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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.
Skeptic, Doubt Thyself!
We tend to think of skepticism as doubt about other people’s propositions. Someone tells you their sister’s best friend’s cousin knows twins named Lemonjello and Orangejello, and you raise one eyebrow and say you’ll believe it when you see their driver’s licenses. A friend forwards you an adorable picture of baby pigs dressed as tigers, with a touching story about their adoptive tiger mom, and instead of saying “Awww,” and hitting Forward, you immediately go to Snopes and debunk it. If you’re nice, you don’t use Reply to All.
But at its heart, I think skepticism is really about trying to acknowledge our own perceptual foibles, and doing what we can to filter them out. And as I’ve mentioned before, we have to be particularly careful about believing information that agrees with our preconceptions. It’s so easy to gloss over deficiencies that you would use to savage an opposing proposition. But if we want to be honest and fair, we need to be as brutal with our own sources as we are with others’.
Case in point: one of my Facebook friends linked to this article, New Study Estimates Neonatal Circumcision Death Rate Higher Than Suffocation and Auto Accidents. I’m against routine infant circumcision, so of course this caught my eye. However, as I read the article, it seemed clearer and clearer that this “study” has little to do with science and everything to do with rhetoric. (For simplicity, I’m going to refer to it as a study in this post)
For instance, “How many children die each year as a result of circumcision in the US hasn’t been recorded or even considered important by any medical establishment.” The first half of this statement could be true to some extent, but the second half is pure, inflammatory speculation. This quote also highlights the fact that this study isn’t using hard data, but an estimate. The later statement “The study also identified reasons why accurate data on these deaths are not available . . .” is really telling.
The study concluded: ‘These boys died because physicians have been either complicit or duplicitous, and because parents ignorantly said ‘Yes,’ or lacked the courage to say ‘No.'” And called the deaths “an unrecognized sacrifice of innocents.”
Whoa Nelly! That is some heavy duty judgment! The author clearly has a lot of anger and outrage on this subject. And while there’s nothing wrong with being passionate, this rhetoric makes it pretty clear that the Thymos study isn’t so much a study as an opinion piece. I can’t read the study itself, because I’m not willing to pony up $15 for it, but from the excerpts provided in the Examiner piece, I’m confident that I can’t rely on this as scientific evidence.
Now, I’m against RIC for philosophical reasons, and I don’t need evidence showing shocking rates of harm to support my position. In my view, the burden of proof is on those proposing to perform surgery on someone who can’t consent. But of course, if there is evidence of harm, I’d be all about alerting people to that. However, if I’d just clicked “Share” without checking out the source, I would have disseminated information that’s obviously slanted and unscientific, not to mention as provocative and hostile as it gets. That’s not going to help my cause. At best, people will ignore it. At worst, they’ll do some digging and conclude that anti-circ people are just as they thought: shrill, underhanded ideologues without evidence on their side.
If we want to be taken seriously, and not brushed off as closed-minded, we need to be very careful to examine our own claims as least as well as we examine those of others!
Would you, could you, in a pill?
After giving birth, truly dedicated earth mothers don’t just delay cord clamping or ceremonially bury their placenta under a tree.
They eat it.
Why would they do this? It’s not completely out of left field. Many mammals, including herbivores, eat their placentas. We don’t really know why yet. Some people have taken this fact, together with the information that the placenta contains iron, estrogen, and progesterone, and concluded that eating your placenta will restore nutrients and hormones lost during labor, and help prevent such problems as anemia, low milk supply, and post-partum depression. Most people seem to go for having the placenta dried and made into pills (“encapsulation”), to cut down on the ick factor. Advocates of the practice are passionate and certain, employing a lot of bare assertion and very little actual evidence.
Check out some of the breathless claims from this placenta-preparation service:
The placenta has great restorative properties to assist you with your postpartum recovery. It contains many vital nutrients including iron, protein, vitamin B6, and the hormones it excreted during pregnancy. Just as it supported and nourished your baby, the placenta, when carefully prepared, nourishes the postpartum mother. It supports lactation and assists in the involution of the uterus to it’s non-pregnant size. It facilitates an easier postpartum recovery by increasing maternal energy and easing transitions.
Placental Services also gives this citation:
“181 out of 210 women who were given dried placenta to increase milk supply had positive results and saw an increase in their milk supply.
Placenta as a Lactagogon; Gynaecologia 138: 617-627, 1954”
Now, first let me say, if you would like to consume your baby’s placenta on the off chance it will do you good, I suppose you should go for it. I don’t see much harm. If it does nothing, you might lose some money to a professional encapsulator. (Of course safe handling is important, just like with raw beef or chicken or whatever.) But really, whatever floats your boat.
I’ll also grant that it’s possible that placentophagy could have some benefits. It’s not completely ridiculous, the way homeopathy is. It’s at least feasible that recouping iron and hormones could be beneficial.
But here’s my problem – this is at best a hypothesis. It’s testable, but hasn’t really been tested (as far as I can tell, that study didn’t use a control group, and the sample is small to boot). It’s a pretty big leap from “animals do this” and “it contains hormones” to “ingesting dried placenta prevents depression and low milk supply.” There’s also no particular reason to think that, say, iron from your placenta would be more beneficial than a Walgreens iron supplement.
And why are people so eager to make that huge leap? Because it’s “natural.” You won’t see this wide-eyed credulity when it comes to vaccines, for damn sure. People who avoid ingesting acetaminophen or corn syrup jump at the chance to chow down on placenta, because that’s what sheep do. It just doesn’t make sense to me. And I’m worried about the general mentality because it leads to distrust of science-based medicine and encourages faith in altmed woo – something that occurs in nature and seems like an alternative to Big Pharma products catches on fast, but any inquiry into whether it’s true is ignored.
Skeptical Mothering 