Worst idea ever: “Natural” alternatives to the Epipen

[NOTE added 12/23/2015: It would appear that the offending article has been taken down. I, of course, have screenshots, and, of course, the Google cached version is still around for the moment.]

Anaphylaxis can be deadly. Anaphylaxis can kill. More than that, anaphylaxis can kill pretty quickly.

Even the most dimwitted purveyor of “natural” cures should know that and stay away from “natural” treatments for anaphylaxis, while the smarter snake oil salesmen also know that you can’t afford to mess around with a medical condition that can cause such rapid deterioration from seemingly perfectly health to dead. It’s not good for business. Yes, “allergies” (often exaggerated, made up, or nonexistent) are a major focus of an incredible amount of woo, but the most serious, hardcore consequences of real allergies, anaphylactic reactions, are something that, thankfully, most quacks stay as far away from as possible. Heck, I even searched Mercola.com and NaturalNews.com, and the only mention I saw of Epipens had nothing to do with suggesting that there are “natural” alternatives to them, although there were claims that quack treatments of allergies can reduce the need for them.

So what am I to make of an article I saw in the Gazette Review by a freelancer named Adam Trent last week entitled Natural Alternatives to Epipen? Let me just repeat that one time. There is an actual article in an actual media outlet entitled Natural Alternatives to Epipen out there. The irresponsibility boggles the mind. As you will see, the most charitable description of this article is that it is muddled and full of misinformation. The least charitable, but probably more accurate, description of it is that it is full of downright dangerous misinformation that could well lead someone to do something stupid enough to result in death. After all, an Epipen is nothing more than a simple-to-use rapid injector that delivers a specified dose of epinephrine. It’s designed to be used as emergency out-of-hospital treatment of an anaphylactic reaction.

The stupidity in this article begins with a photo featured in the article, which looks to me like an insulin pen. I kid you not. This is the photo in the article represented as an Epipen:

This is not an Epipen.

This is not an Epipen.

 

And this is what an Epipen looks like:

That's an Epipen!

Now, that’s an Epipen!

 

It really doesn’t give me a warm and fuzzy feeling inside when the writer and editor don’t know enough about Epipens to be able to tell the difference—or when they don’t even bother to go to the Epipen website or Google the word “Epipen” to find photos of Epipens. [Note: I see that either the editor or Trent has replaced the original insulin injector photo with a photo of an actual Epipen since my post went live. As of this writing, the Google cached version (of which I took a screenshot that I might add to the post later) still shows the original photo of the insulin pen.]

It gets worse right from the very first passages. Right after pointing out that anaphylaxis is a “serious medical condition” (no kidding, Dr. House) that “can be fatal when left unchecked” (well, duh!), we’re treated to this passage:

Epipen is an autoinjector used to administer a select dose of epinephrine to relieve anaphylaxis. It is a must in every first aid kit, and should be readily available especially when you or a loved one is susceptible to such dangerous reactions. Effective as it may be, epipen is not without any risk when used. The injector can cause complications to the vein where it was injected, not to mention the chance of triggering symptoms like chest pain, headache, and irregular heartbeat. Epipen also does not prevent future anaphylaxis attacks.

Yes, but these complications are far superior to being dead.

Also, one notes that the Epipen is not meant to be injected into a vein. The instructions on how to use an Epipen are described explicitly to minimize the possibility of an accidental injection into a vein. Instructions say to inject into the lateral (outer) side of the thigh because there are large muscles there and no major veins. Users are cautioned not to inject into the buttock because an inadvertent venous injection can occur. Yes, an intramuscular dose of epinephrine (a.k.a. adrenaline) can result in rapid heartbeat, headache, and the like. And, yes, if you inject into a distal extremity (hands or feet) you can endanger the blood supply to your digits. Yes, if you accidentally hit a vein you can cause tachycardia and arrhythmias that, in a worst case scenario, can lead to cardiac arrest. Those risks, however, are worth taking if the alternative is death right now due to…anaphylaxis!

Even sillier is the observation that Epipen does not prevent future anaphylaxis. Why might this be? Hmmm… One wonders, one does. Oh, yes, I remember. It’s because the purpose of Epipen is to save the life of someone on the verge of or in the middle of suffering a life-threatening anaphylactic reaction! it is not intended to prevent future attacks.

So what is the “alternative”? Well, take a look at a paragraph with what has to be one of the single most irresponsible pieces of medical advice that I’ve ever seen, and that’s saying something, given my eleven year history of taking on quackery and pseudoscience:

For Epipen’s natural alternatives, these herbs and remedies bring relief, encourage the prevention of future attacks, and build the body’s immunity against allergies. However, these said alternatives do not work as fast as Epipen, so do not expect it as an emergency immediate relief. Coupled with a healthier lifestyle, regular exercise, and an avoidance to vices, there is a greater chance of avoiding that next allergic attack, or at least minimizing its severity.

Bring relief? From an attack of anaphylaxis? Seriously? They don’t “work as fast as Epipen”? “Do not expect it as an emergency medical relief”? That’s the deadly understatement of the decade! It seems that the Trent of this piece wants to have it both ways, to claim that he’s writing about “natural” alternatives to Epipen without specifically directly claiming that what he is writing about can stop an anaphylactic reaction.

Meanwhile, the things he recommends seem—at best—disconnected from the entire issue of doing what Epipen does. For example, the first thing mentioned is the Neti pot:

The use of these pots may sound unpleasant, but many people swear by its efficacy in epipen-alternative-neti-potrelieving allergy problems. Neti pots flush out debris and mucus that have pent up in the nose, an act also known as nasal irrigation. The practice originated in the ancient Indian healing system Ayurveda and is also part of the Yogic body purification practice Shatkarma. Neti pots are the main containers used for nasal irrigation. It is done by sticking the spout in one nostril, inhaling the water or solution stored in the pot, and then letting it flow out of the other nostril. Studies attest to the efficacy of neti pots, however long term use is not recommended as it can weaken the nasal shield against foreign substances. Make sure that the water you use in the pot is sterile, as you do not want to exacerbate your allergy by using tap water. You can also use essential oils (more on that below) in your neti pot.

While it is true that Neti pots can be used for nasal irrigation and provide short term relief from nasal symptoms due to colds or allergies, neti pots are not recommended for long term usage, as they increase the risk of recurrent infection, apparently through weakening the body’s mucosal defenses. What this has to do with being a “natural” alternative to Epipen, I don’t know.

The same applies to the other remedies as well, all of which appear to be being sold as nothing more than allergy relief. For example, here are some essential oils that are recommended:

  • Eucalyptus – This oil contains a strong scent that ensures a smooth flow of secretions that plague your respiratory tract. It also relieves headaches that come along with allergy attacks as it enhances the flow of blood in the brain. Always dilute it with a carrier oil first (like coconut oil) prior to use with a steam inhaler or neti pot.
  • Lavender – Simply drop some lavender oil on your palms or a cotton ball then inhale. In case of blocked sinuses and chest congestion, rub the oil on your chest and cheeks. The oil has anti-inflammatory and anti-allergic properties that can remedy your allergies while helping you relax with its calming effects.
  • Lemon – A known disinfectant that both cleanses and refreshes. Lemon encourages better blood flow and unclogs the airways, and it works better in conjunction with other essential oils. The oil can be rubbed on your forehead and chest, and it can be stirred in both cold and warm drinks for it to work internally.

Of course, the article neglects to point out that allergies to plant oils like this are common. Even quacks who sell essential oils point out that if you have allergies, asthma, or food intolerances, you are likely to be more prone to develop contact dermatitis or allergic reactions to these oils. This makes sense, of course, because these oils are derived from plants and contain complex organic molecules.

Other items on the list of “alternatives to Epipen” include quercetin, alfalfa, apple cider vinegar, and various vitamins and minerals. Evidence for the efficacy of these “powerful medicinal herbs” against anaphylactic reactions—or even just against your run-of-the-mill allergic reactions or allergy symptoms—is presented for exactly zero of these suggestions.

I hear some of you saying (or imagine some of you thinking): So what? This article isn’t really recommending these things as alternatives to an Epipen. It’s just recommending them as a way of alleviating allergies, whether there’s any evidence or not that they do such a thing and even in the face of evidence that some of the proposed remedies can actually provoke allergic reactions. Here’s the problem. Even if the intent wasn’t to discourage use of the Epipen, the underlying message is that epinephrine injections are somehow not “natural” and that it is better to avoid using it. Never mind that there is no evidence that neti pots, lavender oil, or alfalfa (to pick three, but the same applies to all of these examples) can do anything to alleviate even mild allergic reactions, much less severe ones, or to decrease the frequency of anaphylactic reactions. It’s incredible that any reputable website would post something so irresponsible around the holidays, when pediatricians are cautioning parents on how to avoid anaphylactic reactions, given that children with severe food allergies are more likely to come into contact with foods to which they are allergic during holiday parties.

One of the commenters put it quite well when he pointed out, “Adrenaline is not the new gluten, where everyone is free to (erroneously) self-diagnose and replace it with the miracle natural therapy of the week.” Except that perhaps it is, even though epinephrine is just as natural as every one of those “natural” alternatives, given that it’s a normal chemical produced by the body, which uses it as a neurotransmitter and hormone. I hope I’m wrong about this, though, and avoidance of “unnatural” epinephrine is not becoming a trend.