Category Archives: Pseudoscience
Do you have Forer’s Disease?
A hidden disorder may be making you ill. It’s quite common, but many people don’t know they have it and conventional doctors tend to ignore it. Medical tests fail often enough, turning up negative while patients continue to suffer a plethora of symptoms. Few people will have all of these symptoms, and most symptoms will be intermittent, and at least partially resolve when the patient is more active, so there will be great variability between patients. An estimated 80% of people experience Forer’s Disease at some point in their lives, yet it is frequently overlooked and misunderstood by the medical community. Forer’s Disease is becoming a popular topic in the medical community; as a result, it is important to recognize the symptoms of this particular condition. Sufferers typically experience a wide assortment of symptoms, and it’s important to learn how to recognize them.
Most sufferers of Forer’s Disease experience some or all of the following symptoms:
- Fatigue
- Backache
- Mood swings
- Digestive upset, such as nausea, indigestion, and gas pains
- Headaches and migraines
- Insomnia
- Low energy/malaise
- Joint pain
- Decreased libido
- Constipation
- Skin irritation
- Memory problems
- Cravings, especially for sugar, salt, and fat
Sound familiar? Of course it does, because the actual condition that leads to these symptoms is “being human.” Pretty much every person (in an affluent nation at least) will experience many of these symptoms at some point in their lives. And people are more likely to experience many of them during periods of high stress or, let’s face it, when we’re getting older.
I borrowed the name Forer from the Forer Effect, in which subjects assign a high level of accuracy to a list of vague and generally applicable descriptions, when the list is presented as a personalized profile of the subject. It is most often used to discuss horoscopes and personality tests (“You are a caring person, but sometimes you fail to live up to your own ethical standards. You enjoy being with other people, but sometimes feel shy and reticent”), but I think a similar effect occurs when someone suffering from obnoxious symptoms reads a list like the one above, paired with a proffered cure. The list of symptoms seems to be so accurate, even tailored to the reader. It’s easy to believe that the web site or book you’re reading is accurately diagnosing what’s wrong with you.
Deliberate quacks and misguided natural health gurus alike have a tendency to cobble together a similar list of “if you’re human you have them” symptoms and assign a disease to them. If you have many of the above symptoms you qualify for Systemic Yeast, Multiple Chemical Sensitivity, Gluten Sensitivity (with negative Celiac test), Subluxations, Adrenal Fatigue, Electromagnetic Sensitivity, and Wilson’s Temperature Syndrome, and probably a dozen more fad diagnoses that have come and gone over the years. The problem is that aggregating a bunch of common symptoms and deducing a particular disease isn’t reliable. As you can see, it casts far too wide a net.
It is true that there are established, scientifically supported disorders that create symptoms on the Forer’s list, and which don’t have a definitive test for diagnosis. But in such cases, emphasis is placed on ruling out other possible causes before diagnosing something like Chronic Fatigue Syndrome or Depression. On the other hand, quackish sources will actually recommend the opposite:
First, list every single symptom that nags you, whether sporadic or chronic. Don’t make assumptions, like my back problems are from sitting too much. Just list them without trying to explain them away.
(From the Gluten Sensitivity link, above.)
It can be particularly confusing because many of these suspect symptom-list descriptions promote disorders that play on the edges of well-established diseases, such as hypothyroidism or celiac disease. And it is true that medical science doesn’t always get things right (to say the least!). So what do you do to try to feel better? Personally, I think there are two vital steps to take before you put yourself on a highly restricted diet or other regimen that may cost money or interfere with quality of life.
First, see a medical doctor who is trained in ferreting out actual, verified disorders. And of course, if a doctor doesn’t take your symptoms seriously when you say they are causing you distress, find someone else. A bad doctor may say, “Systemic Yeast isn’t real – it’s all in your head!” A good doctor will say, “Systemic Yeast isn’t a recognized diagnosis, but we do need to get to the bottom of the recurrent vaginal infections, fatigue, and stomach pain that have been bothering you.” It’s also important to remember that more than one thing could be wrong. Recurrent vaginal yeast infections might turn out to be a misdiagnosed bacterial infection, fatigue may be from low Vitamin D levels, and stomach pain could be from lactose intolerance. If you assume at the outset that an entire list of disparate symptoms must spring from a single underlying disease, you could be missing some obvious answers.
Second, go ahead and follow the universal recommendations among healthcare professionals of every stripe: eat a plant-heavy diet full of fruits and vegetables and low in processed foods. Get moderate exercise on a regular basis. Drink water when you’re thirsty. Practice good sleep habits and give yourself enough rest time. Pretty much everyone agrees that these practices are the foundation of good health, and introduce little to no risk. Adopting these habits is likely to ameliorate most of the symptoms above, and it’s no coincidence that a lot of cures proposed for Forer’s-like diseases happen to introduce some or all of them. Unfortunately they also tend to be so restrictive that they detract from quality of life, and go hand in hand with alt-med supplements or treatments that likely do no good and at least cause the harm of extracting money from you needlessly.
(N.B.: I also borrowed all the scare-language in the first paragraph from the various malady web sites I linked to.)
My new vegan diet cure!
A few weeks ago I had a couple anxiety attacks. We had discovered a pretty extensive infestation of carpet beetle larvae around the house, including in the pantry, and literally the next day we found the kids had lice. I had a lot of trouble coping with all this. Twice it got so bad I was hyperventilating, my heart was pounding, I was dizzy and feeling dissociated. Luckily my husband is made of awesome, and he took over the cleanup, with help from his amazing mother. And my epically wonderful friend Ginger came over and nit-combed my hair, then carefully vacuumed each individual molecule in the kids’ playroom.
Meanwhile, I went to the doctor for some freaking Xanax. Or something. My blood pressure was 155/90, noticeably higher than my usual less-than-120/80 zone, so I knew I was really having a serious physical reaction, not just overdramatizing. I wanted a medicine to force my fight-or-flight reaction to calm down, as I felt like I was in a feedback loop of worry–>adrenaline–>panicked feeling validating worry–>more adrenaline.
My regular HCP wasn’t in, so I saw someone else. She didn’t want to give me a benzo drug, because of all the potential problems with them, and I can understand that line of reasoning to an extent.
But then she told me what I really need to do for my anxiety and panic attacks is switch to a vegan diet.
And she didn’t just mention it in passing. She got pretty damn vegangelical on me. She seemed to think that being fat is a key part of my mental illness, and getting fit would make me better. And veganism is the way to get fit. Even though my response to the first attempt was to scowl disbelievingly and say, “No,” she didn’t let my unmistakeable body language and monosyllabic retorts stop her – she pushed it several more times, trying to cajole me into trying it. She was very sure that during this stressful period when I was having trouble coping with life, what I really needed was a complete diet overhaul to a new, highly restricted way of eating.
So you know what, I guess I’m convinced. Here is my new vegan diet plan, which will make me thin and solve all my health problems!
Breakfast:
Cocoa Puffs with full-fat coconut milk
Apple Cinnamon Pop Tarts
Ghirardelli Hot Chocolate
Snack:
Little Debbie cake donut
Starbucks Venti Toffee Nut Soy Latte
Lunch:
“Chicken” nuggets
Biscuits (made with Crisco)
Corn chips with guacamole
Kool-Aid
Snack:
Barbecue Fritos
Hansen’s Cola
Dinner:
Veggie burger on potato roll
French fries with mayo dip
Canned creamed corn
Bulleit bourbon and water
Marie Callender cherry pie
I can NOT wait for the health returns to start rolling in with this! Soon I’ll be slim and fit, as well as mentally healthy. I bet I won’t even need to go to the gym or therapy anymore! Who knew perfect health could be this easy and appealing?
Seriously, my normal PA prescribed a beta blocker to tamp down the adrenaline, and that allowed me to use my cognitive behavioral therapy techniques to much better advantage. I feel normal again. And I’m making braised beef shanks for dinner.
Oh, and more thanks to Ginger for being so funny about this whole topic and alerting me that Pop Tarts are vegan, thus giving me the idea for this post.
Why I gave my children homeopathic cold pills
The placebo effect is real and powerful. For many conditions that won’t cause harm if left untreated, it would be perfectly reasonable to give the patient a placebo to help them cope. The problem is ethics: doctors cannot give a patient a medication and lie about what it contains. That would prevent informed consent and would be a serious breach of trust and professional responsibility.
However, as a mom I can give placebos with a pretty clear conscience. It’s my job to take care of my children’s health without their informed consent. Of course as they mature, I will solicit more and more input from them, but right now I basically run their healthcare.
My older daughter in particular has inspired me to explore placebos. She has extreme sensitivity to flavors and textures, and is largely unable to take children’s medications. Of course if she has a high fever or needs antibiotics, I work with her to make sure the medicine goes down. But it’s not worth cajoling, finagling, and risking some spectacular reverse peristalsis to get some cough and cold medicine into her when she’s uncomfortable at bed time. I offer, sure, but she always declines.
So I started to think about placebos. I was sure if I could give her something and tell her it would make her feel more comfortable, she would be more relaxed and less likely to obsess about her symptoms, and could go to sleep. My first thought was Tic Tacs, but I knew she’d catch on. She’s 8, and she’s already familiar with them. The telltale shape and flavor would surely tip her off.
Then I thought of homeopathy. It’s just water! Hyland’s makes tablets that dissolve immediately. Perfect. Well, the one drawback I thought of at the time was, of course, putting money in the pockets of scam artists. But my immediate need overrode my boycott circuits, and I grabbed some Hyland’s C-plus.
It worked really well. I have since used it several times for cold symptoms, and once with my three year old for boo boo pain drama. I never actually said they would cure anything – I told them that the pills would make them feel better, or make it easier to deal with being sick. (But yeah, I essentially lied. I’m going to just assume that our Santa honesty balances it out.)
But when I did a little more research on the C-Plus tablets, I discovered they contain Yellow Jessamine at a mere 3X dilution. I started to think about whether 3X means that there could be some actual molecules of this poisonous plant in the tablets, but I only got as far as a vague notion that it would involve molarity and Avogadro’s number before I had to go lie down. So I decided to just function on the supposition that there could be a trace of actual factual poison in these things. Between that and the issue of supporting snake oil, no more homeopathic remedies for us.
I will however seek out a more ethical and safer placebo for those times when my kids can’t stop focusing on their snotty noses and can’t sleep, or when there’s much wailing and gnashing of teeth over a small scrape. I’m open to suggestions – they must get by a fairly sharp 8yo, as well as being easy to take.
(And yes, I will be filling them in on the ruse at some point before they go off into the world and might try to buy such remedies for themselves or their children.)
Eczema and Bleach Baths!
Since I recently posted about severely off-label uses of bleach, here’s another story, from the International League of Skeptics, to tide you over while I’m sick as a dog.
Kills germs on surfaces – so we should definitely drink it!
“If it’s not accepted as medicine, it will cure you!”
This seems to be the mentality of many folk who extol the virtues of bizarre home remedies. These people are the most confusing to me. I can kind of understand where you’re coming from if you want to avoid pharmaceuticals, pesticides, toxic cleansers, and so on. Many people are trying to live a “natural” life, and while that may be a fantasy in some ways, it does make sense to eat whole foods, avoid unnecessary drugs, limit exposure to pesticides, plasticizers, and other chemicals that may cause problems for our bodies or our environment, and even to use home-grown herbs to treat the symptoms of mild, self-limiting diseases. Hell, I can even understand the use of homeopathy to an extent – it’s billed as a mild, side-effect-free to make sure the body is working at its best. It was specifically formulated as an alternative to toxic and dangerous treatments used in the 18th century. People like to think that there’s something more natural, that won’t cause bad side effects, that they can use to cure themselves. That’s understandable.
But then there’s this subset of people who seem to latch on to a particular cure which isn’t herbal or natural in any way. It may be the product of standard industrial processes or pharmaceutical research. But the key to this woo is that the substance not be used as intended by mainstream science.
The most extreme case I can think of is bleach. Bleach is a very mainstream product. It’s manufactured by big companies. It’s corrosive. It’s a substance often avoided by crunchy people due to its potential to harm humans and the environment. Bleach has been shown to be very effective at killing microbes on surfaces however. It’s recommended for cleaning in the home for HIV patients because it kills bugs so well. Bleach disinfection is even promoted as a stopgap method of killing HIV in heroin syringes if no clean needles can be obtained.
Somehow people have extrapolated all that microbe-killing power to a notion that ingesting bleach can cure diseases in the body. “If bleach kills HIV in a syringe, it will kill HIV in my bloodstream” is how the thinking goes. It almost makes sense, if you ignore the fact that drinking bleach will cause major burns in your esophagus, stomach, and intestines, and will kill you long before it would provide any theoretical benefit.
Similarly, silver can be used as an antiseptic and is used in topical application to prevent infection. Some cranks have made the “if it’s good topically, it must be great ingested” leap and advocate ingestion of colloidal silver to cure, well, everything. However, there’s no evidence showing ingestion of colloidal silver treats any disease or condition. It’s probably not as bad as drinking bleach as far as immediate injury, but colloidal silver can cause kidney damage and seizures. Far more entertaining is its celebrated, non-toxic side effect, argyria. It turns your skin and mucous membranes gray-blue. So if you want to get no benefits whatsoever, risk major organ damage, and wind up looking like a sick smurf, colloidal silver is for you!
Here’s a quick list of other products of good old toxin-laden, money-driven, factory-produced technology, that are hailed as cures for things that science doesn’t use them for:
Dichloroacetate, allegedly a cure-all for cancer, in reality a substance that might fight cancer, but may be too toxic for use in the body.
Laetrile, another cancer “cure.”
F***ing Magnets, how do they work? They don’t.
Vicks on your feet to stop a cough.
Tagamet for warts.
Aspirin dissolved on a sore tooth, rather than ingested.
Milk of Magnesia for acne.
Listerine for everything.
I won’t pretend to understand all the psychology underlying this behavior of off-label use as alternative medicine. But it seems to me that a large part is just desperation – when the doctor only has difficult, complex, or slow-working answers, these remedies can make people feel like they’re fixing the problem. And certainly the idea of getting one over on The Man is appealing. The medical-industrial complex may want to charge you a lot of money for a treatment that might or might not work, but you can show them up by just rubbing Listerine on [body part] and fixing yourself! That sense of control is really appealing.
And ultimately, I think Mark Crislip has a large part of the answer:
As I have discussed before, users of alternative therapies are not comfortable with nuance and subtlety, and, I think, prefer black and white binary approaches. Mercury in one form is toxic, so all forms of mercury are toxic. Some forms of silver are beneficial, so all forms of silver of benefit, including colloidal silver. The inability to deal with shades of gray is a hallmark of many forms of alternative therapy.
This is why we get angry
A self-styled “holistic healer” injures several and nearly kills one with arsenic-loaded remedies. (To be fair, the remedies were indeed all-natural.)
A homeopath and his wife allow their infant to die a slow and tortuous death of infection due to severe eczema, because they believe homeopathy will cure her, despite repeated warnings from doctors.
A woman eschews medical treatment for her breast cancer, opting for The Secret and a quack’s ideas about acidity causing disease. She dies.
Lots of people believe that alternative treatments will extend their lives or even eliminate their cancer, and some of them give up entirely on conventional medicine. It’s one thing to decide that the cost of chemo is too high and make an informed choice to live as well as possible. It’s quite another to rely on alternative treatment to save you, then die anyway.
People go to a chiropractor to get pain relief, but may wind up with a fatal stroke,
Or the chiropractor might tell the person to stop taking her medication for epileptic seizures, resulting in her death.
People take “dietary supplements,” which are practically unregulated by the FDA, and wind up dying, or if they’re lucky, just going into liver failure.
This isn’t to say that conventional medicine is risk-free. But typically there is a good chance a remedy will actually do something beneficial that will balance out the risk. With alternative remedies, usually the most you get is placebo effect. Sure, regular medical practice is not always actually evidence-based, but at least that is the goal. With alternative practices, there are no standards whatsoever, and perhaps more importantly, there is no mechanism for improvement. There can’t be when proponents take a “heads I win, tails you lose” approach that rationalizes every failure and lauds every apparent success.
For more examples of the dangers of woo belief, see Whatstheharm.net.
Quick and Easy Guide to Spotting Altmed Bunk
(Another busy day today! I look at it as an opportunity to recycle – an oldie but a goodie.)
Immersed in the world of breastfeeding and attachment parenting as I am, I am unfortunately bombarded with loads of alternative medicine hogwash. As I dutifully (and usually futilely) research and dissect the latest advice from someone’s naturopath, or the information they got from their chiropractor, I have noticed certain signs that will cause my bullshit meter to bury the needle. What follows isn’t a detailed discussion of why altmed practices are unscientific, or how to decide if a research study is reliable, or a treatise on the philosophy of science. It’s just a quick and dirty list of features that anti-scientific quackery tends to share.
1. Most of the hits on Google are sites that promote or sell the product in question. Typical site names are phlebotinum.com, phlebotinum-advisory-group.net, drlaceyunderall.net, yournaturalhealth.com, and so on. Many strive to look like health information sites, but if they have only good things to say, and an easy link to purchase the product, you can bet it’s just a commercial site shilling. If you get a high proportion of hits like Webmd, Mayo Clinic, National Institutes of Health, and maybe stuff like CNN or ABC stories, it has a much greater chance of being a real thing.
2. The remedy is promoted as a solution for vague and ubiquitous maladies. Usual suspects are fatigue, insomnia, body aches, headache, mood problems, low sex drive, weight gain, nausea, and constipation. Now these can be real symptoms of real problems. But when you see a product promoted as solving a long laundry list of these issues, it’s time to raise an eyebrow. These symptoms are typically experienced by most people at least some of the time, especially in a culture plagued by poor diet, low rates of exercise, too little sleep, social isolation, and chronic stress.
Most of these symptoms are self-limiting, or can be alleviated by lifestyle change. But most people don’t relish a prescription of “eat plenty of fruits and vegetables, exercise regularly, and get 8 hours of sleep a night.” Lifestyle changes are difficult to initiate, harder to maintain, and are frankly a total drag. But give us a pill, a cream, or someone waving their hands over us once a week, and we perk right up – seems easy!
3. Self-diagnosis is encouraged. Whether it’s checking off the laundry list of vague symptoms, or buying a test kit you can do at home, do-it-yourself is the name of the game for quacks. And if you did get tests at the doctor’s office, they encourage re-interpretation. Doctor says your thyroid levels are fine? Well check your number against this web site’s “more accurate” scale. Doctor says your hormone levels are healthy? Take a saliva test to find out more!
4. Remedy is promoted by an actress of fading fame. E.g., Jenny McCarthy and Suzanne Somers.
5. Proponents laud how natural the remedy is, and decry the toxins in the environment and/or conventional medicines. Arsenic is as natural as it gets – it’s an element! Hemlock is a plant (make sure you get organically grown). Meanwhile insulin for diabetics is synthetic. Using “natural” as a synonym for “good” doesn’t make sense. (Also look for the keyword “allopathic” to describe conventional medicine.)
6. Relies on testimonials, anecdotal evidence, appeals to authority. Approaches that work don’t need this type of weak support, because they have strong scientific evidence – the kind that attempts to sweep away all the human foibles that can prevent us from seeing what’s really happening, and determine if an intervention has a real effect.
7. Provides citations as though they refer to peer-reviewed scientific journals, but the cited material is actually a book, presentation, or web site of an individual proponent of the remedy. It doesn’t matter how many letters are after your name – just because you say it doesn’t make it reliable. Publication in a respected journal indicates your claims have been examined and probed for mistakes and found robust. Publication on a website means you successfully Googled GoDaddy.
8. Users respond to skeptical inquiry and questioning of the evidence by saying, “I KNOW this works – it worked for me.” When the people trying to sell you on something have no clue about placebo effect, confirmation bias, coincidence, self-limiting conditions, and general methods for removing human perceptual bias, you can dismiss pretty much everything they say.
9. Praises or demonizes according to fad. Acai berries are magically delicious, but VDTs, power lines, electrical transformers, cell phones, Wifi is evil.
10. Invokes the Pentaverate. Promoters wave away criticism as the result of wide-reaching conspiracies involving doctors, pharmaceutical companies, the CDC, and other entities.
11. The remedy is said to have no possible side effects or risks. Generally if something can have an effect, it can have a side effect. If it can change your body in some way, that change might turn out badly for you. Even such benign and universally prescribed practices as exercise and high fiber diets have risks and side effects.
12. Oprah.
Skeptical Mothering 