Prepare yourselves for yet another collection of the various odds and ends from the world of irregular medicine that I’ve collected over the past few days.

“I am an educated, vaccine-choice mother.”

The ongoing saga of a 9-year-old Michigan child caught between the push and pull of divorced parents was covered in typical extensive detail by a friend of the blog yesterday, but I will provide a quick synopsis. The boy’s father had successfully petitioned the courts nearly a year ago to ensure that his child received the full protection of the recommended vaccine schedule. Despite this, the child’s mother refused even after being given an ultimatum by a judge last week.

Yesterday it was reported that she will be jailed for 7 days and that the child’s father will be granted temporary custody. This will allow the child to receive any vaccinations necessary to be caught up. As is often the case, the media has not done the best job covering this issue. In the Respectful Insolence post linked to above, Orac describes the false balance that has been employed by the press and also the disgusting response from the anti-vaccine community. Essentially, they are going after the boy’s father and even implying that he hopes that his child will die from a vaccine injury so that he won’t have to pay child support.

Meanwhile, the mother has admitted to lying about her impetus for refusing vaccinations, after initially going the route of claiming religious reasons. It appears, however, that she evolved from a position of vaccine hesitancy, with acceptance of a delayed/spaced out schedule, to 100% anti-vaccine based on her own personal research. She also is attempting to wield the banner of vaccine choice, implying that in part she is also refusing because she objects on principle to being forced to vaccinate her child.

Regardless of the outcome, this child is likely going through a very tough time. I’m happy that at least he will be protected from vaccine-preventable diseases. I do worry, however, that the this high profile parental battle might distract from a possible need for counseling to help him have as successful a transition as possible through this difficult period in his life.

Un duo d’absurdité d’acupuncture!

Acupuncture has been covered many times on the pages of Science-Based Medicine, and I don’t see any signs of it going away any time soon. Cases in point, two examples of acupuncture related nonsense came to my attention this week. The first involved a study on acupuncture for menstrual pain that was first reported on back in July, when it was published in PLOS One, and again this week for some reason.

In the study, 74 women were randomized to one of four arms. This included manual and electroacupuncture that was subdivided into high and low frequency of treatments. Each subject underwent 12 treatments over 3 months, with the high frequency group receiving 3 close together at the start of each period and the low frequency group receiving 1 each week. The primary outcome was reduction in peak menstrual pain after 12 months, but they looked a number of other pain and quality of life measures several times during the course of the study.

They found that the type and frequency of acupuncture didn’t matter much when it comes to subjective reports of menstrual pain, with all groups having statistically significant improvements, but manual treatment resulted in less pain medications being taken. The authors admitted that they actually expected the opposite to be found. Subjects getting three treatments close together at the beginning of each period had statistically significant improvements in more subjective quality of life measures compared to the once a week group.

This study is fairly worthless, despite claims being made by the authors and in the press, and certainly doesn’t do much to counteract the lack of plausibility that shoving needles into the skin would improve menstrual pain. The authors suggest that there may be an anti-inflammatory effect, however. But it’s a small study with just a handful of subjects in each arm, and there were significant numbers of patients lost to follow-up.

Other than the distinction of manual versus electroacupuncture, and treatment frequency, there was no consistency to the treatments at all in regards to where the needles were stuck. Also some got moxibustion, some didn’t. Each treatment might have been completely different based on subject feedback to the provider. Subjects also got diet and lifestyle advice.

This was a pragmatic pilot study, which is dumb. You have to prove that there is an effect before you run a trial without blinding, because numerous placebo effects can skew the results, and most of the subjects said that they expected the treatment to work. This is now commonplace in acupuncture research, unfortunately, I assume because acupuncture doesn’t work and research with good methodology wasn’t any fun.

Because it’s such a worthless study, no conclusions can be drawn. That being said, it was interesting that there were no differences between manual acupuncture and electroacupuncture for any pain outcomes. In both groups, there was manual insertion of the needle and manipulation until the power of suggestion resulted in the sensation of de qi, which is believed to signal that the acupuncture is working. In the electroacupuncture group they just also ran some juice through the needles. So if taken at face value, which I wouldn’t recommend, this implies that the electricity wasn’t necessary.

But manual acupuncture appeared to be better in the only objective outcome, how much pain medication the subjects needed. It’s just noise, but again if this were legitimate data it would seem that the electric current actually made things worse for subjects. But, again, for reals, it’s all nonsense and it makes me sad.

The second example of acupuncture nonsense is considerably more concerning. It involves an article from Medical News Today on the treatment of diabetes using various forms of acupuncture. It gets the history and epidemiology of acupuncture wrong, making the claims that it’s ancient, commonly used for diabetes in China, and that acupuncture is increasing by leaps and bounds in the United States. It isn’t…at all.

The author also claims that research supports the use of acupuncture for diabetes, as if there is just one diabetes. The studies it bases this conclusion of acupuncture safety and benefit on are terribly cherry picked. They include one study in rats and two in Acupuncture in Medicine, not exactly an unbiased source of peer reviewed research. The article makes the claim that acupuncture is safe, but failed to mention this.

Who says we can’t learn anything from naturopaths?

Naturopathy is nonsense, employing all manner of unproven, disproven, and not even wrong approaches to health. Here is an example, one of many, where a patient suffered at the hands of a naturopath. The patient, diagnosed with gallstone disease, suffered acute liver failure after being advised by a naturopath to consume large amounts of hydrous magnesium sulfate, more commonly known as Epsom salt, in order to flush the stones out. There isn’t a shred of evidence to support this, although it is a common recommendation from people practicing medicine without a license.

Despicable Him

I have said for many years that the most despicable claim I’ve ever encountered from practitioners of alternative medicine was that chiropractic care of newborn infants can prevent SIDS. I stumbled upon a new low this week. In this video, Chiropractor Dan Barrett makes the claim that the man who only just a few days ago gunned down 58 people in Las Vegas would not have done so had he been undergoing regular chiropractic care since infancy.

This isn’t surprising considering that Barrett is a Maximized Living chiropractor, a concept which I discussed in my last post. This means he is a hardcore straight practitioner advocating a dogmatic philosophical approach that is anti-science, anti-vaccine, anti-germ theory, etc. It typically employs fundamentalist Christian beliefs as well. And while this was the only example I could find of a chiropractor making specific claims regarding the prevention of mass murder, there are many examples of chiropractors claiming to treat various forms of mental illness.

See ya next time!

Sorry for the brief (for me) and unfocused installment. In two weeks, I’ll have a post with a little more substance. I’ve been meaning to take the AAP to task for their approach to alternative medicine for quite a while, and I think I’m ready.

Posted by Clay Jones

Clay Jones, M.D. is a pediatrician practicing at Newton-Wellesley Hospital in Newton, MA, and a regular contributor to the Science-Based Medicine blog. He primarily cares for healthy newborns and hospitalized children, and devotes his full time to educating pediatric residents and medical students. Dr. Jones first became aware of and interested in the incursion of pseudoscience into his chosen profession while completing his pediatric residency at Vanderbilt Children’s Hospital a decade ago. He has since focused his efforts on teaching the application of critical thinking and scientific skepticism to the practice of pediatric medicine. Dr. Jones has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @skepticpedi and is the co-host of The Prism Podcast with fellow SBM contributor Grant Ritchey.