, completely standard scientific medicine. Nobody here has the least problem with it so long as it’s done competently and honestly.

One nitpicky point: I wouldn’t shriek too much about the fact that a web article cites a poster abstract of research too newly completed to have been published yet.

Poster abstracts are grossly insufficient to hold the weight placed on it by the article Orac is discussing. At best your argument amounts to “but, but, but, it MIGHT turn out to be accurate!”

Even in scientific writing in many fields, it is considered acceptable to cite an abstract under such circumstances, rather than fail to mention someone else’s relevant work. Of course, you point out that it is “work in progress” or a “preliminary report.”

Precisely. You DON’T use it as the foundation to supposedly justify an entire profession.

“FWIW, I pretty much share your opinion of naturopaths. ”

And a broken clock is right twice a day.

Hey brothers and sisters, what do the NDs need all that research for anyway- they have the gift of spirit, life energy, vision, emotionalism and – above all- ESSENCE, to guide them

I hereby postulate Walter’s Law- which states-

The woo-ier the woo, the more it shall be reliant upon spiritual, religious or ultra-mundane explication.

Anyone else notice that “a possible adverse reaction to a dietary supplement” and “a possible adverse reaction to iron supplementation” were reported in the study? I thought admitting that was against the party line (supplements never have side effects! They’re natural!).

Denice @11:24 — Again, with the essence.

Women uh… women sense my power and they seek the life essence. I, uh… I do not avoid women, Mandrake.

@ palindrom:

Of course, because women have innate powers of *intuition* and can *sense* subtile presences

Now, I’d better duck to avoid the airborne projectiles aimed in my general direction…
I was JOKING.

Orac: “All of this is why one of the more disturbing developments in quackery lately is the move for naturopaths to market themselves as primary care practitioners. It is a role for whyc they are woefully untrained., their delusions otherwise notwithstanding.”

For a moment there I thought I was reading about the push, several years ago, when the “doctors” of chiropractic were beginning to push their putative bona fides as primary care physicians. Which ones are more unqualified – the DCs or the NDs?

I’ve challenged a few chiros about their belief that they’re really as qualified as medical doctors to serve as entry level physicians. The typical response is indignation! I’m sure it’ll be the same with the naturopaths.

“It’s hard for those who actually read the research that’s published on medicinal plants to dismiss all of TCM as “hokum” when one traditional recipe after another after another shows efficacy in double-blind placebo-controlled trials.”

There are several problems with this statement:

1. There are comparatively few rigorous clinical trials of various herbal extracts and traditional medicinal preparations that use human subjects… most such studies are done in cell cultures or small animal models. In addition, many of these studies are conducted in the country that the traditional medical approach was developed. Experimenter bias is a real issue: I cannot think of any Chinese study on traditional herbal medicines, for example, that has questioned or challenged the notion that the preparation-in-question worked as claimed. Rather, the m.o. is to take the agent (or an extract of it), add it to various cell/tissue cultures, observe some reaction (not surprising, since herbs contain biologically-active compounds), and conclude that the observed reaction supports the traditional use – badda bing, badda boom. I have yet to see a negative study of this kind – and I’ve looked at quite a few over the years.

Point being, you can’t just “read the research” on traditional medicinal plants in a vacuum. Some knowledge of real science and a healthy dose of skepticism is needed to assess the value of what you read.

2. It is not hard to design studies which essentially “stack the deck” in favor of the desired conclusion… and these are the types that the supplement/natural products industry favors (when it funds studies at all vs. cherry picking positive studies from PubMed).

3. Something may indeed work better than a placebo, but this does not tell us how it may stack up against other treatments (even herbal ones). This leads to tremendous confusion over what the “best” approach might be for a given condition.

4. Most studies on herbals/traditional medicines (even those with human subjects) are generally small and relatively short-term. Safety studies are in short supply; ditto those looking at how such compounds are metabolized and excreted. Thus, practitioners “prescribing” such nostrums have less insight and information on potential interactions and adverse effects.

5. Having read a lot of research on medicinal plants, I certainly don’t dismiss them as “hokum,” per se. Many natural compounds from traditional medicinal plants have been integrated into prescription meds, after all. What I do dismiss as “hokum,” however, is the irresponsible use of (typically) preliminary and incomplete research by inadequately-educated “experts” to recommend treatments.

(supplements never have side effects! They’re natural!)

You can tell because they look indistinguishible from the unnatural concoctions of Big Pharma.

I think I shall start bigstickopathy. The sticks will be unarguably natural, and have a 100% success rate at keeping the doctor away (no guarantees about undertakers).

I once got into it online–I really do try not to, you know, but I just couldn’t help it that time–with someone who was trained in the bach Flower Essences. She was *sure* that since she scored well on her studies, that she knew better than I did, even though I was pointing out that what she was saying had no scientific meaning whatsoever. She studied it, therefore she knew it, therefore I was wrong. Nothing I could say would shake her certainty that since it was written down and she had studied it, that she knew it was true.

Studying does no good if what you’re studying is bogus in the first place. Naturopaths “study” as much science as an MD? Suuuuure.

It’s hard for those who actually read the research that’s published on medicinal plants to dismiss all of TCM as “hokum” when one traditional recipe after another after another shows efficacy in double-blind placebo-controlled trials.

At which point the active ingredient or ingredients will be isolated, their molecular structure elucidated, analogs synthesized to investigate structure and function, lead compounds nominated, etc., all the way through Phase I, II and III clinical trials and FDA/EMEA approval for marketing.

None of this represents science embracing ‘woo’: just business as usual.

How else did you think we came up with aspirin, Taxol, digitalis, etc.?

“I’ve seen the bit about the Nazis using coffee enemas for pain. Aside from the aptness of this “treatment” (“You vill talk, or it’s more Folgers up the butt for you“), is there any evidence to back up the fantasy that German medics, once they ran out of morphine, carried coffee enema kits to successfully treat pain from battlefield injuries?”

Dangerous Bacon @ 10:24

I don’t know anything about coffee enemas, but anyone with any real knowledge of WWII can identify this one as a myth. During the war, coffee was completely unavailable in German-held territory, and therefore could not have been used as an enema or for any other purpose.

It’s not enough to do research, it helps to do research right.

Just spotted this: .

Parents who choose not to vaccinate their children using conventional immunisation techniques should not be penalised according to an Orange naturopath. Yvette McRae said homeopathic immunisation is more effective then modern medicine and is harmless.

Sorry, messed up the formatting there (please can we have the preview function back?). There should have been a link to the story:

Vaccination rule a sore point for some

Parents who choose not to vaccinate their children using conventional immunisation techniques should not be penalised according to an Orange naturopath. Yvette McRae said homeopathic immunisation is more effective then modern medicine and is harmless.

mojo @839 — To my amazement, the five or so comments that the story had attracted were all downright scornful of the homeopathic vaccinator, and in some cases berated the paper for giving her space. No me-too-woo.

Jane who is new to our ways . . .

First, let me say that is one fine immitation of Cartman’s mom.

Flattery aside, do try actually reading the opinion of our host (as well as many of his minions) as pertains to pharmacognosy. We all know that plants contain chemical compounds. We know that they can be beneficial. That our host prescribes Taxol for some of his patients and that it was isolated from the Pacific Yew tree is not a shocking revelation to any of us. Purity and dosage as relates to herbs as medicine is a whole ‘nother smoke, however.

Our distilled and concentrated disdain for TCM is derived from the fact that, as a system, TCM is based on superstition and bullshit. That doesn’t make all of the observations of generations of herbalists totally wrong, but it puts everything under suspicion. Let’s not forget the ancient wisdom of the widespread use of aristolochia for stomach ailments, or wiping entire species off the globe in a pathetic attempt to help their marks achieve better boners.

So here’s some respectfully insolent advice. When visiting a new website, try to get the general lay of the land before clutching those lovely Mikimotos, embarrassingly spewing forth the tired, old “god of science” trope, compounding that with a false equivalency or two, and finally igniting a small army of strawmen. It will save Eric so much humiliation. And speaking of Eric, see if you can get him to lay off the Cheezy-Poofs™, talk about childhood obesity . . .

G: “Studying does no good if what you’re studying is bogus in the first place. Naturopaths “study” as much science as an MD? Suuuuure.”

Maybe they do. And maybe the claims about chiros’ voluminous basic science coursework are true as well. It doesn’t mean much though, when so much of the rest of their training is spent denying and obfuscating the principles and evidence they are supposedly exposed to during their “education”.

For instance, one website dealing with naturopathy claims that students’ coursework includes biochemistry.

Anyone who takes a biochemistry course should have a basic understanding of acid-base homeostasis. That is not the case for naturopaths like the one who stated the following:

“Maintaining high alkaline in the body is the basic fundamental of health. When your alkaline is high, your body, mind, and spirit function on healthy levels. When your body begins to show signs of high acidity, your body becomes vulnerable to disease and illness. Gray hair is an indicator of significant stress and a strong sign of acidity in the body. Alkalizing your body is the best thing you can do to have optimal health. ”

ht_p://www.naturopath.ca/alkaline-vs-acid-012386.php

(again, the recommendation for “plenty of laughter” is gratifyingly supplied by the website itself)

Pariedolius

Our distilled and concentrated disdain for TCM is derived from the fact that, as a system, TCM is based on superstition and bullshit.

And this superstition and bullshit has brought some animal species to the brink of extinction and resulted in great cruelty to other animals such as bears being used for bile extraction. By championing TCM, Jane is encouraging this barbarism.

Let’s see, what is the sacred term of art to be employed in response to such a comment? Oh yeah … STRAW MAN.

Jane it would be a straw man if I accused you of claiming Rhino Horn, Tiger Penis, Bear Bile etc were effective and endorsing the use of these remedies. I do not say this. However, you are definitely claiming “one traditional recipe after another after another shows efficacy in double-blind placebo-controlled trials” which definitely implies that the bulk of TCM is valid rather than the bulk of it being superstition and bullshit. I was however pointing out (as did Dangerous Bacon) what are the consequences of such credulity.

And it’s still based on bullshit “elements” like fire, earth, wood, metal and water. What? No humours and miasmas? Let’s not forget unintentionally hilarious concepts like flavors, zang, fu, senses and tissue. Oh, and let’s see some citations and links to those studies.

Let’s not forget unintentionally hilarious concepts like flavors, zang, fu, senses and tissue.

Dagnabit, I thought I came up with ‘zang’ all on my own.

Narad

Dagnabit, I thought I came up with ‘zang’ all on my own.

There seems to be some sort corollary to Poe’s Law with CAM. It is nearly impossible for a skeptic to come up with a silly concept or phrase that has not been previously used by an altie.

Dangerous Bacon : Re German coffee enemas.
It was during ww1. The German supplies of pain killers was low, but they could still get coffee. In desperation, one German field hospital doctor tried a coffee enema, and the patient responded favorably. (no doubt due to placebo effect)
This started up a whole chain of such things, leading Gerson to later (and erroneously) claim that the coffee enema washed toxins out of the liver. Thus the Gerson protocol.

At least coffee enemas are to be prefered over bleach enemas.

Not meaning they do anything good, but bleach enemas are something I really wouldn’t like to experience.

Mr. Weeks did not post the following comment that I left after his Huff article. Wonder why? I tried reposting again without the links, but that didn’t get through either.

Naturopaths terrify me. They routinely use products that have never been evaluated for safety or efficacy. One or more of these products could be totally useless and as lethal as cigarettes but by the time that is known, it will be too late to prevent many premature deaths.
http://rosemary-jacobs.blogspot.com/2012/04/naturopaths-terrify-me-nds-do-not.html
http://rosemary-jacobs.blogspot.com/2012/05/deadly-folk-medicine.html

Worse still, they use dangerous snake oil like silver which disfigured me over 50 years ago.
http://rosemaryjacobs.com/naturopaths.html

Naturopaths practice a belief-based system of medicine, not an evidence-based one with the result that when there is overwhelming evidence that something like silver is useless and dangerous they are emotionally unable to believe that because the idea that something natural can be harmful and useless is contrary to their religious or philosophical belief that Nature heals.

Rosemary Jacobs

Yet another story from the dinosaur.

I used silver nitrate to treat small granulomae in wounds. It was quite effective but had the unfortunate side effect of oxidising and turning the the whole wound black.

Flamazine, a burn treatment which i used to great effect, especially in the Falklands War, also contained silver salts and, not surprisingly, also made the wound and skin black.

On the subject of coffee enemas, i have a 1930 edition of The Naval Sick Berth Ratings Handbook. It states,

“Hot Coffee, administered rectally, is a useful stimulant in the treatment of an unconscious drunk.”

“Hot Coffee, administered rectally, is a useful stimulant in the treatment of an unconscious drunk.”

At very least, it would probably get someone to swab the deck of their own accord.

My Airedale would make a fine acupuncture/trampletherapist, by all the beliefs of woo-opathy. She’s overly enthusiastic, knows nothing of science, and would continue treatment long after it’s useful.

I used silver nitrate to treat small granulomae in wounds.

I would feel negative about that.

@ peebs:
I trust that that unfortunate side-effect did not tarnish your sterling reputation.

I did once apply flamazine to the face of one of my shipmates who had quite nasty sunburn. By quite nasty I mean a mixture of superficial and intermediate burns.
She then went back straight out into the sun. I got grief from her and her husband when she returned looking like Al Jolson.

Oh, how the rest of us laughed! (It should be noted that in our Armed Forces sympathy is but a word in the dictionary, between shit and syphilis).

Herr Doktor, I’m probably being as thick as the complete works of Dickens in large print but, unusually, your cryptic comment has left me floundering.

peebs

Silver nitrate was (maybe still is) the light sensitive chemical in black and white photographic negatives.

I think these days the negatives start out drenched in silver nitrate, before this becomes silver halide as part of the manufacturing. If anyone’s still making negative film these days.

Obviously could have been funnier.

I should have known that. I just wasn’t thinking laterally enough, embarrassingly I used to be quite an accomplished photographer, though in my defence, I used mainly transparencies.

Silver nitrate was also of course, used on X Ray films.

Have any of you been to a naturopath?

As a practicing ND since 2004, I have seen life-changing things happen in my office. What distinguishes ND’s from MD’s are a few things: first, we spend an hour 1/2 with our first office calls. We get to know our patient’s health history from the start, in detail. We get to know their diet and their lifestyle choices, their fears and concerns, their accomplishments. We take detailed history’s of each and every chief complaint and follow that with differential diagnosis, the proper physical exams and blood work and then use every tool in our tool box to help them get well. We start with diet and lifestyle changes and add treatment options little by little if and only if the least invasive option isn’t working. Traditional medications are the last on our list for most.

An example, for 2 years I worked with type 2 diabetics reversing their diabetes. These were patients on metformin and insulin, some of them, not because they weren’t making their own insulin, but because their doctors didn’t know what else to do to get their Hba1c down. When I asked them what their doctors told them about diet and lifestyle changes, they would most often say “nothing..oh, yea, stop eating as much sugar.”

After getting my patients off of all refined carbohydrates (everything made with flour or sugar) and finding a weight loss plan that worked for them and gettting them to understand how a whole foods diet is important for proper blood sugar regulation, I would see Hba1c’s come down from 9.0 to 5.8% I was able to take all my patient’s off their metformin and insulin, some in as few as 4 months and most within 6-8 months.

But it took a lot of education, counseling, inspiring, motivating and calling patients a few times a week to keep them on the path.

So you mean to tell me that you actually think that going into your MD’s office and spending 5 minutes with them only for them to throw at you an increased dose of Metformin is more “scientific” and “better medicine”?

Are you sure that all this ranting isn’t coming from a place of fear and mis-understanding, because it is different than what you have always understood to be the proper way of doing things?

Come see me. I will change your mind.

Rian Shah, ND
http://www.shahfamilymedicine.com

Rian Shah,

What you say you do for diabetes treatment sounds perfectly sound, based on my understanding of the risk factors for diabetes. Cutting down on sugar and starch, reducing weight, and increasing exercise should improve diabetes particularly in borderline cases. On your web site you list the following services, and I’d be interested in how you justify them:
– reiki
– detoxification
– Craniosacral

There are a couple of others (like heavy metal toxicity) that could be pretty reasonable, though they often are used in invalid ways. If you have any information about why you call those out in particular, I’d also be interested.

We start with diet and lifestyle changes and add treatment options little by little if and only if the least invasive option isn’t working.

So, if your approach is exactly the same as REAL doctors, what’s the point?

Diabetes 2 Winter Hibernation Gone Astray and Diabetes 1 Summer Drought gone astray.. A SEASONAL EXPLANATION FOR DIABETES.

HIBERNATION DIABETES 2
With weight gain the body interprets this as the person heading for deep freezing winter where food will become scarce or unavailable (as with hibernation). Fat stores have to increase to carry him or her through the deep freeze, and what is happening in the plant world exactly matches that of the animal world. The plants provide precisely the right nutrients for the animals for that time of year and vice versa, the bowel flora of the animal’s feces, the composition of it’s urine is precisely right for the plants. More nitrogen is locked up in the animals and more carbon is locked up in the plants and I’d reckon that the carbon:nitrogen ratio shifts between the seasons. More muscle mass in in the animal relative to fat in summer means more nitrogen to carbon in summer. Have to think about the plants, eg lignin.

Coming on a winter freeze he or she has to conserve energy by being less active, as is taking place throughout the entire forest, hence the shift in the number of insulin receptors from muscle cells to fat cells. (peripheral resistance to insulin in diabetes 2) The simple sugar sucrose in the berries and other fruits, necessary for fast ‘fight or flight’ reactions in summer has been replaced by an increase in the more slowly ingested starch. The glucose from the breakdown of starch is being increasingly converted to fat in fat cells and of course liver (fatty liver) rather than glycogen in muscle cells as they atrophy. Soon glucose, even from starch, won’t be available or needed as the animal ceases eating and goes into ketosis and ketones will replace glucose as a fuel in so much of the animals tissue.

What glucose the animal must have will come from gluconeogenesis, a part of going into ketosis in this context. Gluconeogenesis is the process whereby the liver MAKES glucose from the bodies own tissues, from 3 sources, lactic acid from the muscle glycogen (although that disappears once starch stops being eaten), amino acids from from the breakdown of muscle protein, glycerol (glycerine) and fatty acids. Fatty acids from fat cells are broken down to ketones, some of which drive what is called the TCA cycle to provide the energy to drive gluconeogenesis and the rest are exported from the liver as fuel for most of the body as cells adapt to ketones. There are 3 different ketones, acetone, betahydroxybutyic acid and acetoacetic acid. When muscle glycogen runs out and to conserve muscle protein for essentials, fatty acids and glycerol from fat cells become the sole source of raw material for gluconeogenesis. Cortisol is the hormone responsible for mobilising the muscle protein as well as fatty acids and glycerol from fat cells.

Thus the big muscles developed by the spring and summer activity are now atrophying as big muscles are no longer needed. As the large fat deposits are needed for fuel during the long fast so the muscles act as a reservoir of amino acids for cell repair, peptide hormone synthesis etc., although this will be minimal as the animal lies asleep, only rousing every now and then. Bone breaks down to provide not just calcium and phosphate, but all of the minerals the body needs, copper, zinc, selenium etc The hibernating animal stops urinating to conserve water. I think hibernating animals can store urea, the nitrogen of protein breakdown, in a crystal form, so a range of other things, eg uric acid, can probably be stored in a crystaline form for recycling as the animal COMES OUT of hibernation.

NOW TO THE POINT.
There is NO FUEL STORAGE going on at all in the hibernating animal. Thus there is no point in hanging onto a lot of cells in organs involved in stimulating any sort of storage, e.g. beta cells of the pancreas and cells of the thyroid. So why not get rid of them as they are just wasting fuel AND CAN BE RECYCLED. Apoptosis or cell suicide is the shot as everything in the cell is broken down to bite sized chunks for other cells to use. Their is no energy wasting inflammatory reaction with apoptosis. Enter auto-immune ‘disease’, only a disease in the concrete jungle which bears absolutely no resemblance to pristine wilderness. (DIABETES IN THE CONCRETE JUNGLE)

I first focussed on this idea when I read about gene clusters DR3 and DR4? associated with auto immune disease. I had already built a model of an animal in the wild of a temperate zone or a human in a temperate zone and these gene clusters were found in people from Central Europe who had diabetes 1 They were active in the pancreas and thyroid, both endocrine organs. Temperate zone equals big swings in temperature, snow in the winter and hot in the summer.

SUMMER DROUGHT DIABETES 1
Then I began to focus on the advantages of trimming these organs with the sudden onset of a life threatening drought in summer when the animal did NOT have big deposits of fat on it’s body, but did have big muscles. THE REVERSE OF WINTER. If the mechanism of storage didn’t fight with those of release from storage, then the transition to ketosis would be much quicker, easier and smoother. Very little or no adrenalin needed to initiate gluconeogenesis, just cortisol, so no water wasting sweat and energy wasting anxiety from hunger. The animal would quickly become soporific, go lay in the shade under a tree and sleep a lot of the time. Sort of summer hibernation.

So Diabetes 1 could be this summer model gone awry in the concrete jungle. I believe that beta cells of the pancreas are vulnerable to big swings in osmotic pressure caused by big swings in blood sugar, for the same reason that neurons of the brain are vulnerable i.e. they don’t have insulin receptors on them and thus don’t store glycogen. I have never been able to confirm this idea, but I can’t see how they can and regulate blood sugar if they store it as glycogen. They wouldn’t produce insulin yet have insulin receptors on them Doesn’t add up. Loss of weight in pre-diabetic 1 equals drought adaption but with lots of sugar thrown in to initiate reactive hypoglycaemia plus expression of gene clusters DR3 and DR4. Thus auto immune ‘attack’, is perhaps apoptosis PLUS necrotic cell death and inflammatory immune reaction. Dunno. All impure speculation of course.

THE CURE
Ok, if the hibernating animal provides a model for Diabetes 2 then it MUST BE REVERSIBLE, ie CURABLE, following the path of the animal coming OUT of hibernation. The right ketone diet modeled on what this animal eats once it resumes eating. That’s next, as soon as I clean it up. Paul Hill

Paul Hill’s knowledge is staggering! Not only is he an expert (self-taught) on cancer, he is also an expert (self-taught) on diabetes and diets. Truly, we are humbled by his mere presence on this blog.
:/

Rian Shah @8:06 28 June

What distinguishes ND’s from MD’s are a few things

Medical School

Agasham.
Yeah, I agree. I’m staggered myself. You obviously know all about this stuff, hence the adulation. Behave yourself and you may touch the hem of my garment.

Rian, can you tell me why naturopaths like yourself always use anecdote, and never or rarely controlled studies, to support their claims of healing?

CHRIS

‘Mr. Hill, why should we care about what you say?’
Chris you are getting a bit repetitious. Must be stuck speechless at my extraordinary brilliance. Oh by the way, how come you know all about moderation, web links etc. on this blog?

Mr. Hill, I will repeat a question until I get a satisfactory answer. You do not exhibit any brilliance, but someone in dire need of real psychiatric help.

I first became acquainted with Orac on UseNet, and started following his blog from the very first day with Oracknows. After over seven years on Scienceblogs one gets to learn about the various and sundry moderation quirks. Especially when they are not a secret and have been mentioned many times.

So, Mr. Hill, justify yourself with some actual honesty.

Rain Shah,
As the foremost authority in the known multiverse on blood sugar disorders I’d have to agree with EVERYTHING you say. My introduction to ‘reactive hypoglycemia’ was a book written by a naturopath. What the allopaths are ignorant of is that this term was suppressed by the AMA in 1972 under pressure from Cadburies Schweppes and Coca cola.

The understanding of blood sugar regulation is now a black hole in allopathy, to the delight of big pharma which provides the treatment for the symptoms whilst making the underlying pathology much worse.

Must be stuck speechless at my extraordinary brilliance.

It’s like a scrawny version of Blackheart/JRS.

paul hill on the medicine and evolution part 13 thread @ July 1, 11:55 pm

Everything I’ve written is bullshit.

Chemmomo

If I say that it is bullshit that everything I say is bullshit is that bullshit. Anyway, what’s wrong with bullshit unless it’s in a cow’s yard and it’s a holy cow. As I am the most brilliant shrink in the entire multiverse, whilst simultaneously being the most deranged patient, then, i think you’ll have to agree, that only I am qualified to treat me.

Some more extraordinary brilliance for the masses to salivate over.

SEASONAL CONTROL of BASAL METABOLIC RATE in the WILD vs the CONCRETE JUNGLE. A Model for Understanding a range of Diseases, including Schizophrenia.

After the rebirth I went through in 1972 I began a fitness program and to get rid of about four stone of excess weight. I waked several miles each day to a Turkish bath and heated seawater swimming pool. Then I started to do long distance swims in Port Phillip bay. To my amazement I lost the weight in about 3 months. I’d tried many weight loss programs in the past and had failed. Now I was just eating good food and doing a lot of exercise. I figured that it had something to do with my completely changed attitude, some relationship between my mind and my metabolism. I’d been a guilt ridden introverted alcoholic manic depressive (my diagnosis) back-slidden Christian fundamentalist. Now I was full of self confidence, happy and completely cured from the grog. I could have one or two glasses of beer then go home.

Okay, standard medical dogma had told me that if you were an alcoholic, and I was a shocking alcoholic, you could never have another drink, join AA and ask God to help you. Once an alcoholic always an alcoholic. It was in your genes. But I did the exact OPPOSITE, not intentionally, it just happened. Freed of the guilt and despair of believing that I was going to Hell one day, I just didn’t feel like the booze any more. AA does the opposite, adds more mumbo jumbo, self flagellation, self loathing etc. It was believing that I was genetically predisposed to the grog that only ADDED to this despair. NOW I WOULD QUESTION ALL DOGMA. I knew that Freud was insane for a start, Eros, Logos, Thanatos, Id, Ego, Superego etc. etc. Bloody absurd. I was now ONE not a pantheon of lunatics all at each others throats. So I had already demolished one ‘science’.

So, to find out how I’d been able to lose all the lard I trotted off to Ramsey’s surgical and bought a swag of medical books. I got into neurology for a while, then lost interest when I began to read an incredible textbook,’Metabolic and Endocrine Physiology’ by Tepperman. This book was different in that it speculated about all sorts of things, discussed different experiments etc.

ENTER YIN AND YANG.
There were two prefixes that struck me over and over again, Hypo and Hyper and the ones that stuck me the most were Hypothyroidism and Hyperthyroidism. They were opposites in so many ways. The hypothyroid, was overweight, slow, lethargic, constipated, unresponsive, had high blood pressure to which I added introverted, self critical etc. There was something manic depressive about this person. I’d been one myself.

Then there was the hyperthyroid, underweight, very reactive, suffered diarrhoea, anxious, high blood pressure but for a different reason, to which I added extroverted, perhaps narcissistic (depending on the degree), socially critical. There was some thing schizophrenic about this person as I’d done a mild version as a sort of reflex reaction to the manic depression on coming out the other side. It was beginning to dawn on me that these two opposite individuals were an exaggeration of the extremes of physiology of an animal in the wild of a temperate forest, and was thus ENTRAINED into the extremes of climate. There was no option other than to be entrained,

What stuck out from my dabble in neurology was the amount of THOUGHT between the summer and winter, In summer there was a lot of ‘fight or flight’ and of course with the much longer days more time to do that fast reactive thinking of chasing lunch or or avoiding becoming lunch. Without going into unnecessary detail winter was the opposite.

Now looking at the regulatory path for the THYROID gland it was STRESS?-thyrotropin releasing factor-thyrotropin-THYROXIN. The stress was speculative. I’ve been around all sorts of mechanical devices all my life and I started to think ‘What if there is some sort of flow meter that measures the amount of blood going to the brain and it’s that rate which regulates the amount of thyrotropin releasing factor’. More thought, more neural activity, more metabolic activity, more glucose needed for that activity, more oxygen, more blood flow.

So the animal in the wild was entrained, had no control over its degree of thought and so no control over thyroid activity. In the winter it became (sub-clinically) hypothyroid and in the summer it became (sub clinically) hyperthyroid. Later I would learn about light shining through the eyes and its regulation of serotonin and melatonin, but I was on the right track. It seemed that the thyroid grew more cells (hyperplasia) in the summer and lost cells (hypoplasia not goitre)in the winter.

Later I began to study calcium metabolism. This was a terrific model as sunlight regulated the amount of vitamin D in both plant and animal. Two opposite words stuck out osteoblasts and osteoclasts. Osteoblasts laid down bone and osteoclasts removed it. So there was more osteoblast activity compared to osteoclast coming on summer and the bones got thicker and more osteoclast activity compared to osteoblast coming on winter and the bones got thinner. No problems, thicker bones for more activity in summer, thinner bones for less in winter, perfect. This seasonal remodelling also speeds up fracture repair.

Muscles got bigger in the summer and adipose fat deposits got smaller, the reverse in the winter. Later it struck me that if the thyroid enlarged in the summer and shrunk in the winter then the same must apply to other organs of the endocrine system, pancreas, adrenals etc. Following that reason it therefore meant that cell surface receptors that bound these endocrine hormones increased in density in summer or the other way round depending on whether they were associated with sympathetic or parasympathetic nervous activity. For example one would expect receptors associated with the catecholamine hormones, adrenalin, noradrenalin and dopamine to increase in summer and decrease in winter. Insulin is a bit more complicated as it is associated with all forms of storage, fat, glucose, protein and bone.

But what about HUMAN animal? They are not entrained into any seasonal rhythm at all. Artificial lighting and heating, wearing glasses, driving cars, eating foods out of season. Worrying like hell in the winter cause she has lost her job and relaxing in the summer because she found one. What about pathological extremes, One one side slow anxiety, guilt depression, (no religion in the wild) self loathing fluctuating between unreal optimism and unreal pessimism. Goes out and buys everyone a present on the manic high believing doors will open to al sorts of thing including lots of sexual partners, then plunges into a depressive low when all the presents have been rejected and the huge bill comes in. Prospects worse than before. On the flip side gets aggressive and threatening, then realising the possible backlash becomes conciliatory. Whilst conciliatory is deemed to be open to criticism for the prior aggression, suddenly snaps at this self righteousness and returns to the insults. Schizophrenia. Later I add blood sugar instability and lots of endocrine deregulation insomnia etc. But it was with the THYROID that this all began.

Schizophrenia. Following the dopamine receptor over abundance theory, this model tells me that it is not a genetic predisposition, but that the actual reason is more likely to be PERSISTANT ANXIETY, probably from early childhood. This fits in with RD Laing’s research that it is extreme conflict in the family with totally opposing beliefs and philosophies imposed on the child i.e. double binds, by each parent, along with violence and sexual abuse. Daddy says to little daughter after sexually abusing her for the first (and subsequent) times, ‘This is a really, really good thing between us, BUT DON”T TELL ANYONE!!!!!! This deranged double bind become the foundation stone of the child’s ‘development’ .

Uncle Sam comes into the village, puts a gun to the villager’s head and says menacingly, ‘You even THINK about collaborating with Charlie (VC) and BOOM!!! A couple of hours later, after Uncle Sam has gone, Charlie comes into the village, puts a gun the the villager’s head and says equally menacingly, ‘You even think about collaborating with Uncle Sam and BOOM!!! VERY, VERY, BIG double bind.
Noddy the hyper hypo sheep.

Cripes, stop feeding this troll. He’s enjoying the attention that he gets. It’s like wrestling with a pig…you get dirty…and the pig enjoys it.

lilady,
Of course I’m enjoying all the attention I’m getting. whaddiya want me to do, hate it. You’re dishing it out after all. Pity none of you lot understand any of this stuff, calling it troll because you can’t understand a word of it. Just putting shit on everything. Pity!! It might do you a helluva lot of good if you did understand it. You don’t HAVE to wrestle with pigs, you know.

Just when I thought I was gonna get away from here I discover that I haven’t been locked out of this thread. So I thought I’d better leave another example of my extraordinary brilliance for mere mortals to salivate over. It is naturophathy in that it sees the migraine as a symptom.

MIGRAINE.
Without just a tiny bit of physics, ie a rudimentary understanding of osmotic pressure, this hypothesis would not have been possible. Oliver Sacks calls the vasospasm spontaneous in his book on migraine. Oliver Sacks GETS migraine, or did when he published it and not a single mention of sugar. He must know the hypothesis, but dismisses it as it comes from the ‘ratbag’ element. Rather have the pain than let go of the dogma. All I know is that the vasospasm disappears when the migraineur cuts out refined sugar.

VASOSPASM. The OSMOTIC PRESSURE HYPOTHESIS.
This hypothesis is based on two things. All of the evidence points to it and 2. Things don’t just happen as the neurologist suggests.

The migraineur might start to experience symptoms of an impending migraine in a couple of days prior to the attack. I’d suggest a series of reactive hypoglycaemia of ever shortening duration as being responsible here. The migrainer wakes up with a sugar craving and is in ketosis, perhaps. Has a sugary breakfast or just a cup of coffee with 2 or 3 teaspoons of sugar in it. But not necessarily so as the person suffering reactive hyper hypoglycaemia seems to become increasingly sensitive to sugar over time, sometimes exquisitely so. Perhaps it’s the caffeine. (I’m just thinking out loud). Within a couple of hours the craving returns. Then the same again but sooner as the swings get bigger, finally a migraine. FEAR of an impending migraine as early symptoms appear obviously exacerbates this vicious cycle, worsening symptoms more fear and vicky verka. Finally up goes the BG to an astronomical high and begins to plunge rapidly.

OSMOSIS and the VASOSPASM..
We can divide tissue up into 3 basic osmotic compartments, intervascular, interstitial or between tissue cells, and intercellular. The intervascular department is a bit different as it contains albumin made by the liver. Referred to as a colloid it transports a range of different molecules on different charged sites and exerts a lot of osmotic pressure. With liver failure, as with cirrhosis, albumin production drops and fluid increasing leaks out of the blood vessels into the interstitial spaces

A range of ions and polar molecules exert osmotic pressure in solution. These obviously include some whole proteins. Whilst the concentration of the different ions is different between the inside of a cell and the outside, e.g. more sodium outside and more potassium inside, as is necessary to achieve an electrical gradient across the plasma membrane, osmotic pressure is balanced between compartments. If it were not so the compartment with greatest pressure would obviously swell up and burst or just leak badly. A range of cell plasma membrane pumps pump some things in and some things out, some like the sodium potassium pump pumps sodium out and potassium in whilst potassium gradually leaks out by passive diffusion. There is also a pH gradient across the membrane, for instance when red blood cells exchange oxygen for carbon dioxide there is a pH swap on which, what becomes their carbhaemoglobin, a site which ionically binds sodium ions swaps this for a hydrogen ion whilst bicarbonate ions in the cell are exchanged for chloride ions outside the cell. You could say that ionised sodium bicarbonate is exchanged across the membrane for ionised hydrochloric acid when oxygen is off loaded and carbon dioxide is taken onboard.

Alkaline oxyhaemoglobin become acidic carbhaemoglobin. Hydrogen ions and chloride ions diffuse into the cell in exchange for sodium and bicarbonate ions which diffuse out, and of course the opposite takes place in the lungs. All well and good. Does that mean that venous blood is more alkaline than arterial blood? From memory not so as free carbonic acid makes venous blood more acidic. Normal arterial blood has a pH of 7.4, however, with very severe metabolic acidosis it can fall to life threatening 6.8. The patient is breathing very heavily as the body to get rid of excess carbon dioxide as it forms carbonic acid in solution

Glucose, being a polar molecule, also exerts osmotic pressure and as long as blood glucose regulation is performing properly, then everything has evolved to be in balance. However, lets say that the BG level shoots up 300% in a half hour. Neurons in the brain do not store glucose as glycogen and thus have no insulin receptors on them. Glucose enters neurons by passive diffusion to be immediately metabolised.. So how does the brain control how much glucose enters neurons to match their fluctuating metabolic rate? The brain controls the ENTIRE BG regulatory system TO SUIT ITSELF, modulating pancreas, adrenals, liver etc. with parasympathetic and sympathetic signals, modulating blood vessels etc. etc. Thus brain cells are bathed in the precise glucose concentration needed to suit their immediate metabolic demands. Localised areas of the brain control blood vessels to match the degree of localised metabolism. Many neurotransmitter (if not all) are also prostaglandin activators,

With reactive hypoglycaemia the brain LOSES CONTROL. So up shoots the BG in the fluid bathing the neuron and because it has no control over it’s ingress it turns on an emergency pathway call a Polyol Pathway (multiple alcohol). The idea is to get the glucose in the cell out of solution as quickly as possible. So first it’s converted to sorbitol then to fructose and because fructose precipitates out at a lower concentration than glucose, fructose crystals begin to form in the cytoplasm.. However, unlike glycogen which is aosmotic (doesn’t exert osmotic pressure) fructose does and when the BG outside the neuron begins to plummet precipitously the fructose crystals begin to pull a lot of water into the cell. The entire brain swells in a migraine and this is why. A lot of neurons may be permanently damaged. Unable to repair themselves, and unable to turn on apoptosis, they ‘inappropriately’ express MHC2(?) receptors, thereby behaving like an APC (antigen presentation cell) and so initiate an immune response against themselves. Auto immune ‘attack’ maybe. Just a hunch!!

In a desperate attempt to limit the osmotic pressure imbalance and limit the damage the brain must secrete a vasoconstrictor in blood vessels supplying it, even though this constriction will worsen the already severe hypoglycaemia and create hypoxia just at a time when cells need both glucose and oxygen to make ATP to DRIVE THE BAIL OUT PUMPS. As noradrenalin is a constrictor in blood vessels in which adrenalin is a dilator, then I’d nominate it, but not coming from the adrenals, but from the brain itself in order to limit this constriction to just these blood vessels alone. This is purely a hypothesis and the reason I believe that it does this is to retain as much electrolyte, calcium, sodium etc. in the interstitial fluid to compensate for the loss of glucose. It is a desperate attempt to balance one crisis against another. If the migrainer is very frightened and is considering the possibility of a stoke, even death, then the extra neural activity of fear (the brain on average uses 40% of the body’s glucose) further exacerbates the overall problem. Fear also creates hypersuggestability, or the ability to imagine even worse consequences, Hellfire, thus even more fear ad infinitum. Blacking out would be protective against this runaway fear and that is why, I believe, an epileptic blacks out before an attack.

Finally the hypoxia added to the hypoglycaemia becomes the predominant problem and flood of vasodilator is released and these blood vessels massively dilate instead. One important dilator is ADP which builds up in cells unable to phosphorylate it to ATP and is released from these cells. Bradikinin sensitises pain receptors so it is possibly involved as well. MIIIIIIIGRAINE!!!!!

Now consider other factors which must contribute to the mental confusion as the blood sugar falls. A huge imbalance in the concentration of ions across the plasma membranes of a neuron, must drastically alter it’s depolarisation/repolarisation when it fires, thereby altering the firing potential of it’s synapses, along with the drastic shift in pH gradient also having a negative affect.
Next, the gyrations of the rest of the soma. Noddy (Paul Hill)

Just when I thought I was gonna get away from here I discover that I haven’t been locked out of this thread.

You haven’t been “locked out” of any threads. Is this just some cut-and-paste of something from elsewhere?

No Narad,
What you have got to get into your considerably thick skull is that every word of this is written by me, based on 40 years of multidisciplinary research and is unique. Go spend a few months searching online for where I pinched it from. I know it beggars your your belief that an uneducated nut case could work something like this out. I’m even gobsmacked myself. Go tell people who have migraine and see if it works for them. The proof of the pudding, as they say, is in the eating.

No Narad

So what’s with the horseshit about being locked out of threads?

Narad.
‘So what’s with the horseshit about being locked out of threads?’
So RD Laing spoke about communication did he and you are an expert. He would rephrase your question thus.
‘Can you tell me what thread you have been locked out?’ See it’s easy. It’s called common courtesy and it is something you may learn once you mature, if that is possible, which I very much doubt. Is this all you exist for, getting onto blogs and slagging everything, destroying what others try to create, making no creative contribution yourself and hiding behind a pseudonym? Very sad really.

MIGRAINE Part 2. Digestion and assimilation of sugars.
The term sugars covers a wide range of compounds, however, I just want to cover the hexoses (6 sided) normally found in food. All dietary sugars are either dimers (2 joined together) or the polymer starch, the exception being honey in which the double sugar sucrose has been hydrolysed by the bees digestive system into single sugars. Fruit sugar sucrose is fructose glucose, milk sugar lactose is galactose, glucose and starch is a long chain of glucose molecules with side branches sticking out from the main trunk. Glycogen, the form of glucose polymer which acts as a storage medium in animal cells is much the same as plant starch except the side branches are located in a different place and cannot be digested in a human’s gastro-intestinal tract. Starch digestion begins in the mouth by the enzyme ptyalin and it is broken down to the double glucose molecule maltose by the time it enters the duodenum.
Okay, now to a VERY IMPORTANT POINT. In the natural world all sugars (except in honey) arrive in the duodenum for digestion as DOUBLE sugars, sucrose, lactose and maltose and cannot be absorbed into the body until cleaved into single sugars by the enzymes sucrase, lactase and maltase which are secreted into the duodenum by the EXocrine pancreas. This is where regulation comes in and is so important in stabilising the blood sugar level, The ENdocrine pancreas, located inside the body and which produces insulin in it’s beta cells and glucagon in it’s alpha cells, monitors blood sugar and it communicates with the exocrine pancreas via the GIP (gastro inhibitory peptide) axis. The idea is that the exocrine pancreas does not secrete the digestive enzymes into the duodenum until it the endocrine pancreas is ready and the exocrine pancreas monitors the presence and level of sugars in the duodenum telling the endocrine pancreas when to begin making insulin. THUS THERE IS VERY TIGHT CONTROL
Insulin takes about twenty minutes to synthesise. However, in the healthy individual there is a residue of insulin remaining in the cells from the previous release, so that there is a so called biphasic release. This residue is to nip in the bud any premature release of sugar into the bloodstream until de nova synthesis has finished and it is lost with reactive hypoglycaemia, as with migraine, because the pancreas is forced to overreact all the time. This loss of biphasic release is destabilising as I will cover in the next chapter.
Now we come to fibre. Plant fibre is composed of lignin, cellulose, hemicellulose and pectin. Fibre exerts strong osmotic pressure in solution and when present in the digestive tract pulls against the absorption of the monosaccharides resulting from the cleavage of the disaccharrides by the digestive enzymes. The monosaccharrides, glucose and galactose are actively transported in to the bloodstream, whereas, from memory, fructose enters by passive diffusion, So active transport also acts as a regulator.

REFINED SUGARS.
Now I want to leave the subject of digestion and assimilation and talk about the sugars of the concrete jungle. It is harmful to eat monosaccharides as they disturb blood sugar regulation. Processed foods contain the monosaccharides fructose, glucose, dextrose (another name for glucose) and food manufacturers are desperate to shove as much of this stuff into their ‘foods’ as possible. Sucrose or refined sugar put into a boiling cup of tea or coffee is hydrolysed into the monosaccharides by the heat whilst the caffeine accelerates the rise in blood sugar.
Caffeine poisons the enzyme phosphodiesterase located on the G stimulatory protein of the RAS (rat sarcoma) signalling pathway thereby preventing the pathway from turning off. Let’s say that adrenalin binds to the RAS beta receptor outside the cell and activates it. Inside the cell the (C terminus) part of the receptor, now activated, draws the G protein to it and the G protein is diphosphorylated and thus activated. Activated G protein then migrates to adenylate cyclase and activates it and adenylate cyclase then begins to make cyclic AMP or cAMP which in turn activates the rest of the signal transduction pathway.. Within milliseconds or seconds phosphodiesterase on the G protein dephosphorylates the G protein and it migrates back to a position midway between the adenylate cyclase and the RAS beta receptor. Thus by caffeine poisoning phosphodiesterase an adrenalin response remains switched on for some time after adrenalin is withdrawn from the bloodstream. As adrenalin raises blood sugar in a number of ways it is obvious that caffeine is destabilising to blood sugar regulation. RAS pathways are ubiquitous in the body and stimulators include embryonic hormones, hence the suggestion that caffeine can be a promoter of cancer once started and it’s cells dedifferientated.
Threobromine is the other blood sugar raiser in Coca Cola and chocolate. It’s a xanthine like uric acid, and is essentially caffeine with one less methyl group on it (caffeine has 4). So, boiling coffee, sugar, a lump of chocolate, a swig of Coke and an hour or so the mouth is spewing and the head is thumping, tremors, sweats, no bloody good at all and very destructive.
In part 4 I want to get into the subject of blood sugar regulation INSIDE the body (the GI tract is officially outside the body). This will begin to touch on panic attacks, epilepsy, asthma and schizophrenia.. I might also start on the subject of how to break the addictions.

So what’s with the horseshit about being locked out of threads?

Made up like all the other stuff he writes?

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