Here’s why, part 4: Alternative Medicine

In this ongoing series answering the question of why ‘mainstream science’ doesn’t take certain topics ‘seriously,’ we get to Alternative Medicine, or alt-med as it is often abbreviated. This term actually doesn’t have a firm definition, except for specifically being not something that a qualified physician would recommend (or alternately, would often recommend against,) and encompasses such approaches as holistic healing, aromatherapy, herbalism, acupuncture, Traditional Chinese Medicine (TCM,) and even organic foods (a topic in itself that may be tackled later on.) Really, there are a lot of approaches that could conceivably fit into the huge umbrella of ‘alt-med,’ which can be anything that someone proposes could benefit your health while not actually having been prescribed by someone with an education in, you know, health. I’m not going to try and tackle even the top ten or anything, just give an overview that explains why ‘science’ isn’t taking this seriously.

First off, science does take it seriously. We spent quite a few hundred years figuring out how our bodies work and what chemicals do and so on, and while we are centuries away from a complete understanding, if this is even possible, we are also centuries into the investigations, using the best methods we’ve ever developed for determining good, solid information. One of the more important aspects of science is the testing and the examination of alternative explanations: was this the cause of the observed effect, or was something else? Our bodies continue to function without any input from us whatsoever, and of course we have immune systems (among many others.) So, chew on a leaf or whatever, and my headache went away? Maybe. Maybe not – it could have been the mere introduction of food or water that I was lacking, the reduction of tension or allergens, the cessation of background noise, or the mere fact that headaches are transitory in nature anyway – they go away on their own, 99% of the time. So to determine that the leaf actually has some worthwhile properties, we have to test it, repeatedly and with as few other variables as possible, to eliminate the other possibilities. This is the scientific method, and it’s proven its effectiveness for the past few centuries as well.

On the flip side of this is anecdotal evidence, which is exactly the same as superstition. I wore these red socks and my favorite sports team won a game? Wow, that’s compelling! And the same may be said for the average consumer review of just about anything – we’re a species that seeks patterns and correlations, and so we’ll see them very frequently when there’s actually no connection whatsoever between factors; it takes diligence to avoid the false positives and weed out the mistakes and wishful thinking, something that alt-med specifically avoids.

Modern, ‘mainstream’ medicine naturally got its start in the folk-remedy treatments handed down through the ages, with the addition of being able to pin down the exact ingredients that produced the beneficial effect, isolate them, and in some cases enhance or improve them; the biochemistry involved is stunning in its scope, and extends far beyond, “many people have reported feeling better.” But at the same time, we’ve also realized that subjectivity is hugely influential, and not in a good way – the concept of the placebo arose because we really have numerous people who report feeling better when they take or do something known to be entirely inert, simply because they believed it was efficacious and beneficial. Self-reporting is remarkably inexact and next to worthless, which is why most medical studies are “double-blind,” meaning that neither the patients receiving nor the doctors administering/recording any tested product know if they’re dealing with the actual product or a fake, inert one, so the bias in reporting can be weeded out – it really is that prevalent.

In that regard, many of the more common alt-med ‘remedies’ have been tested, quite thoroughly, and found to produce no worthwhile result when the self-reporting bias is removed. Many others are known to have no active ingredient, or something so common that no one would be susceptible to the illness it was supposed to treat anyway since most people receive it routinely.

So to understand the alt-med influence, we have to examine the common arguments and a bit of the psychology within.

The human body is healthy by default. This is so far from the truth that it’s criminal. Life and evolution exist because there’s a constant struggle to survive, whether it’s by us or by the pathogens that developed naturally all around us, ones that evolve a lot quicker than we do by dint of having far shorter reproduction cycles. It’s amazing how many advocates of this approach seem to conveniently forget the much shorter life expectancy of humans until very recently, or the fact that the youth mortality rate remained close to 45% until the past century. They’re apparently never seen the skeletons of those ravaged by disease, or recognized that few can ever be found older than 45 years. While our immune system is astoundingly good and adaptive, it received its biggest boost through our expanding knowledge of pathogens and our medical procedures and drugs. The evidence is simple to find, and mostly well-known anyway – it takes a concerted effort to ignore or deny it, really. More on that below.

Chemicals are bad. This is perhaps the largest example of the slippery-slope, failure-to-comprehend approach so prevalent in much of the health advice spouted anymore. Everything is ‘chemicals.’ No, really – it just refers to substances that have changed, and since we’re not dealing with subatomic particles, that’s everything else. But even the thought of stuff that is not ‘naturally-produced’ doesn’t help us any, because separating it from its natural source doesn’t change it, unless we intend to. Meanwhile, countless naturally-occurring chemicals are extremely bad for us. We can’t make any kind of blanket statements like this and achieve anything at all, and those that do aren’t looking for solutions, only excuses.

Natural is good. Same thing, and just as stupid. A significant percentage of the alt-med advocates are also organic food, no additives, no processing, etc. types as well. Again, the slippery-slope approach based on how many foods have lost nutritional value when prepared to have more flavor and appeal, but there’s a distinction in here that usually isn’t even recognized: some processed foods may not be as good for our health as their raw constituents, but this does not make them actively harmful – they’re just not optimal. Virtually none of this translates over to medicine in any way, though the association is made constantly.

There is a common belief that nature will provide everything that we need, as if there’s a plan being enacted or something. You’d think the countless species that went extinct, or the enormous child mortality rates before the last century, would put an end to this blather, wouldn’t you? ‘Nature’ just doesn’t work that way. Life develops and occupies a niche when the conditions are right, but conditions change constantly, and any living organism adapts to keep up. The various illnesses that can befall us, from rapidly-evolving bacteria and viruses to cancerous cells developing, do not provoke ‘nature’ into providing anything at all to counter them – we’re on our own. And while it is true that no species will develop a need for something that is not available within the environment, it is enormously easy to have a need for something that becomes unavailable.

By the way, the most significant way that our own species adapted to cope with the changing environment is by developing complicated brains that solve problems. That’s why we’re the only species that actually has medicine in the first place.

Big Pharma/Big Medicine/The Illuminati et al are conspiring to make us sick. Sure. This is why our life expectancy is the best it’s ever been, and we’re going through a population explosion. Makes perfect sense [I’d better explain that this is sarcasm, since the ones that it’s aimed at aren’t likely to snag it.] It’s funny how anyone can coin a term or phrase and it automatically becomes legitimate, like it’s been proven to exist. It would be nice if the standards of evidence for people believing something actually extended farther than hearing a rumor from an unsubstantiated source, but people find Truth™ with consummate ease when it’s something that they want to hear, regardless of how ludicrous it might be. While it’s certainly true that pharmaceutical companies are just as profit-driven as anything else in this country, they’re also regulated out the ass, requiring FDA approval after a battery of extensive tests for anything, and this usually takes years. Had ‘Big Pharma’ the power that most alt-med advocates seem to believe, the FDA wouldn’t even exist, and neither would health inspections.

Those that believe that, for instance, inoculations and vaccinations are methods of making people depend on drugs never seem to notice how infrequently these are given, much less required by any governing body – pretty much when a child enters school, and that’s about it. For nearly everything else, they’re suggested, and made readily available, but never required. Yeah, that sure sounds like the work of controlling overlords [sarcasm again.]

Science is untrustworthy. This one is perhaps the most hypocritical of them all. Alt-med advocates are quick to denigrate any study, any medical recommendation, that fails to agree with their preconceived notions, implying and openly stating that science/medicine isn’t dependable – though, how would they know? How, exactly, does one determine that something does or does not work if they won’t trust studies and tests? What would their source be for dependable information in that case? Psychic intuition? Chicken entrails? Product reviews that read, in their entirety, “I swear by this product, whatever it is!”? Alt-med advocates – the same ones that complain that science isn’t taking their interests seriously – seem to feel that there’s another ‘science’ that takes place somehow, without any quotable studies, without tests, without standards, and without controls. These are the apparent sources of their info about how well beetlejuice or crystal extracts work, and they never seem to notice how infrequently a name is even attached, much less a source that they can find for themselves.

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There are probably more claims made regarding alternative medicine, but these are the biggest that come to mind right at the moment. Now, we’ll talk about the various problems with alt-med:

Tests actually show little to no effect. Clinical trials have already been undertaken regarding a great many remedies claimed by alt-med advocates, with proper double-blinding, and the vast majority came up sorely lacking in notable effect. As skeptical comedian Dara Ó Briain noted, those that actually showed usefulness simply became ‘medicine’ – it’s where pharmaceuticals began in the first place. Despite opinions, ‘science’ (and society as a whole) would be delighted to find effective medications that didn’t require extensive lab development, didn’t cost significantly to produce, and didn’t require a doctor’s prescription to prevent the abuse and misuse of – but it rarely happens, and we’ll touch on this below.

Anecdotal evidence is next to worthless. Time and time again, we’re fooled by hearing someone’s claims, for a variety of reasons. The first is, correlation is not causation: because B follows A does not mean that A caused B – it could be countless other things. Second, confirmation bias comes into play, counting all of the ‘successes’ while ignoring the much larger number of ‘misses’ – we can have perfect five-star reviews of any product if we ignore all of the lower reviews, but what good is that? There’s also the placebo effect, a clinically-proven psychological trait of humans where we feel better if we think we should, partially because how we feel is wildly subjective, partially because our bodies really do have a limited ability to control how we feel. Without careful procedures to reduce these factors as much as possible, no claims about efficacy are worth anything – which is where double-blind testing and very large sample sizes come into play; we call these, “clinical trials.” It’s also where we find out that some test drugs have nasty side-effects, and in what percentage of the subjects.

We have a long and ugly history of folk remedies. ‘Snake Oil Salesman’ is a derogatory phrase for a very distinct reason, because before careful regulations, anyone could make any claim for remedies and ‘patent medicines’ and receive no legal action – many, many of these contained actively harmful substances. We developed regulatory agencies in direct response, and now, no one can market anything that we consume without strict controls – which means that those items that aren’t under strict FDA regulations are pretty much known to contain only inert ingredients.

Along the same lines, people are notoriously bad about dosages. A large percentage of the public believes that, if one pill works this fast and has this effect, two pills works twice as fast and has twice the effect, which simply isn’t how our bodies work – chemical reactions and their distribution throughout the bloodstream take place at their own pace, and increasing the dosage can result in everything from our bodies simply discarding the unusable surfeit to having significant negative impact. Active ingredients in painkillers are calculated to account for the tendency of some people to overmedicate while others actually follow directions, and the drugs that are more detrimental when overdosed are prescribed by one physician, and distributed by another. It doesn’t solve the problem, but it helps. Any claimed remedies that have no restrictions and no calculations for things like body weight obviously aren’t producing much, if any, effect in the first place.

Nature doesn’t tend to gather useful medications. Any plant, any collection of minerals, any complex compound, develops solely by what has evolved as effective for the plant, or simply happenstance (for instance, inert minerals from the environment,) and this can happen for anything. We ourselves developed in such environments, and so, most of the vitamins and minerals that we require to thrive are available through our diet. Concentrations of, for instance, compounds that can ward off specific viruses simply don’t happen, since plants don’t have a reason nor method to produce them. It would even be detrimental to them, since it would mean the death of the plant, usually before its reproductive cycle – not something that evolution favors. Let’s be real: we have fruits simply because animals eating them spread the seeds around, which is why the seeds are indigestible to anything that favors the fruit. In fact, there is an ongoing competition between predators and prey, natural defenses versus how to thwart them, so a natural remedy would typically only arise if it was beneficial for the plant to do so – and it takes thousands of years, untold generations. Hell, virtually all of our foodstuffs (plant and animal) were specifically bred by our efforts into the form we now know them within, having developed nowhere near as useful to us on their own. Which leads to…

Medicine and pharmacology take up where nature leaves off. It’s hard to say what most alt-med advocates imagine the medical fields to be, but in short, the goal with medicinal research is to isolate the active compound, determine the effective dosage, and find a way for the body to make use of it. In some cases, this is recognizing that compound n will have such-and-such effect on human cells or processes, even when n doesn’t exist in a natural form (or exists, but extremely weakly.) In the process, all extraneous stuff is left out, while occasionally other compounds that assist the effect are added. If, of course, someone has an inherent fear of ‘chemicals’ or the scientific process, this is where they feel the rot sets in, but that’s their own little bugaboos, and not supportable by any real studies. Side effects still occur, as well as aberrant reactions, since humans are not homogeneous; what works for you may not work the same for me. But overall, the greatest benefit with the least detriment is the goal, and achieved remarkably often.

And yes, on occasion (generally pretty rare,) some folk remedy or alternative medicine has a grain of truth to it, an actual beneficial effect – and these are taken and distilled down to the most efficient and effective manner possible. Aspirin is one such example, naturally obtained by chewing willow leaves – which would perforce require everyone to have easy access to a willow tree all year round (they are deciduous, so winter becomes an issue,) as well as dealing with the adverse effects of the high cellulose content that’s hard for us to digest. Or we can go to the store and get a bottle of pills and eliminate all the difficulties. That’s what medicine does.

We don't need to do a clinical trial of this change because the standard of care is to adopt new ideas without doing clinical trials.
xkcd by Randall Munroe
Alternative medicine is rife with weasel words, hedging, vague claims, and a distinct lack of sources. This is another of the hypocritical practices in alt-med, because purveyors make frequent attempts to imply that their product/remedy has undergone plenty of testing and examination – you know, like we rely on from real medicine – but can never produce any evidence of it. Meanwhile, their descriptions of effects are couched in careful, vague terms, mostly because distinctive claims require them by law to support such claims or be guilty of fraud; this is why you hear such chestnuts as, “Can help boost your immune system,” which is true for anything that has calories, or, “Millions of happy customers,” which is only a sentence fragment and literally applies to nothing. Most of us are aware of the common practice of review-bombing, where people are paid to write positive reviews of a product, and most times these are remarkably easy to spot. Alt-med reviews and claims tend to be a little harder, but careful consideration of the claims will usually reveal the attempt to mislead.

If in doubt, contact the purveyor or representative and ask for the supporting documentation, or do a simple web search. Compare it against a search for any common ‘mainstream’ medication, such as ibuprofen or whatever. Note the distinctive differences.

Toxins! There really is not such thing. Toxicity is a matter of dosage, not ingredient – anything at all can be toxic in enough quantity, so the word ‘toxin’ is nigh-meaningless, and you’ll never see a doctor or biologist use it, except in the sense that a species administers a defensive chemical, and even then, biologists tend to be more specific (like ‘hemotoxin’ for various snake venoms.) “Ridding the body of toxins,” a phrase alt-med is absolutely enamored with, is unsupported by any branch of biology and any study you care to look for. Unused portions of food simply get excreted (which some alt-med proponents insist that we should drink back in!) While some compounds such as lead are capable of being retained within the body to detrimental effect, these tend to be rare, and no amount of juice or kale is going to shift them; such contaminants generally require chelation, targeted solely towards the contaminant and in specific and regulated doses. The thought, however, that we are under a constant barrage of ‘toxins.’ that can all be cleared with one magical potion or practice, is ludicrous, and another example of the vague wordplay adored by advocates.

Alt-med purveyors and practitioners need few to no qualifications. Far too many of the qualifications that practitioners and purveyors list don’t require any serious or extensive schooling, if they have any meaning at all. Among these are Doctors of Natural Medicine, Homeopaths, Herbalists, and Nutritionists, which have limited to nonexistent regulation and oversight – see the bit about weasel words, above. Simply adding a title or abbreviation to one’s name fools far too many people, and coupled with grandiose yet still vague claims, alt-med puts on quite a show for those who aren’t critical of the meanings (and of course, those already predisposed towards disliking mainstream medicine in the first place.) In most cases, there is no such thing as malpractice because no regulatory body is in place, so one’s recourse in any cases of failed treatment or failing health is through civil actions, and in a lot of cases the courts have an overriding attitude of, “You shouldn’t have listened to that idiot in the first place.” Let the buyer beware, which should be a standard practice anyway, but doing a modicum of research is beyond the efforts of far too many people.

But it gets much worse. Practices like acupuncture, chiropractic, and Traditional Chinese Medicine are regulated and defined, and can be practiced by a licensed MD/PhD, and yet still be horseshit. Chiropractors in particular fall into two camps: those that alleviate pain from muscular and spinal stresses, especially following an injury, and those that claim that muscular/spinal manipulation affects the health of other areas of the body, and/or can ‘contribute’ to cures – the latter, of course, remains completely unproven in most clinical studies undertaken (and there have been plenty.) Acupuncture has been proven, hundreds of times, to be no better than placebo, yet it’s still allowed to be considered ‘legitimate.’ And Traditional Chinese Medicine was actually promoted by Mao Zedong, despite the knowledge that it was mostly folklore and ineffective, because it helped alleviate the shortage of qualified physicians within the country, while also serving as unifying propaganda. Fantastic.

There’s big money in it. Many of the complaints about ‘Big Pharma’ revolve around the profit motive, and the idea that ‘they’ (as if there’s one consolidated entity and not, you know, a collection of competing companies like those that exist everywhere) are happy for people to be sick just to make a buck. Yet somehow, the advocates never seem to think this applies to alt-med purveyors, who have no regulations, no development, no tests, no clinical trials, and very often, no expensive ingredients. As long as they avoid specific claims, and as long as they don’t cross over into regulated territory, practitioners can blather at will about “holistic healing” and “natural wellness” and “like cures like,” et al, because none of these are actionable or even have a meaning. 95% or better of alt-med remedies is marketing, and nothing more – grandiose claims that random herbs, a copper bracelet, or specially shaken water has the ability to do something beneficial for us. But there’s the more insidious aspect of it all too. While there are countless claims that ‘Big Pharma’ and the AMA and all that want you to be sick (so you keep buying their products of course,) alt-med is notorious for telling you that you’re already sick, from toxins in prepared foods and cellphone towers and everything else in your environment, so you need their products all the time to fight off this pervasive threat. The human body isn’t going to feel tip-top 100% of the time – it’s a system with lots of variables, and at times you’ll feel ratty. Alt-med wants you to believe that any such times are indications of dire threats and need to be treated, rather than the body compensating for them in a day or so, and the only recourse is a regular regimen of their products. You’ll notice the difference here, in that very few drugs recommended by licensed physicians need to be taken regularly, and those are, almost without exception, things that will cause a serious crash in the human system without (like insulin.) Physicians are usually trying to prevent routine use and addiction, because there are no constant threats to the human system. Does your physician tell you to come back every two weeks to keep things in order? How about your chiropractor?

Of course, it’s dangerous. In many cases, alt-med remedies have little to no effect, positive or negative, to the human body, which is why they’re not regulated. This is a distinction that’s been allowed to exist (more so in this country than many others) because free enterprise and all that. But the claims are something else, and even when not claiming anything specific because of their careful phrasing, they may induce people to believe that there is a distinct efficacy involved, that the alt-med remedies will not only work well, but better than medicine. In such cases (and there are millions,) people end up counting on their herbal supplements and TCM and not actually getting qualified help. That’s no big deal if the ‘malady’ is the alt-med wolf-at-the-door, the typical aches and pains we have routinely, that go away on their own – not so much when there’s a real illness involved that should be receiving real treatment. My poster child of choice is Steve Jobs, whose entire business model relied on marketing and convincing buyers that Apple products were unparalleled, and thus three times the cost of the competition that did the exact same thing. Yet he failed to recognize the same bullshit when he saw it, and treated his mild pancreatic cancer (that has a high success rate through mainstream medicine) with juices and ‘cleanses,’ until it was no longer mild and had passed the point where mainstream medicine could treat it. Yeah, fucking genius.

There’s also a curious trait of marketing, in that the people who failed to recognize the hedging claims and the weasel words happily and enthusiastically promote their interpretations of the claims, as well as their own uncritical experiences, as actual efficacy. These are legally actionable, but only if someone brings a suit directly against the individuals, and half the time that wouldn’t even work, because such things are often considered ‘opinion’ despite distinct claims of medical effect – and of course, what would be gained would only be a cease-and-desist order anyway. Listening to your average Joe is done at your own risk.

[Yes, I’m aware that I say this, personally, on a blog, and in fact stand behind the sentiment. Go ahead and do the legwork yourself – that’s what I espouse anyway.]

Most insidious about this is the mindset that’s fostered, the barrage of sources that encourage people to be, not just distrustful, but outright dismissive of mainstream medicine, and often by extension, the scientific process in itself. Being distrustful is almost commendable – skeptical, as in, “prove your claims,” is what’s encouraged and most useful. Too many people, however, will concentrate on the failures of medicine that they see, yet never count the successes, or apply the exact same standards to their alternate choices. They skip merrily down the slippery slope of Unwarranted Association and Rampant Extrapolation, convinced that there’s some sinister cabal afoot throughout all of mainstream medicine, as if the vast majority of practitioners and suppliers, the world over, would happily accept such affairs, and the only people really looking out for their health and welfare are the scantily-educated holistic healers et al (who also just happen to be hucking their own remedies, imagine that.) Sure, it sounds silly when it’s laid out like this, but enough people really have this mindset even though they’ve never actually laid it out to themselves in this manner.

Listen, I’ll be the first, and the loudest, in saying that the US healthcare system needs major renovations (actually, outright trashing and rebuilding from scratch) – but that’s in fees and costs. What it accomplishes (not just in the US) remains stunning, and undeniably the most advanced healthcare that we’ve possessed throughout our history. It’s not perfect, and nothing ever is, nor should it be expected. But we’ve spent centuries combining the best knowledge and methods that we have to reach our current state, which is advanced over what it was only yesterday, and be more advanced tomorrow. Our investigations into the biology and functions of our organs, the chemical processes taking place within, and the various factors affecting their operation amount to billions of hours of research, by millions of people; it’s intricate and convoluted, and we’ve barely scratched the surface. But to believe that inert crystals or simple herbs are the secret to correcting any issues with this apparatus is, quite simply, ludicrous. A little learning is a remarkable thing.

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