I’ve frequently written about what I like to refer to as “quackademic medicine”; i.e., the infiltration of quackery into academic medical centers. I’ve been using the term for twelve years now, although I did not coin it. Because I’ve been using it for so long and have gained some notoriety as a blogger and, more recently, on Twitter, people think that I coined the term, but I did not. Dr. Robert Donnell actually coined it. (I really wish I had, though.) When I first started out, I frequently wrote about quackademic medicine in medical schools, academic medical centers, and private hospitals affiliated with academic medical centers. (So far, the Cleveland Clinic probably wins the “prize” for the worst quackademic medicine, but UC-Irvine is definitely up there, given its embrace of homeopathy.) Unfortunately, the problem, if anything, has continued to get worse, particularly given the increasingly more prevalent unholy alliance between corporate medicine and academic medical centers. So I suppose that I shouldn’t be surprised by an article I saw published by UCHealth, The many benefits of acupuncture in winter.
UCHealth is, of course, the medical system affiliated with the University of Colorado, and this article was published on the UCHealth website right before Christmas. It liberally quotes one of UCHealth’s acupuncturists, Kelley McDaneld, who practices at the UCHealth Integrative Medicine Clinic in Steamboat Springs. She’s a Chinese herbalist, as well:
Kelley earned her Master of Science degree in Oriental Medicine from Southwest Acupuncture College in 2005 in Boulder, Colorado. Kelley also earned her Diplomate in Oriental Medicine from the NCCAOM in 2005, currently the highest certification that the NCCAOM awards. She is Board Certified by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) in both acupuncture and Chinese herbs. Kelley is also a licensed acupuncturist in the state of Colorado. Kelley earned her Bachelor of Science degree in 1997 from Duke University, where she majored in Biology and minored in Spanish.
In-between earning her bachelor’s and master’s degrees, Kelley worked for the US Forest Service, based in Steamboat Springs. She also lived in Seattle, Washington where she met and worked for Dr. Zhaoxu Xing, a Chinese medical doctor who served as the personal physician to the King of Oman for four years. It was this experience with Dr. Xing that motivated Kelley to begin the study of Chinese medicine.
So what are the “benefits” of winter acupuncture? According to McDaneld, they are many, because of course they are. But, first, shame on UCHealth for publishing such a credulous article about acupuncture! Yes, according to UCHealth, acupuncture can “boost the immune system”:
Acupuncture has been shown for some individuals to boost the immune system, which helps prevent colds, the flu and other illnesses that are more common in winter months.
It works for some, in part, because acupuncture may increase white blood cell counts – specifically T-cell counts – which are an important component of the immune system, while also possibly decreasing inflammation throughout the body. “
One hypothesis for why that happens is that when the needles are inserted, you’re creating a little irritation that the immune system responds to,” McDaneld said.
Regular acupuncture may also prevent an illness from taking hold, especially when done 12 to 24 hours after the first sign of sickness.
There is no credible scientific evidence that regular acupuncture can prevent illnesses like colds or the flu or make them less severe when you do get them. It is irresponsible in the extreme for UCHealth to allow such claims to be credulously made by a quack on its website. That bit about a “little irritation” from the needles stimulating the immune system is the most ridiculous explanation for acupuncture’s claimed immune effects that I’ve ever seen.
Let’s look at the paper cited by McDaneld to back up that claim, Enhancement of immune cytokines and splenic CD4+ T cells by electroacupuncture at ST36 acupoint of SD rats. First off, it’s a study in rats, which, even if you buy the results (and I, of course, do not) does not mean that its results translate to humans. More likely than not, they don’t, and, again, that’s even if you buy the results. Moreover, it’s a bait-and-switch study of electroacupuncture, not acupuncture. So there was actual current being passed through the animal in addition to needles being stuck into it.
The study basically took Sprague-Dawley rats and divided them into three groups: (a) a control group in which the animals received no treatment and were housed at the animal facilities; (b) a non-acupoint group in which electroacupuncture stimulation was applied to the abdominal muscle as described in a previous study; (c) and a ST36 acupoint group in which electroacupuncture stimulation was applied to the ST36 acupoint. The ST36 acupoint is located in the proximal hindlimb. Of course, it never ceases to amuse me how acupuncturists take maps of their mystical magical imaginary acupuncture meridians and points on humans and then map them onto all manner of animals, even mice, rats, and elephants. Electroacupunture stimulation was repeated each day for 1, 3, 7 or 14 consecutive days on different rats, and the groups compared.
The authors report finding:
Our results showed that successive electroacupuncture at the ST36 acupoint for 3 d significantly enhanced the interferon-γ (IFN-γ) level in he serum of SD rats. The results also showed that the serum and extracts from spleen cells of the ST36 acupoint group contained higher levels of interleukin (IL)-2 and IL-17 compared to those of the other two groups. Immunohistochemical analysis showed that electroacupuncture applied to the ST36 acupoint enhanced the expression level of CD4 in spleen cells.
The authors concluded that their observations “indicated that electroacupuncture stimulation at the ST36 acupoint enhanced the level of immune cytokines and splenic CD4+ T cells through TRPV channels in this system.”
There are, of course, a number of problems with this paper, and PLoS ONE really needs to be taken to task for crappy peer review. First, it’s utterly unclear to me what statistical tests were used to compare the groups. It looks to me as though the authors probably didn’t do the proper statistical test for multiple comparisons (ANOVA with the appropriate post-test controlling for multiple comparisons) but instead probably did multiple t-tests. However, I can’t be sure because nowhere did I find a description of the statistical test(s) used. p-values are listed, but I have no idea how the authors came by them. More importantly, although there was a supposedly statistically significant difference between the “true” acupuncture group and the no treatment and sham acupuncture controls, the differences shown were really unimpressively small. It’s legitimate to question whether the differences observed even have biological, much less clinical relevance, to immune functions. Also, again, none of this validates acupuncture. Even if the results reported aren’t spurious, the most that you could say is that running an electric current through this particular acupoint very modestly increases the levels of the cytokines examined in the blood and spleen, with no evidence that these increases are biologically relevant in terms of immune function.
Then of course, there’s another issue. This is a study out of China, and, as I’ve been discussing lately (and as Edzard Ernst has said for a long time), virtually 100% of acupuncture studies published in China are positive. Why this is seems to be a mixture cultural bias and taboo:
The question why all Chinese acupuncture trials are positive has puzzled me since many years, and I have quizzed numerous Chinese colleagues why this might be so. The answer I received was uniformly that it would be very offensive for Chinese researchers to conceive a study that does not confirm the views held by their peers. In other words, acupuncture research in China is conducted to confirm the prior assumption that this treatment is effective. It seems obvious that this is an abuse of science which must cause confusion.
Again, even if the results of this study were replicated by other investigators, it wouldn’t show that acupuncture “boosts the immune system” or that the results have any bearing on human physiology and immunity.
Next up, on behalf of UCHealth, McDaneld claims that acupuncture can relieve seasonal depression and decrease stress:
Acupuncture has been shown to increase endorphins in the body, and that naturally boosts your mood. It can increase the release of neurotransmitters, such as serotonin and dopamine, which also help,” McDaneld said.
In Chinese medicine, mild cases of depression are attributed to a stagnation of “qi” or “chi,” also called the life-force or energy, and acupuncture may help get that qi moving.
Every individual reacts differently to acupuncture, so benefits may vary. “It depends on the person,” McDaneld said. “Some people really respond, while others don’t as well.”
Yes, placebo effects do vary from person to person. As for depression being due to stagnation of qi, that mystical magical imaginary “life energy” upon which much of traditional Chinese medicine is based, that’s just pseudoscientific (or, more accurately, prescientific) nonsense.
Finally, the official PR organ of UCHealth credulously claims, through one of UCHealth’s acupuncturists, that acupuncture “decreases stress”:
In traditional Chinese medicine, winter months are considered a good time to rest and let the body rejuvenate.
“The winter season in Chinese medicine is the time to slow down, to replenish your energy, to store up for the upcoming spring and summer months,” McDaneld said. “It’s not very often that people take an hour out of their day to mindfully rest. That really calms the nervous system overall.”
Decreasing stress not only helps you feel better, but it also decreases risk of illness.
“Stress depletes qi, or one’s energy stores, but by reducing stress, you’re more resilient and stress is less likely to take a toll,” McDaneld said.
If you decide to try acupuncture and are not dealing with a specific injury or illness, McDaneld recommends scheduling a session once a week for two or three weeks, then spacing sessions out further. It’s ideal to try acupuncture first when you’re well, so you and your practitioner understand how your body reacts to the treatment.
No, it’s better for the acupuncturist if you try acupuncture while you’re well, because you won’t realize that it’s not doing you a damned bit of good, that it’s nothing more than a theatrical placebo, and the acupuncturist still gets paid. Of course, McDaneld is correct that it’s good to take an hour out of the day to rest, but, really, you can do that without having to schedule a session in which someone sticks needles into your body.
Quackademic medicine infiltrates medical academia in many ways, large and small. Large ways include setting up quack functional medicine centers to bilk the worried well willing to spend large sums of money on large numbers of unnecessary tests and unnecessary supplements to correct the random abnormal lab values found whenever batteries of unnecessary tests are performed. Small ways include the corruption of the PR machine of a place like UCHealth so that it publishes bullshit—and, I’m sorry, that’s the nicest way to describe it—like this article.