Lies, Edzard Ernst, and Research: Don't Believe Everything You Read

There have been several articles published in medical research journals which are pointing out just how flawed, biased, and just plain wrong biomedical research has become. Such studies can cause serious harm. Paxil was used as a teen anti-depressant  for years, largely based on a study which massaged the data to come to absolutely false conclusions about its safety and efficacy. Vioxx, the miracle painkiller that killed, was allowed on the market due to research designed to hide its deadly side effects.  As far back as 2003, bias was noted in the biomedical reesarch literature, but little has been done to change things. At most, some journals ask investigators to self-report any conflicts of interest they may have. Of course, few do.

The fact of the matter is, that pharmaceutical companies control the vast majority of grant money going to research institutions, and as an investigator, your livelihood can be put on the line if your grant money dries up.

Not surprisingly, bias and hidden agendas come up in the research on alternative medicine and chiropractic in particular. Mostly this occurs in the form of journal articles using research that has been hand-crafted to make chiropractic spinal manipulation appear dangerous -- when, in fact, you have a higher risk of serious injury while driving to your chiropractor's office than you do of any treatment you receive while you're there.

A case in point is the article, "Adverse effects of spinal manipulation: a systematic review," authored by Edzard Ernst, and published in the Journal of the Royal Society of Medicine in 2007. Ernst concludes that, based on his review, "in the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation."

This conclusion throws up several red flags, beginning with the fact that it flies in the face of most of the already-published, extensive research which shows that chiropractic care is one of the safest interventions, and in fact, is  safer than medical alternatives.

For example, an examination of injuries resulting from neck adjustments over a 10-year period found that they rarely, if ever, cause strokes, and lumbar adjustments by chiropractors have been deemed by one of the largest studies ever performed to be safer and more effective than medical treatment.

So the sudden appearance of this study claiming that chiropractic care should be stopped altogether seems a bit odd.

As it turns out, the data is odd as well.

In 2012, a researcher at Macquarie University in Australia, set out to replicate Ernst's study. What he found was shocking.

This subsequent study stated that "a review of the original case reports and case series papers described by Ernst found numerous errors or inconsistencies," including changing the sex and age of patients, misrepresenting patients' response to adverse events, and claiming that interventions were performed by chiropractors, when no chiropractor was even involved in the case.

"In 11 cases of the 21...that Ernst reported as [spinal manipulative therapy] administered by chiropractors, it is unlikely that the person was a qualified chiropractor," the review found.

What is interesting here is that Edzard Ernst is no rookie in academic publishing. In fact, he is a retired professor and founder of two medical journals. What are the odds that a man with this level of experience could overlook so many errors in his own data?

The likelihood of Ernst accidentally allowing so many errors into his article is extremely small. It is far more likely that Ernst selected, prepared, and presented the data to make it fit a predetermined conclusion.

So, Ernst's article is either extremely poor science, or witheringly inept fraud. I'll let the reader draw their own conclusion.

Interestingly enough, being called out on his antics has not stopped Ernst from disseminating equally ridiculous research in an unprofessional manner. Just a few days ago, Ernst frantically called attention to another alleged chiropractic mishap, this one resulting in a massive brain injury.

Not only has he not learned his lesson yet, Ernst tried the same old sleight of hand again. The brain injury, as it turns out, didn't happen until a week after the "chiropractic" adjustment, making it highly unlikely, if not impossible, for the adjustment to have caused the injury in the first place. Secondly, the adjustment wasn't even performed by a chiropractor. As the original paper points out, "cervical manipulation is still widely practiced in massage parlors and barbers in the Middle East."  The original article makes no claim that the neck adjustment (which couldn't have caused the problem in the first place) was actually performed by a chiropractor.

It is truly a shame that fiction published by people like Ernst has had the effect of preventing many people from getting the care they need. I can only hope that someday the biomedical research community can shed its childish biases so that we all might be better served by their findings.

This religion is the greatest threat to Western society.

Forget ISIS. Forget the Taliban. Forget Quiverfull. There's a new extremist religion that is permeating our society, and its tendrils are reaching to the highest levels in our government. You won't hear its adherents uttering the name of their religion, but it has all of the characteristics of a religious cult. It has leaders who are idolized and whose pronouncements dare not be questioned. Similarly, it requires that all of its adherents believe in the exact same dogma. Any variation from the accepted "truth" results in excommunication, shunning, and economic ruin.

At the same time, this religion engages in barbaric practices, including the ritual torture and murder of animals. Some of its temples have their own standing armies.

If you're not worried yet, you should be, because this religion is increasingly controlling public discourse in this country, using astroturf groups and social media to  limit debate and control thought.

This religion? It's called Scientism. And it is doing far more damage to our country and our society than Muslim extremists ever will.

Scientism is the belief that the methods of science are the only appropriate means of inquiry about the universe, and that only its conclusions are valid. While its practitioners usually claim they are practicing "science" (the methodology) rather than "science" the religion, most of the educated masses in the West are, in fact, believers in scientism.

The priests of scientism are, of course, the scientists. Like any priest, he or she wears traditional garb that identifies him as a member of the exalted class -- the lab coat -- and is accompanied by various instruments of office, depending on their sect. Philosopher Ivan Illich has pointed out that the medical priest, for example, often wears a stethoscope around his neck that identifies him as a member of the exalted. Others may be accompanied by various forms of obscure computing devices or, increasingly, wearable tech.

Their temples are windowless, climate-controlled, artificial environments with guarded entries to keep out the hoi polloi, because they surely could not understand the arcane rites within and would likely confound its rituals. Their temples also serve to wall out the wider world with its chaotic processes and systems so exceedingly complex that they still overwhelm the Scientist's wards of office.

In one respect, at least, they are correct -- I doubt that the common man would understand the Very Important Reasons for keeping sentient animals in five point restraints with their skulls exposed, under constant torture until they die, all so that we can better understand the Supreme Knowledge, to use but one example of the excesses of this religion.

What Scientism's practitioners have forgotten is that science is a tool, not a belief system, one tool among many which mankind can use to understand and organize the world. And science is a spectacularly useful tool, that should not be denied. None of you reading this blog does not benefit almost every second of every day from the fruits of scientific investigation.

Yet the true believers go too far. As scientist Austin Hughes has written about his profession, "The temptation to overreach, however, seems increasingly indulged today in discussions about science. Both in the work of professional philosophers and in popular writings by natural scientists, it is frequently claimed that natural science does or soon will constitute the entire domain of truth. And this attitude is becoming more widespread among scientists themselves. All too many of my contemporaries in science have accepted without question the hype that suggests that an advanced degree in some area of natural science confers the ability to pontificate wisely on any and all subjects." (Hughes, Austin L. "The Folly of Scientism." The New Atlantis. N.p., n.d. Web. 08 Feb. 2015.)

But like all tools, science must be guided by morals, ethics and systems of constraint that are not part of its own organization. However, that does not exist today. While there are boards of ethics which presumably oversee some research, all of these boards consist of practitioners of Scientism themselves, either as lay members of the church, or as clergy. That's exactly the same as having the Catholic church investigate its priests in claims of pedophelia, and the results in Scientism have been just about what you would expect.

Scientism now invades our public discourse on matters of great importance. Take, for example, the recent controversy regarding vaccination policy. The pro-vaccination camp immediately claimed the high ground of alleged scientific legitimacy, accusing all naysayers of being "anti-science." Now identified as heretics, those questioning current vaccination policy were considered fair game for all of the usual behavior-control tactics available to religion: Shaming, shunning, accusations of other-worship -- in other words, the exact same techniques used by all extremist religionists to eliminate dissent.

What got lost in the astroturfed "debate" was a nuanced and critical examination of what the research actually does say about the risks and benefits of vaccines -- something which varies from vaccine to vaccine, and is not the monolithic single risk/benefit equation that the pro-vaccination camp tries to glue over a much more topographical research landscape. They don't want you to see that their gods don't always agree.

The need to adhere to established doctrine does not just apply to the populace at large, however. It applies even more strictly to the acolytes and junior priesthood, who lose jobs and careers if they dare to question the recieved wisdom of institutional science.

Even those with established bona fides are not secure from the tyranny of scientific zealots. You saw it with Linus Pauling, as he explored the concepts of orthomolecular therapy before that discussion could be controlled by the pharmaceutical companies. Or, to cite a more recent example, Rupert Sheldrake's banned TED talk and his ongoing excommunication for having the temerity to advance a research-based hypothesis of vitalism.

Scientism presents a danger on many fronts, not only in its ability to frame public policy debate in ways which force a predetermined income but, more importantly, by controlling the nature of scientific inquiry itself. The rate and direction of scientific advance is entirely dependent on the questions scientists ask. The more that these questions are restricted to only support the status quo, the less progress will be made, eventually turning the focus of science so inward on itself that the entire charade of "advance" collapses.

Perhaps that will be a good thing. At that point, we as a society will become more free to choose the best lenses through which we view the world, and in so doing, escape the tyranny of materialistic rationality -- a tyranny which has as its only goals the elimination of self-determination, quashing of educated discourse, and invalidation of the richness of individual experience.

In which I unwittingly join a movement and realize the parallels between wireless routers and alternative medicine.

A few weeks ago, I upgraded the digital infrastructure at my office, the Center for Alternative Medicine. The new router I installed included the capacity for multiple wireless networks, so I added second wireless network without a password.

The goal was to provide a means for kids, parents, spouses, and other members of our patients' entourage to easily access the internet while waiting in the reception area. I generally don't (or at least try very hard not to) keep patients waiting, but there is usually a coterie of people in the reception room cooling their heels, either waiting for Christine DeCarolis to finish massaging a friend or David Pavlick to help someone understand the inner workings of their psyche, or for me to take the acupuncture needles out of someone. And, inasmuch as the cellphone service at the Center can only be generously described as "spotty," I thought this would be a convenient benefit for the nice people who come to visit us.

As I booted up the new router, little did I know I was joining a movement. The Open Wireless Movement:

"The Open Wireless Movement is a coalition of Internet freedom advocates, companies, organizations, and technologists working to develop new wireless technologies and to inspire a movement of Internet openness. We are aiming to build technologies that would make it easy for Internet subscribers to portion off their wireless networks for guests and the public while maintaining security, protecting privacy, and preserving quality of access."

It's an interesting idea. The internet has become a pervasive enabler of modern life, the digital road outside everyone's front door. And since I have large amounts of unused bandwidth, why not donate it to the greater good? In terms of security, the open, guest network is entirely isolated from the Center's internal network, so our data remains secure.

As I read more about the Open Wireless Movement, I realized that in many ways it parallels steps I have already taken with the Center's technology. For the past 6 years, all of our software has been based on Open Source software. Instead of Windows or OSX operating systems, all of my computers run Ubuntu. Instead of Microsoft Word, we use LibreOffice. Instead of a $30,000 proprietary Electronic Medical Records system, we use OpenEMR (a choice which allowed me to deploy electronic medical systems comprehensively long before most other doctors, and at very little cost).

All of this software is free. All of the code is open. The only payment I make is by reporting, and assisting in the resolution, of software bugs. Open Software is a community effort, that allows both users and developers to dedicate their time to create highly functional, stable applications.

Without stretching the point, this is also how I view health. We are not isolated entities, encountering and fighting off maurauding species intent on our demise. We are ecosystems. We are walking, talking, thinking conglomerates of living entities, from the bacteria that live in our gut and help us digest our food, to the beneficial prions that protect our nerves. Like whales, we proceed through life surrounded by pilot fish who both live off us and help us to live. Every single one of us is not a single organism but a cooperative collection of organisms. We cannot live without one another.

It's an amazing thought, isn't it? That we, in ourselves, are not one, but many? The recognition of that concept is why alternative medicine succeeds in the locations where traditional medicine fails. In many conditions, it is the balance between ourselves and our environment, or our micro-ecology, that is the culprit.

Mainstream medicine's tools, are blunt and traumatic in this arena. When the problem is not the presence of bad bacteria in the gut, but a lack of commensural bacteria, the big hammer of an antibiotic is a poor choice of tools. Changes in behavior, and even in thought, are more effective here than any antibiotic. There are many similar examples, but you get the idea.

And in the exact same way, alternative medicine and mainstream medicine are complementary. Where the MDs tools are weakest, mine are the strongest; conversely, where I may lack the skills to help someone, my peers in mainstream medicine are often helpful.

Or, as I put it to one of my patients, "I'm not the doctor you want to see when you're having your heart attack; I'm the doctor you should have seen 10 years ago."

So, yeah. Next time you're in our office, enjoy the open wifi. At some very basic level, we're all on the same open network already.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Why You Are Sick

Today, more than ever, we live in a disease-ridden society. But that's not because we lack sanitation, hygiene, abundant foods or opportunities for exercise.

We live in a disease-ridden society because we are creating diseases. Or, more accurately, we are having diseases created for us, and through careful manipulation of our fears, we have come to accept these manufactured diseases as real.

Anyone who watches television or reads a magazine has seen (albeit largely unconsciously) how cleverly marketing first creates a disease, ensures that lots of people come down with it, and then offers a "cure" to get rid of it.

As an example: Until Viagra came along, impotence was either an occasional mishap resulting from emotional causes or secondary to other disorders, such as circulatory problems, nutritional deficiencies, and diseases or trauma interfering with nerve function.

Then Pfizer came along, developed a drug that increases blood flow to the male penis, and needed a market to sell it to. Nevermind that Viagra's ability to improve function is limited to a single mechanism that really only works for a few men (those that are producing insufficient amounts of nitric oxide). That market was too small. What Pfizer needed to do was to create a larger market.

First, they created the need, and that was easy: What man doesn't want to be better in bed? Second, they created the disease, i.e., the reason you're not better in bed. They took the old name -- impotence -- and scotched it, because of its negative connotations. The word "impotence" conjures up images of a skinny-armed teen getting sand kicked in his face by the guy with the rock-hard biceps and bosomy blonde in tow. Or the cuckolded husband coming home from his 9-to-5 only to discover his randy wife in bed with the next door neighbor.

No, those are not images with which any man would associate himself. So Pfizer created a new disease -- Erectile Dysfunction -- with an entirely neutral connotation -- and craftily expanded the boundaries of this  created disease. The really, really important thing to note here is that Pfizer took a symptom of several diseases and made it into a disease by itself so that they could sell a drug to "treat" the disease.

It still hasn't reached the point where a man is going to sit down on the bar stool, look over at his neighbor and say, "Damn, dude, I just got diagnosed with ED. Pass the peanuts, wouldya?"

But the reformation of impotence (the symptom), into ED (the value-neutral disease), mainstreamed the concept to the point where healthy young men are now taking the drug for a perceived extra performance edge.

And Pfizer is putting lots of money in the bank.

---------------------------

Another excellent example of a manufactured disease is osteopenia.

There was a time when osteopenia was an incidental finding on an x-ray, a way you would describe a bone which had gotten more transparent than others. It was an indicator of the loss of mineral in that bone, and a sign that, as a doctor, you might want to be on the lookout for osteoporosis further on down the line.

Or maybe not. Plenty of people experience temporary osteopenia, which reverses on its own. A number of pharmaceuticals cause osteopenia as a side effect, and as soon as the drug is no longer taken, normal bone is restored.  People living sedentary lifestyles, either due to other health problems or simple neglect,  often develop osteopenia which disappears with a return to activity.

But for several years, I had many a middle-aged woman come to my office with the "diagnosis" of osteopenia, for which they had been prescribed Fosamax or one of the other bisphosphonates.

Again, here we have a symptom, or exam finding, that has been carefully recrafted into a disease.

The rebranding of osteopenia came with the development by Merck of a new drug that could increase the mineralization of bone. But this new drug -- Fosamax -- like, Viagra, had a very limited audience. People with osteoporosis, a true weakening of the bone.

But in 1997, Merck hooked up with the developer of a cheap and easy x-ray machine which purported to measure bone density in a way that would predict risk of fracture.  The DEXA scan immediately multiplied Merck's market by creating a new class of disease sufferers, this time people who had the new disease of "osteopenia."

And the market took off. With the addition of standards manufactured by the drug companies themselves, medical doctors started prescribing Fosamax to a huge number of middle-aged women.

The wheels have since come off that cart, at least a little bit. No so much because subsequent research shows that Fosamax does not create healthier bone, nor because Fosamax has also been shown to actually cause bone death and increase fracture risk in certain bones (true). Nor has the fad decreased because research has also shown that the DEXA scan does not adequately -- or even remotely -- predict bone fracture (true).

No, the fad has passed because the patent on Fosamax ended in 2008, and the horde of no-name drugs has reduced the value of Fosamax considerably. With competition, Fosamax is no longer the money maker that it once was.

But the lesson that Merck learned was a valuable one. No, not the lesson about the consequences of releasing a dangerous and poorly-tested drug onto the market.

The real lesson here was that coupling tests which purport to objectively demonstrate the presence of a "disease" with a drug that cures that "disease" is an extremely potent form of marketing.

Today, consultants of pharmaceutical companies are offering week-long seminars on how to couple drug development with tests that will increase the demand for that drug, and then market them to medical doctors and consumers alike.

This development has gone largely unnoticed, and unreported, and the vast (and unwarranted) trust that Americans have in their medical physicians makes such sales easy to make.

Medical doctors, on their side, are seeing pharmaceutical company payouts, in the form of "consulting fees," as a lucrative sideline to offset the continuing pressure on their income. Medical doctors are also paid ludicrous sums for enrolling patients into research programs, to the extent that some practices have hired specialists to sift through the studies available and determine which will be the most profitable to participate in.

And patients, on their side, are manipulated by the fear spread by pharmaceutical companies that previously unheard-of diseases will dramatically affect their quality of life.

But you know what? Most people aren't sick, and most people don't need prescription drugs -- although 50% of the U.S. population are taking them.

In fact, most of the people taking drugs today are not the victims of disease, they are victims of a lucrative marketing scam no more ethical than an email from a banker in Kenya.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Time For Your Flu Vaccine? No.

I'm going to talk to you about the flu vaccine. Now, before you dismiss me with a hand-wave and think to yourself, "Oh my god, another anti-vaxxer idiot," let me make a few things clear.

I'm not anti-vaccine. I'm pro-science. I believe that public health policy should be firmly based on the best available research. And what the best available research says, according to the top researchers in the world, is that the flu shot is useless.

But I'm pretty sure that nobody involved in mainstream medicine wants anyone to actually think about whether you need the flu vaccine.

They just want you to line up and get the shot. You see, everybody in medicine makes money from the vaccine, from the Semi-Registered Nurse's Assistant's Aid's Best Friend (i.e., part-time CVS employee who just washed her hands) who actually injects you, to the stockholders and executives at Novartis and Glaxosmithkline, who make the vaccine, to the CDC, which gets lots of money indirectly by pimping the flu vaccination each fall.

The trouble is, it's bad medicine. And bad science.

Don't believe me? Then believe the Cochrane Collaboration. This is an independent organization which performs analyses of medical research, and one of the sources that evidence-based doctors, such as myself, use to guide their recommendations to their patients (of course, I'm absolutely *not* making any recommendations to any of my patients, and if any of my patients are still reading this, I want you to stop immediately).

According to the Cochrane review, the advantages of vaccinating healthy adults are virtually nonexistent. This recent study found that the flu vaccine:

• Did not reduce the number of days lost from work;
• Did not reduce the number of people hospitalized;
• Did not reduce the number of complications due to secondary infection (pneumonia, etc);
• Was effective in only 1 out of 100 people;
• Paralyzed 1 out of every 1,000,000 people who were vaccinated.

Furthermore, the study's authors hedged their conclusions even more. The authors said "Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions" (Emphasis mine).

For those of you who are not familiar with reading scientific studies, this is a researcher's polite way of saying they think the data is trash.

This conclusion was reached by Cochrane researcher Tom Jefferson, in a 2006 analysis published in the British Medical Journal. Dr. Jefferson concluded that there is an "absence of evidence" that vaccinations have any effectiveness at all.  "In children under 2 years inactivated vaccines had the same field efficacy as placebo," Dr. Jefferson said, "and in healthy people under 65 vaccination did not affect hospital stay, time off work, or death from influenza and its complications."

But what about our aging American population? The elderly is a group heavily targeted by influenza vaccine marketing, but that is primarily the result of easy and profitable Medicare reimbursement more than any evidence that flu vaccines actually help this population.

In fact, the evidence is so bad that Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy has suggested that those who recommend the flu vaccine for older people are at best ignorant and at worst disingenuous.

"These 36,000 deaths that we keep talking about with the flu, that we want to get people vaccinated for so they don't happen, really is not going to occur. And we have to be honest about that," Osterholm told NPR last year. "I know that some people are going to find it very challenging to basically understand that much of what we've probably done has had little impact on deaths," he said.

Nor is the Cochrane Collaborative silent on this issue. This study, first published in 2006 and reviewed again in 2009, concluded that "the available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines for people aged 65 years or older." The study went on to note the "low quality" of the research, as well as "likely presence of biases, which make interpretation of these data difficult and any firm conclusions potentially misleading."

Some of the research backing Osterholm's claim includes research by Dr. Lisa Jackson and published in Lancet. Dr. Jackson's study -- which spanned 3 years and included over 3,500 people -- concluded that vaccines don't really help, particularly in the area of secondary infection prevention. Specifically, " influenza vaccination was not associated with a reduced risk of community-acquired pneumonia," her paper concluded.

What other studies seems to show is that, far from aiding those with weak immune systems, flu vaccines either fail to help or overtly damage people with already-compromised immune systems.

The Cochrane Collaborative's persistent claim that the data regarding flu vaccine research is compromised has been bolstered recently. A paper authored by researchers at the British Columbia Centre for Disease Control found that data from several Canadian hospitals reported peak vaccine effectiveness before the flu season had even started. They concluded that this created a "bias tending to over-estimate vaccine protection," which as other research has shown, is marginal at best.

However, there are research-proven ways of significantly reducing your risk of contracting the flu this winter, and the best ways of avoiding the flu involve no vaccines, no doctors, and don't cost you any money.

• First of all, according to the CDC itself, washing your hands is one of the best ways to prevent the acquisition of most infectious diseases.
• Exercise has also been proven to prevent death from the flu as well as other infectious diseases.

Those are probably the two most important ways to prevent the flu. And the research is unequivocal at this point that nutritional status has a profound effect on immune function, which determines how likely you are to get the flu. But then again, how many doctors actually test your nutritional status to make individual-specific recommendations for improving your immune function during the flu season?

Actually, I do know of one.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

Estrogen: It's Not Just For Breakfast Any More

Industries from pharmaceuticals to plastics to agriculture are all dependent on the bureaucratically-induced hallucination that our estrogen-soaked food supply is safe. Unfortunately, this view is contradicted by the research, all of which points to growing endocrine dysfunction in many species, including our own.

If you follow health-related news at all, you are probably aware of the recent study that was released, showing that many plastics -- not just those containing BPA -- have been found to leak estrogen-like substances into our foods. While estrogen is a useful and necessary hormone, the additional estrogens we are absorbing through our food and our environment may not be so good for us.

Certainly, the hormone replacement therapy studies which came out during the last decade proved the folly of mainstream medicine's belief in the protective effects of estrogen. Though it had been believed that estrogen reduced the risk of heart disease and cancer in women, long-term studies showed that the exact opposite was true. Long-term estrogen replacement actually increased the risk of chronic and lethal diseases.

Though the warnings about the health risks of environmental estrogens are couched in enough verbal hedges to make a diplomat happy, the fact of the matter is that nothing good can come from the chronic absorption of estrogen-like chemicals. These chemicals have been linked to increased male infertility, increased rates of breast cancer, and ovarian cysts, among other problems.

The fact of the matter is, however, that there are some 3,000 food additives which have been approved by the FDA, and not a single one of them have been tested for estrogenic activity. Interestingly, while synthetic estrogens are allowed into the food supply without testing, and alleged to be safe, natural phytoestrogens such as those found in licorice, wild yam and dong quai, have been subjected to extensive review and carefully worded warnings about their unguided use (the implication being that you are far safer with the synthetic estrogens and whatever crazed mutant hormones are leaching from your plastic-wrapped meats).

The mainstream medical community's waffling on the dangers of synthetic estrogens is clearly the result of the FDA's desire to avoid biting the plastic hand that feeds it. Industries from pharmaceuticals to plastics to agriculture are all dependent on the bureaucratically-induced hallucination that our estrogen-soaked food supply is safe. Unfortunately, this view is contradicted by the research, all of which points to growing endocrine dysfunction in many species, including our own.

Which leads me to today's quiz: What was the first time that a significant number of humans were exposed to estrogen-like chemicals, and what was the result?

The first person to email me with the correct answer will receive a 10% discount on their next purchase from our Dispensary. Your order can be of any size.

Good luck!

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

The 5 Most Deadly Heart Disease Myths

If you have read this blog for more than 5 minutes, you probably already know two things:

1. I believe (because the research demonstrates) that taking control of your health care is the best way to become, and remain, healthy.
2. I believe (because the research demonstrates) that mainstream medicine has absolutely failed in the prevention and treatment of most chronic diseases.

You may not yet know that heart disease, though it is the number two killer in this country (after medicine itself, which is in first place as the leading cause of death) is a chronic disease which is comprehensively preventable. But the "pill for every ill" mindset has prevented us from addressing the problem of heart disease in any kind of effective, comprehensive way. In fact, most of what you have been told by the media and your medical doctor about the causes and prevention of heart disease is wrong.

Hopefully, I can change that in a small way, on Wednesday, February 16. That evening, I will be giving my first seminar of 2011, titled:

The 5 Most Deadly Heart Disease Myths

• Why your cholesterol levels really don't matter.

• Why the drugs you are taking may be doing you more harm than good.

• The "bad" foods that are actually good for heart health.

• The real causes of heart disease, and how you can prevent and reverse it.

• Why the heart disease statistics are fatally wrong.

Please join me on Wednesday, February 16 at 7 p.m.

Litchfield Community Center

Seating is limited -- Call or email today for reservations.

Annual Fear Campaign Set To Begin

The annual Fear Campaign is about to begin, as everybody with a pulse will have it hammered into their heads that if they don't get a flu shot, They Will DIE! Remember the swine flu campaign of last year? It turned out, as I predicted, that the projected swine flu pandemic was vastly overrated, and was primarily a marketing campaign, as opposed to a public health campaign.

Epidemiological research has consistently shown that flu shots are minimally effective and do very little to influence the course or spread of the disease -- as this picture so aptly demonstrates.

Fortunately, 2010 will see the return of the Center's Alternative Flu Clinic. Details to come soon.

Dr. Avery Jenkins is the president of the Center for Alternative Medicine in Litchfield, CT. You can email him at alj@docaltmed.com.

Violation of an Oath, a Person, and a Profession: Erin Vaught and Ball Memorial Hospital

At the beginning of every physician's career, there is a moment in which we commit ourselves irrevocably to the wellbeing of our fellow humans. At that moment, when a physician takes his oath of responsibility -- whether it is the Hippocratic Oath of the medical physician or the Chiropractic Oath of the chiropractic physician -- we become responsible to a good far broader than our petty, individual prejudices. From the moment I took my oath to the present day, I have striven to uphold its tenets. Whether it is navigating the thickets of a patient's privacy requirements to ensure that they receive the best care, or challenging health insurers whose policies would require me to commit malpractice, I have always held in mind the obligations of this oath.

So I am understandably sickened when I come across examples of other doctors who not only ignore their moral obligations, but actively violate them to the detriment of their patient. Of course, the Josef Mengele wannabees who conducted the Tuskegee Experiment immediately come to mind.

But not far behind is the as-yet unnamed doctor and his employer, Ball Memorial Hospital, who recently threw a critically ill woman out of their emergency room because she is a transsexual woman. But the expulsion only occurred after several hours during which hospital patient Erin Vaught, vomiting blood and suffering from intractable pain, was subjected to ridicule and derogation at the hands of other hospital employees, being referred to as a "he-she" and being entered into the hospital database as a male, even though her ID card clearly identified her as a female.

Here is part of what happened, in her own words:

They completed my regestration [sic] and I saw that had put "M" as my gender. I pointed out that my ID says female. She looked annoyed and the lady next to her snickered. She told this jock type triage person to take my vitals; he glared at me for a second and turned his head and said, "Remember payback sucks."

You can read her full account here.

Those of you who read my blog regularly know that I have previously written extensively about how transgender people should be treated by doctors, and that I hold in low esteem those who discriminate against people with gender variations.

I fully understand that sometimes people do hurtful things to others out of ignorance. But in this day and age, there is no excuse for any health professional to be unaware of the needs of this demographic. In addition, and quite clearly, the activities of Ball Memorial Hospital and its employees went far beyond those which can be written off as ignorance.

They were words and actions intended to hurt. Intended to humiliate. Designed to violate the very core of the oath that those physicians had taken on the day they became doctors.

I am absolutely appalled, yet at the same time, relieved. I am appalled that the incident even occurred, and even more stunned at the hospital's decidedly pusillanimous response. And I am at the same time relieved that I do not belong to a profession which indulges and condones such bigotry.

Regardless of what unethical behaviors that chiropractic physicians have been accused of over the years, none of it even approaches the level of disregard for patients and their rights which is a standard feature of mainstream medicine. From selling confidential patient data to pharmaceutical companies to denying medical care to black men to watch them die from untreated syphillis, my profession has never come close to the level of depravity demonstrated so often by mainstream medicine.

I hope Ms. Vaught and her family find the courage to sue Ball Memorial Hospital. Though such a suit will likely not touch the individuals who perpetrated the crime, it will be as close as anyone gets to a reprimand.

Otherwise, the same reprisal that was visited upon the Tuskegee doctors will also befall the Ball doctors.

That is, nothing. Nothing at all.

Look Mikey, We Found A Gene!

The New York Times today reported on the utter failure for medical research to find anything useful to do with the human genome. A full 10 years after the human genome map was completed (and the rush to patent your body parts began), the promised treatments for cancer, Alzheimers and other diseases have yet to materialize. Companies purporting to develop cures based on genetic manipulation have become little more than serial failures. That wasn't what everyone was sold 10 years ago when, as the Times reports, "Francis Collins, then the director of the genome agency at the National Institutes of Health, said that genetic diagnosis of diseases would be accomplished in 10 years and that treatments would start to roll out perhaps five years after that."

"Over the longer term, perhaps in another 15 or 20 years, you will see a complete transformation in therapeutic medicine," Collins said, according to the Times.

Uh-huh. This is exactly the type of bloviation from which the medical community suffers which I noted in my last post.

The problem here is not so much a lack of effort or funding -- billions of dollars have been poured into this research -- but a basic lack of understanding of the role of genes in human health. Which shouldn't be surprising, given that mainstream medicine has not yet even figured out the real cause of something as simple as heartburn, despite the evidence in front of it. (If you want to find out the causes -- and a simple treatment -- for heartburn, you'll have to click here and subscribe to my newsletter.)

Several years ago, I took some interest in the low-cost DNA tests that were just beginning to be offered. Always one to look for a better way to gather the data I need to treat patients, DNA testing seemed to be just the thing. It would -- I thought -- help me to tailor my nutritional therapies for patients.

It wasn't long until I realized that the tests were virtually useless. The tests told me nothing about a patient that I couldn't surmise -- more accurately and at less cost -- by conducting a thorough history and doing a proper examination. Interestingly, a research study looking at risk factors for heart disease came to the same conclusion.

The trouble is that the mere existence of a gene does not mean that the gene is active. Genes get turned on and off all of the time -- in fact, that's what most cells do for a living, turn a gene on, produce a couple of proteins or other necessary items, and turn it back off.

Genes can be turned on by a variety of things -- environment, drugs, and even -- hold onto your hat, Annie -- food! Yup, nutrients cause genes to do all kinds of things. In fact, you could quite safely argue that when I recommend supplements to patients, I am conducting a form of gene therapy. (And you thought chiropractic wasn't cutting edge!)

Add this genetic plasticity to the fact that (except in rare conditions that we've been aware of for half a century), there exists no one-to-one correlation between a gene and a disease (as well as the fact that genes can play multiple roles in different processes), and you arrive at the rather obvious conclusion that this approach doesn't really seem like a good idea.

Even if you were able to develop a drug that could manipulate genes on such a massive scale, the odds are that it would have enough side effects to kill a horse, limiting its utility.

So 10 years after the gun went off, all of the horses are returning to the gate, sweaty, tired and without their riders. The promise of gene therapy has turned out like all days at the track -- noisy, hot, and after watching everybody run  around in circles for a long time, you go home poorer than you left.

Do Chiropractors...?

Here's a fun little exercise for rainy days. Go to Google, type in the beginning of a search, and see what Google's autocomplete feature suggests. It gives you a sense of what people are asking about, in a more granular way than looking at Google's overall search trends. And as any good quantum scientist can tell you, the question you ask gives as much information as the answer does. Thus, it was with some concern that I looked at the autocomplete results when I typed in a search phrase starting "Do chiropractors...." Here's what came up:

This screenshot, more than anything, is a testament to the success of the smear campaign conducted for nearly 100 years by the AMA and its cohorts. And even after the Federal Court ordered the AMA to stop defaming chiropractic physicians, the smear campaign continued in the form of fringe groups with funding of uncertain provenance.

So even now, after millions of clinical successes and thousands of studies demonstrating the value of chiropractic services for the treatment of myriad disorders, we are faced with these questions, which I will address one by one. First, to the perennial, AMA-disinformation induced question: Do chiropractors work?

The efficacy of spinal manipulation has been demonstrated for a variety of musculoskeletal and non-musculoskeletal disorders. The efficacy of nutritional treatments and herbs for another gazillion disorders is also well-established, and it should go without saying that a chiropractic physician is far more equipped to deliver science-based nutrition than any other type of physician. Finally, when you couple that training with the increasing number of chiropractic physicians with advanced training in acupuncture, it is clear that chiropractic physicians are health care's most powerful triple threat against illness.

In short: Yes, chiropractors work. And quite effectively, I might add. Do chiropractors really help?

See the preceeding question. I'm just dumbfounded that this question continues to be asked.

Do chiropractors go to medical school?

Nope. But don't let that confuse you. Chiropractic school requires the same number of hours as medical school, and we study many of the same subjects during the first two years: Anatomy, physiology, pathology, endocrinology, etc. It is during the latter two years where the differences come more into play, as the students of each discipline begin to focus on the practical aspects of their professional tasks: Medical students to drugs and surgery, and chiropractic students to adjusting and nutrition. Do chiropractors prescribe medication?

Not currently, although the chiropractic physicians in one state are currently changing their scope of practice to incorporate prescriptions.

For the most part, however, chiropractic doctors really don't see the need for drugs, or have the interest in using them. My single biggest advantage over an MD is that I don't use drugs, a fact which brings more patients to my door than anything else.

Do chiropractors help?

Yes, we do. But whether a chiropractic physician can help you is something only you can decide in consultation with the chiropractic physician him- or herself.

But during my 15 years of practice, I have had many patients come to me and with hugs or tears in their eyes, thank me for changing their lives.

In all honesty, it wasn't me. It was the patients themselves that changed their lives. I just helped them along the path, that's all.

And, I suppose if you are looking for the clearest difference between medical doctors and chiropractic doctors, it is that one simple thing. While medicine and big pharma bluster and brag about their "new miracle cures" and "medical advances," and put themselves on the pedestal rightly belonging to the patient, chiropractic doctors recognize where cures really come from -- and are much humbler of our role in the process.

25 Things You Didn't Know A Chiropractor Could Do #4: Osteoporosis

It appears that the medical community is about to foist yet another quack "cure" for osteoporosis on the women of this country. Prolia, the latest alleged treatment for osteoporosis, is an injectible that was approved by the FDA primarily on the basis of a single study paid for and conducted by the company that developed the drug. Ok, let me repeat that one more time. The FDA has approved a dangerous (we'll get to that in a minute) drug on the basis of research that the developer bought. Not to put too fine a point on it, but government oversight of BP's woebegotten Deepsea Horizon was more stringent than this.

And I haven't even gotten to the good parts yet. Prolia, it turns out, suffers from the same problem as all of the other osteoporosis drugs -- it actually kills bone, rather than create healthy bone. This rather unfortunate tendency is already the subject of multiple lawsuits from women who have been permanently disfigured and disabled by the drugs that were supposed to cure them. Despite the fact that Prolia destroys bone, the FDA has allowed it's release as a treatment for osteoporosis.

Lest I forget, some of the other effects of Prolia include back pain (!), severe calcium deficiency, increased urinary tract infections, increased respiratory infections, increased risk of cancer, eczema, cataracts and joint pain.

I respectfully suggest that if your medical doctor recommends that you receive Prolia injections for your osteoporosis, you should run, not walk, to your nearest chiropractic doctor for osteoporosis treatment that is safe, effective, and inexpensive.

Which brings me to the point of this column. Yes, Virginia, chiropractic doctors do treat osteoporosis, and quite successfully.

Osteoporosis is yet another one of those lifestyle diseases that is most appropriately treated at the source, with changes to habits and diet, using both supplementation and in some cases acupuncture to correct the initial imbalance.

Using these tools, I have been able to reverse bone loss, a reversal which was significant and measurable by laboratory testing.

And it's with the laboratory tests that I begin. Because the cancer-causing radiation tests that medical doctors like to use (they *did* tell you that the bone scan increased your risk of cancer, didn't they?) provide only a snapshot of limited value. They tell you nothing about the health of the bone nor of the rate of calcium loss from the bone, both of which I would consider absolutely fundamental data to have before beginning any treatment.

With labs and physical examination results in hand, I can then put together a treatment plan goes a bit further than "take 1,500 mg of calcium daily" that the medical community substitutes for informed nutritional advice.

With my patient we work on diet, we work on exercise, we work on all of the factors that have led to the bone loss from which they suffer -- and which can lead them out of it.

Drugs? -- Who needs 'em? When it comes to osteoporosis, chiropractic physicians have a far better answer than any other health care provider.

Are You Integrated?

Those of you who have followed this blog for some time, or who receive my DocAltMed Newsletter, know that I frequently point out the failings, follies, and dangers of mainstream medicine. I don't do it out of vindictiveness or spite, or because mainstream medicine is competition for the traditional medicine that I practice. However, I do feel that there is the need for a voice -- even a small one such as my own -- to counterbalance all of the advertising, marketing, and whitewashing that passes for medical "research" and news coverage. That said, I need to periodically point out that I am not fundamentally anti-medicine (though I am fundamentally anti-stupid and anti-greed). There are medicines that work, and there are times that they are appropriately used. That they are used too often, for the wrong reasons, and with little regard for patient safety is my main beef.

This is an issue which came to the fore just the other night, as I was addressing a local MS support group.

Multiple sclerosis (MS), is a chronic, disabling disease which often proceeds in a perplexing course of exacerbation and remission. This characteristic makes it exceedingly difficult for a single doctor, or his patient, to adequately assess whether or not their chosen therapy is working.

As is the case for many chronic, degenerative diseases, mainstream medicine doesn't have very good answers for people with MS. One of the points of my lecture was that alternative medicine offers equally good efficacy, typically at a significantly lower cost and with a greatly reduced risk of painful and dangerous side effects.

At the end of the lecture, one of the attendees asked me if I would be willing to treat someone even if they were taking medications.

My instant response was, "Of course I would!" It wasn't something I have to think twice about.

I frequently manage patients who are taking drugs prescribed by other physicians. They can cause collateral damage in the form of nutritional deficiencies, gastrointestinal dysfunction or organ damage, and I consider it part of my job to respond to those issues, but never would I presume to tell a patient that I could not treat them so long as they were taking a prescription drug.

As good as I am, I don't have all the answers. I never will. The other guys have some pretty good tools, too. But on both sides of the Great Medical Divide, there are doctors who put ideology above practicality, and it is exactly that type of either/or arrogance that has put our health care system in its current sorry state, with the patient often getting the short end of the stick.

Interestingly, after the lecture and the Q&A session, as I was wandering around talking to people, someone else came up to me to tell me that on at least one occasion, she had been told by an acupuncturist that she would have to give up her medications in order to begin acupuncture.

Now that's just wrong. There is no injunction against concurrent forms of treatment with traditional Chinese medicine, and in fact, that's how it is most often practiced these days in Asia, let alone the West.

It's not good science and it's not good protocol. It is just ego. And when ego gets in the way, it is the patient that suffers.

The fact of the matter is that MS is another one of those disorders, like asthma, which is likely best co-treated by both a mainstream physician and an alternative medicine physician such as myself. In this "balance of powers" best-case scenario  -- known as "integrative medicine" -- the patient's more frequent contact would be with myself, with the neurologist called in for periodic review or to help manage severe exacerbations. There is no reason for the exclusion of either discipline, and the patient would benefit greatly.

Beware the Surgeon Selling Spinal Fusion

Spinal fusion, a type of surgery in which the vertebra of the spine are locked together using rods and screws, is a popular surgery promoted by some orthopedists for everything from bulging disks to "weak or unstable" spines (whatever that really means). The trouble is, spinal fusion...umm...doesn't really work better than the alternatives (the safest of which is chiropractic care, by the way). Failure is common and risks are high. So why is it being performed?

Well, according to a study published this month in the Journal of the AMA, the answer is: It makes money. That's right, increasingly useless (and dangerous) surgeries are being performed purely for profit.

The writers at ChiroACCESS put it this way:

There is a lack of evidence-based support for the efficacy of complex fusion surgeries over conservative surgical decompression for elderly stenosis patients.  There is, however, a significant financial incentive to both hospitals and surgeons to perform the complex fusions.  Spinal stenosis is the most frequent cause for spinal surgery in the elderly.  There has been a slight decrease in these surgeries between 2002 and 2007.  However, there has also been an overall 15 fold increase in the more complex spinal fusions (360 degree spine fusions).  Deyo et. al. in yesterday’s issue (April 7, 2010) of the Journal of the American Medical Association concludes that  “It is unclear why more complex operations are increasing. It seems implausible that the number of patients with the most complex spinal pathology increased 15-fold in just 6 years.  The introduction and marketing of new surgical devices and the influence of key opinion leaders may stimulate more invasive surgery, even in the absence of new indications…financial incentives to hospitals and surgeons for more complex procedures may play a role…”  There is a significant difference in mean hospital costs for simple decompression versus complex surgical fusion.  The cost of decompression is $23,724 compared to an average of $80,888 for complex fusion.  Despite the much higher cost, there is no evidence of superior outcomes and there is greater morbidity associated with the complex fusion.  The surgeon is typically reimbursed only $600 to $800 for simple decompression and approximately ten times more, $6,000 to $8,000 for the complex fusion.

So if anyone suggests to you that you need spinal fusion surgery, first get a proper assessment of your condition by a chiropractic physician.

In some cases, surgery may be required. But the research is clear: Rarely is spinal fusion an appropriate option.

The Economics of Pharmaceutical Research

I'm starting to get a little worried that, with this post, two out of the last three posts involve comics. I really do read other things than the comics section of the local newspaper. Honest.

March Podcast — Brittle Bones and Bad Drugs

The March edition of the Alternative Healthpod is now available. If you are not a subscriber, you can listen to it here, or as always subscribe to it by clicking on this feed. You can also subscribe via iTunes. Show Notes:

Two new studies published last week show that long-term use of oral drugs prescribed to prevent osteoporosis may be associated with unusual fractures of the thigh bone -- in other words, they are weakening the bone they are supposed to strengthen.

The research is not the first to link the drugs, known as bisphosphonates, with fractures. Other research has found that these drugs also increasing the risk bone death in the jaw.

Dr. Melvin Rosenwasser, a professor of orthopedic surgery at Columbia University College of Physicians and Surgeons in New York City, and co-author of the study, said that when bisphosponates are "used beyond a certain point...they may actually be bad."

A second study looked at bone biopsies taken from the thigh bones of 21 women, all past menopause, who had suffered fractures at the site. Nine had not taken the drugs, while 12 had, for an average of 8.5 years.

The women on the bisphosphonates, researchers found, had 90% "old" bone, meaning that new bone was not being created in the women taking the osteoporosis drugs.

Source: American Academy of Orthopedic Surgeons Annual Meeting, 2010.

If you are taking osteoporosis drugs, or are concerned about your risk of fracture, please contact me immediately at 860-567-5727, or email me at alj@docaltmed.com.

A Video Is Worth How Many Words?

Apologies to my readers: The link to the video on this post got broken, and I have not been able to re-locate it. I will insert the new link as soon as I find it.

Alternative medicine is under attack as it hasn't been since the 1st District Court found the AMA guilty of antitrust violations in its ongoing war against chiropractic.

Pharmaceutical companies and "mainstream" medicine are feeling insecure as the sands of health care reform shift under their feet. And one thing they want to avoid at all costs is allowing chiropractic physicians an even playing field -- because they know that will unlock  the floodgates, allowing patients who are seeking alternatives to drugs and surgery to freely find the assistance they so desperately need. As a result, the distortions about alternative health care in general and chiropractic physicians in particular are piling up again.

This video sets the record straight. Although I am not its producer, many of the facts presented in this video are data that I have used frequently in my own writing and seminars. But, as they say, a picture is worth a thousand words.

Please watch it. And pass along the link to this page to anyone who you know who cares about the future of healthcare.

You Can’t Make This Stuff Up

Following on the heels of my previous entry regarding the absolute lack of credentials that MDs have in the field of nutrition, I discovered today that there is actually a movement afoot in the medical community to define an interest in healthy eating as a disease. I kid you not.

Their new "disease" is called orthorexia. Of course, they are defining an interest in healthy eating as an "obsession," but eating a raw foods diet, an Ornish diet, a vegetarian diet, a paleolithic diet, or essentially anything but an SAD (Standard American Diet), is considered prima facie evidence of an "obsession" with healthy eating.

Of course, if any of these doctors actually followed the nutritional research, they would know that the SAD diet is incredibly unhealthy. It is undeniably the root cause of both obesity and adult-onset diabetes, as well as the primary cause of heart disease.

In comparison, the diets which are claimed to be symptoms of orthorexia are actually quite useful for clearing up a variety of health problems, many of which were caused by the combination of a SAD diet and prescription drugs in the first place.

Of course, that brings us to the recommended cure for this "disease." It is drugs, of course! Specifically, antidepressants, because, by all means, a focus on improving one's health through diet is a sign of depression, right?

Err...no. Actually, quite the opposite. But that's a topic for another day.

What is also interesting is the background of some of the medical "authorities" promoting this imaginary illness.

Let me first point you in the direction of Steven Bratman, MD. No, I'm not going to post his URL here, because just reading that site makes me a little ill, but you can find it easily enough with the help of Mr. Google.

Bratman is a self-proclaimed "quackbuster," which means he ignores all research which disagrees with his preconceived opinions. He has also written a book, "Health Food Junkies," which -- surprise -- is all about this mythical disease of orthorexia.

Of course, Bratman has the qualifications to address nutritional disorders and therapeutics because, according to his biography,  he opened a now-defunct health clinic, where he "worked closely with a wide variety of alternative practitioners, and received training in acupuncture, herbal medicine, nutrition, massage, osteopathic manipulation, and body-oriented psychotherapy."

Ok. So this guy's qualifications are...he watched someone else do nutritional counseling? Holy cow, asking Bratman for nutritional advice would be like asking someone to pilot an airplane because they've watched a few take off.

He's also written a lot of books, mostly for the pharmaceutical industry, and serves as a "consultant" in alternative medicine, whatever that may be. Pretty good for a guy who, according to his own data, possesses no certifications, license, or formal education in the field of alternative medicine.

In fact, I would be willing to bet I have had more formal education in pharmacology -- drugs, that is -- than Bratman has had in clinical nutrition.

Unfortunately, people do listen to unqualified individuals such as Bratman, and thus incredibly inane ideas such as orthorexia get wheels.

All of this wrongheaded manipulation over proper eating reminds me of a case I had a number of years ago. A mother came to me concerned because she thought her teenage daughters should be on a diet. Of course, I agreed to evaluate the girls and see if there would be some way in which I could help.

A few days later,  the patients came in. I conducted a history and physical exam, and low and behold, the girls were healthy. While perhaps a bit on the high side of normal in terms of their body fat, they were still within the normal range. They were physically active, with no complaints. Their diet, while not the best in the world, actually included some fruits and vegetables, which I considered an astounding success for two late-20th-century adolescents.

In short, there was really nothing much to do.

I consulted with the parent, and said that the girls looked fine, and I thought any special diet was unnecessary.

Mom began arguing with me. "Isn't there some diet you could give them?" she asked.

I told her to bring the girls back in a few days, during which time I would do a more thorough analysis of their food journals and see if there were some pertinent recommendations that I could make.

When they came back,  they entered the office with an air of excitement and anticipation. And it slowly began to dawn on me what was happening.

I was the instrument of a rite of passage: A Girl's First Diet. Like menarche or a training bra, the Diet was a step on the pathway to womanhood, because, of course, dieting is something all women must do.

I brought the girls and their mother in, and sat them all down. I explained to them that I had reviewed their diets carefully, as well as their physical exam findings, and that the best thing that they could do for their diet would be to include more fish and have more vegetables, particularly cruciferous vegetables. They should also make sure they should drink plenty of water.

Their faces fell with disappointment.

"Don't you have a meal plan for us?" One asked.

"I don't really like fish," said the other.

"What about foods they shouldn't have?" said the mother.

I explained to the disappointed multitude that, in fact, their diets were already pretty good, except for the absence of omega 3 fatty acids, which would be satisfied by the inclusion of fish. I added that I saw no reason to restrict their foods or create an unnecessary diet plan to follow, given their overall good health.

Their disbelief was palpable. I had ignored all of the sacraments of this ritual, developed at the Church of Weight Watchers and practiced at the altar of Jenny Craig. There was no arcane list of proscribed foods. No complex eating plan. No admonishments against those foods which medical doctors consider bad for you, like butter, or whole milk, or red meat.

We went back and forth for a while; it really took a good 15 minutes to get through to them that I really didn't want them to restrict their eating, but rather they should just emphasize certain foods. After they eventually realized I was not about to capitulate to their desire for their First Real Diet, two confused girls and a rather angry mother left.

I don't know whether or not the girls eventually got their diet or not, but the encounter did get me thinking about how twisted the messages about healthy eating and good nutrition get in this society. Somehow, medicine and marketing have turned a wholesome diet full of a range of nutrients, with an emphasis on foods that do not contain pesticides, hormones, chemical additives and preservatives, into an illness.

Orthorexia? If it were really a disease instead of a chimera, I would wish that more of my patients suffered from it.

Bad Advice from the Wrong Source

Would you accept investment advice from a physical therapist? Would you do an exercise program designed by an attorney?

Of course not. While  those people may have expertise in their own field, they lack any qualifications for advising others outside of their field.

So why on earth do people listen to nutritional recommendations from their medical doctors?

Over the past few months, I have noticed with disturbingly increasing regularity, patients coming in and telling me that their MD has recommended that they take XYZ supplement or the herb Herpatoxicus hippocratus or some such.

Unfortunately, however, the quality of the advice which my patients are receiving is only slightly worse than that which they would get from the high school kid at the cash register of the local health food store.

In one case at my office, the recommendations so helpfully supplied by one of my patient's MDs was downright dangerous, because the MD was apparently unaware of the interaction between the nutrient she was recommending and the drugs that she had  herself prescribed!

Fortunately, I was able to rectify the error before it became an emergency room visit.

But increasingly, MDs are trying to provide their patients with nutritional advice when, in fact,  they really don't have any background, education, qualifications, training or clinical experience on which to base their recommendations.

In all likelihood, they are probably only repeating something which their friendly drug rep passed on to them. Which, according to more than one recent study, is how most MDs decide which drugs to prescribe. (Don't believe me? Look here. Or here.  Or here. Or...do you really need more?)

So, in short, most prescriptions are written by doctors on the advice of a good-looking 30-40 year old with a bachelor's degree, a hot car, and who buys pizza for the staff. (By the way, before you listen to any nutritional advice from any medical doctor, go check out the food in the staff room.)

Each day more than 101,000 drug company reps—one for every five office-based physicians—call on the nation's doctors. Primary care physicians, on average, have 28 interactions a week with drug reps, according to a 2005 report by the Health Strategies Group, a consulting firm for manufacturers of health care products.

Honestly, I'm feeling kind of left out. The last time I saw a rep from one of the nutrient companies whose products I recommend was two months ago.

But I'm afraid I got away from my main point here, which is that MDs are  "prescribing" supplements and nutritional regimens to their patients and they don't have a clue what they are talking about!

Seriously. You know how many hours of education an MD has in nutrition?

0

Ok, if you didn't get it the first time, I'll repeat it.

0. None. Nada. Zilch.

This wouldn't be so bad if they were actually honest with their patients, and said something like, "Gee, um, I really don't have a clue about how nutrition works, but this guy who was in my office the other day and brought us all egg rolls and pork fried rice told me he heard from another one of his clients that this works, and actually I suggested it to my cousin's in-law's sister, and she said it worked great, so I think you should take it."

Truthfully, this is the level of critical decision-making that goes on in an MD's brain when making nutritional recommendations.

Which is in part because (1) the average MD doesn't have a clue how clinical nutrition actually works, and (2)  as I mentioned above, most of their prescriptive recommendations are made on heresay, anyway.

In the medical/mechanistic model of the human body, MDs are taught basic one-to-one correspondences. Pain is paired with antiinflammatories; hypothyroidism is paired with synthetic thyroid hormone;  infection is paired with antibiotic.

Within that framework, there may be subsets of, for example, painkillers or antibiotics. But the one-to-one correspondence is the essence of modern medical thinking.

In comparison, approaching a health problem from a nutritional  point of view requires that you look beneath the condition to the process which created the condition. You then alter that process, by altering the environment in the body which allows that process to exist. When the environment is no longer conducive to the behavior, the process is discontinued and the symptoms resolve.

So there can be no one-to-one correspondence, because many different processes can cause the same problem.

Take osteoarthritis, for example. The typical MD approach is to (1) prescribe a painkiller and (2) recommend (or "prescribe") glucosamine or chondroitin sulfates.

All well and good, except for the fact that glucosamine actually doesn't work that often. It does work in the percentage of the population whose chondrocytes actually have the ability to utilize the additional glucosamine, or people who are glucosamine deficient. In short, probably about 20-30% of the population.

On the other hand, what I and other alternative physicians try to do is understand where the body's processes have gone awry, and for what reason. So for four patients with "osteoarthritis," one might recieve chiropractic manipulation, one might recieve MSM, one might recieve Chui Feng Tou Gu Wan, a third will be placed on a detoxification diet, and the fourth will receive omega-3 fatty acids.

That's how nutrition is done. Unlike medicine which is pathology-oriented, clinical nutrition is process oriented, not pathology oriented.

And it is this basic, fundamental concept that MDs don't understand,  which only compounds their overall lack of knowledge about nutrition.

So my recommendation to anybody is: Take any nutritional recommendation from an MD with a grain of salt.

(By the way, did you know that salt plays a role in high blood pressure in only 10 percent of those who have this problem? I'll bet your MD didn't.)

Secondly, if you receive a nutritional "prescription" from an MD, for your own safety, consult with a chiropractic physician before taking it.

And, finally, for any medical doctors who are reading this (fess up, I know you do): For your own patient's safety, please refrain from making nutritional recommendations and refer your patients to a doctor more appropriate for this type of therapeutic intervention.