From time to time I see advocates of alternative medicine recommending various pseudoscientific remedies to fellow vegans. I think it’s quite frightening in many ways, but more seriously – it fuels the stereotype of an irrational vegan.

 Homeopathy

Homeopathy is something that still is being recommended by various people and even used at medical centers in some cases. It’s commonly seen in health stores in many parts of the world. So what is the idea of homeopathy? Homeopathy is based on the belief that if one takes a compound and dilute it enough, it would have a therapeutic opposite effect. Let’s take a look at how the Society of Homeopaths puts it:

“Homeopathy is a system of medicine which involves treating the individual with highly diluted substances, given mainly in tablet form, with the aim of triggering the body’s natural system of healing […] Homeopathy is based on the principle that you can treat ‘like with like’, that is, a substance which causes symptoms when taken in large doses, can be used in small amounts to treat similar symptoms. For example, drinking too much coffee can cause sleeplessness and agitation, so according to this principle, when made into a homeopathic medicine, it could be used to treat people with these symptoms.” (The Society of Homeopaths, 2016)

Homeopathic remedies are usually diluted so much, that not even a single molecule of the original compound are likely to be present in the solution since they are diluted beyond Avogadro’s number. The dilutions are serially diluted according to a decimal or a centesimal potency scale, which go way beyond Avogadro’s number – which is not exactly, but somewhere in the realms of 1:1000000000000000000000000. The allowed arsenic levels in American drinking water is about 1:100000000 (EPA, 2015). The dilution above is just an intermediate dilution, for the more “powerful” dilutions one could probably add a couple of hundred zeroes. There are many analogies to explain how many masses of planets one would have to drink every day to get a single molecule after hundreds of years, but I think you get it – they are very diluted. It’s essentially water.

There is an obvious problem here. For homeopathy to work, there must be some fundamental misunderstanding of how chemistry works. Water must have some type of undiscovered “memory” for homeopathy to even have a theoretical plausibility.

Colloidal silver

Drinking water might not be directly harmful but when it comes to a different alternative medicine remedy it’s a different story. Colloidal silver is a solution of tiny silver particles sold in bottles to be used for various proposed applications. Silver has some antibacterial properties since it’s toxic to bacterial cells in vitro. Thus, silver has been used for quite some time to coat surfaces in medicine and science to inhibit growth of bacteria. It’s worth to mention that the efficiency has been questioned of different applications of coated silver products (Li, Yuan, Wang, Du, & Deng, 2012).

Now we turn to a problem that seems to infest the minds of practitioners of alternative medicine in general and maybe not only the advocates of colloidal silver. Many different things kill bacteria in a petri dish, lots of things. That doesn’t automatically mean that the given treatment is suitable as a medication. Fire, arsenic and handguns are all capable of killing bacteria in vitro, but there is a slight difference between fire and penicillin – the suitability and safety as a drug. Gamma radiation is also efficient at killing microorganisms and is widely used for that purpose. But we tend to not use gamma radiation to sterilize a patient with a bacterial infection – since it’s likely to kill the patient. How about colloidal silver then? The National Center for Complementary and Integrative Health, an organization under the NIH (National Institutes of Health says:

“Scientific evidence doesn’t support the use of colloidal silver dietary supplements for any disease or condition”. Scientific evidence does however support well-known adverse effects such as argyria. Additionally it can inhibit the uptake of several real drugs. FDA warned in ’99 that “colloidal silver isn’t safe or effective for treating any disease or condition” (NIH, 2004).

FDA have also advised consumers about the lack of benefit and the risks of using colloidal silver (FDA, 2014).

In Sweden the government has prohibited the sales of colloidal silver marketed as a medicine and/or food supplement (Medical Products Agency, 2015). However, alternative medicine advocates still sell colloidal silver with a disclaimer that it should only be used as a water purification agent. This is just to circumvent the law and make the illegal health claims verbally instead. Here is an example of this.

I’ve also come across the argument that one uses colloidal silver instead of antibiotics because of the threat of antibiotic resistance. First of all, if you don’t “believe” in science-based medicine, how do you think antibiotic resistance is a threat? Secondly, if you do use antimicrobial products that do not have any effect, you actually pose a risk of resistance development for real applications of silver in medicine. Lastly, the major threat of antibiotic resistance is not patients that have a treatable diagnosed bacterial infection that take prescription antibiotics and follow through the treatment. 

Other alternative medicine

There are of course a vast number of alternative medicine teachings, remedies and schools I could discuss here. However, the unifying factor for alternative medicine is that they do not work, or work in the way they claim they do. They are not backed up with science and if they were, they would be called medicine. There are active substances in herbal medicines sold, but it’s problematic that the regulations are lacking, competence of sellers and the suitability for a given condition is questionable. Again, that an herb contains a pharmacological active substance do not automatically render it a suitable drug. If the effect is truly beneficial, we could produce real safe drugs using that molecule instead.

Big pharma

One of the most persistent arguments that advocates of alternative medicine use to justify their consumption of quackery products is that they do not want to support “big pharma”. This would be the big pharmaceutical companies that develop and sell pharmaceuticals. The main argument is that big pharma have large profits, unethical behavior and somehow controls the scientific field of medicine.

First of all, pharmaceutical companies typically have quite large revenue. At first glance, it might seem unethical to profit on people who are in need of healthcare. Thing is, developing drugs is really expensive. The average cost of developing a drug that reaches the prescription market is 2.6 billion USD (Mullin, 2014). As a reference that is roughly a third of the entire Swedish budget for healthcare 2016 (Sweden has free healthcare) (Government Offices of Sweden, 2015). To be able to afford the development of new drugs, it’s quite obvious that the companies developing the drugs need to get this money from somewhere – profit from other drugs. Eventually the patents run out and the production of generic drugs starts, which dramatically lowers the price. One could argue that one favors a different system, but I don’t think that boycotting pharmaceuticals is the way to change the fundamental economic system.

There are many absurd claims about “big pharma” from various advocates of alternative medicine such as they would “hide” the cure for cancer. This is of course utterly ridiculous. I’m pretty sure no one wants cancer, not even people employed by pharmaceutical companies. Cancer is an extremely complex array of hundreds of diseases that share the genomic characteristics of malignant cell growth. A single cure for all cancers is unlikely, and even more unlikely is that single cure being a quack-juice.

“Big placebo”

The ironic thing about practitioners of alternative medicine that don’t want to support “big pharma” is that the alternative medicine industry is quite a big industry with large revenue as well. In the US, the out-of-pocket expenses for alternative medicine are mind-blowing 11.2% of the total costs of healthcare. There seem to be big money to be made in the business of selling alternative medicine. Even better, in the alternative medicine business, one does not have to pay for expensive trials and evaluations of the safety and efficiency of the product one sells. I would hope that people the buy alternative medicine realize that instilling conspiracy theories about “big pharma” is in direct economic interest of practitioners of alternative medicine. Since some time ago, one cannot sell food supplements with making health claims that doesn’t have scientific evidence in the EU (European Comission, 2015).

The anecdotal evidence and distrust in science based medicine

Typically health claims of alternative medicine are based on anecdotal evidence. Meaning that people put trust in a statement given from someone who claims that: “it worked for me”. There are several immediate problems with using anecdotal evidence for  – anything. The most obvious problem is that a single data point of a subjective experience is just that. One does not know the distribution, standard deviation or if the point is representative for the data. Anecdotal evidence do not control for confirmation bias, placebo, belief bias, false causality claims and most importantly – confounding factors.

The false causal link between treatment and recovery is probable the most common mistake done by people who use anecdotal evidence. As an example, you have a cold – a common virus infection. You go to a homeopath and buy some expensive water and use that as instructed for the following days. You feel better after a few days and think, “well, that really worked”. But, you will get better from a cold almost regardless of what you do (you can of course make it worse) since you have an immune system. Your use of the homeopathic remedy only coincided with the recovery; it did not cause the recovery.

The demographics of the use of alternative medicine seem to be a bit contradictory. In the US, the use of alternative medicine is more prevalent in the high income high education group (NCCIH, 2008). But as an example, among women with breast cancer, the use of alternative medicine is a marker for greater psychosocial stress and lower quality of life (Burstein, Gelber, Guadagnoli, & Weeks, 1999). I speculate that one of the reasons why people turn to alternative medicine is that they feel that the science based medicine didn’t meet up their expectations or that they didn’t get the help that they need. Science based medicine is not able to cure all conditions nor can it even help relive all symptoms. However it’s a false dichotomy that since science based medicine can’t – alternative medicine will.

Placebo

Placebo is a real thing. That’s why scientist performing clinical trials includes placebo groups in placebo-controlled double-blind trials, which is sort of the gold standard of clinical trials. Even though placebo is a real thing, one should not over-exaggerate the beneficial effect of placebo. Typically placebo is a bias one wants to get rid of when conducting trials. Placebo seems to be able to relieve the subjective experience of having a particular condition or pain, it cannot do anything about the actual underlying condition, disease or cause (Hróbjartsson & Gøtzsche, 2001). Placebo could maybe help relieve the pain for a cancer patient, but it will not have an effect on the actual cancer.

So what is the problem, why can’t we sell placebo products if it helps people?

Symptoms are the reason why patients seek medical attention in the first place. For some diseases such as cancer it’s absolutely vital that the diseased is diagnosed as early as possible to reduce mortality. If one starts to feel symptoms, use placebo without seeking medical attention, and the symptoms are relived. The risk is that the patient waits longer to seek medical attention if the symptoms are treated with placebo. The problem is that many people who use alternative medicine are actually in the belief that they do actually help curing the underlying cause of the symptoms, which is simply not true.

The unethical behavior of practitioners of alternative medicine is that they do not disclose that the products they sell are merely placebo and don’t have an actual physiological effect. Them believing in it themselves is not an excuse. If you think it’s unfair of “big pharma” to profit on sick people, well, alternative medicine profits on sick people without actually helping at all.

I wouldn’t have a problem if the people selling these products were open with that the products they sell do not actually have any effect, and that the consumers were aware of that the products do not have any effect other than placebo, and should never ever replace science based medicine. Thing is, placebo might work even if you are aware of that you are given a placebo medicine (Kaptchuk et al., 2010).

Conclusions

As we have seen, alternative medicine is simply remedies without any scientific evidence for efficiency against symptoms and diseases. Once/if they do, they would just be called medicine. Keep in mind that, things that have been thoroughly tested without any positive results are highly unlikely to have a still have an ‘undiscovered effect’ since if it had clinically significant effect, it would probably been seen already given adequate experimental design. There are no reasons to not trust in science when it comes to medicine (or anything for that part). Science is by far the most efficient method in acquiring trustworthy information.

People who profit on sick people who might have had unsuccessful conventional treatments are in my opinion deeply immoral. Either they don’t care or they don’t realize that their fraudulent behavior actually hurts people – I don’t know what is worse.

I really want to passionately disconnect alternative medicine with veganism, there is no reason what so ever for the seemingly overrepresentation of belief in alternative medicine within the vegan community. I would prefer if there were sufficient alternative methods to animal testing in the pharmaceutical industry, but I don’t think boycotting of medicine is in any sensible way the way to go. I’m very doubtful that it would have any effect at all. The demand for cheap reliable alternatives to animal testing exists, since animal testing is really expensive. A healthy and living vegan can do much more good than a sick or dead vegan that refused real medicine.

References

Burstein, H. J., Gelber, S., Guadagnoli, E., & Weeks, J. C. (1999). Use of Alternative Medicine by Women with Early-Stage Breast Cancer. New England Journal of Medicine, 340(22), 1733–1739. doi:10.1056/NEJM199906033402206

EPA. (2015). Chemical Contaminant Rules. Retrieved January 28, 2016, from http://www.epa.gov/dwreginfo/chemical-contaminant-rules

European Comission. (2015). Health claims. Retrieved February 7, 2106, from http://ec.europa.eu/food/safety/labelling_nutrition/claims/health_claims/index_en.htm

FDA. (2014). Consumer Advisory: Dietary Supplements Containing Silver May Cause Permanent Discoloration of Skin and Mucous Membranes (Argyria). Retrieved February 7, 2016, from http://www.fda.gov/food/recallsoutbreaksemergencies/safetyalertsadvisories/ucm184087.htm

Government Offices of Sweden. (2015). Statens budget 2016 i siffror. Retrieved February 7, 2016, from http://www.regeringen.se/artiklar/2015/09/statens-budget-2016-i-siffror/

Hróbjartsson, A., & Gøtzsche, P. C. (2001). Is the Placebo Powerless? New England Journal of Medicine, 344(21), 1594–1602. doi:10.1056/NEJM200105243442106

Kaptchuk, T. J., Friedlander, E., Kelley, J. M., Sanchez, M. N., Kokkotou, E., Singer, J. P., … Lembo, A. J. (2010). Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. PLoS ONE, 5(12), e15591. Retrieved from http://dx.doi.org/10.1371%2Fjournal.pone.0015591

Li, X., Yuan, Q., Wang, L., Du, L., & Deng, L. (2012). Silver-coated endotracheal tube versus non-coated endotracheal tube for preventing ventilator-associated pneumonia among adults: A systematic review of randomized controlled trials. Journal of Evidence-Based Medicine, 5(1), 25–30. doi:10.1111/j.1756-5391.2012.01165.x

Medical Products Agency. (2015). Läkemedelsverket förbjuder försäljning av Ionosil Kolloidalt Silver med olika påståenden om läkemedelseffekt. Retrieved February 7, 2016, from https://lakemedelsverket.se/Alla-nyheter/NYHETER-2015/Lakemedelsverket-forbjuder-forsaljning-av-Ionosil-Kolloidalt-Silver-med-olika-pastaenden-om-lakemedelseffekt/

Mullin, R. (2014, November 24). Cost to Develop New Pharmaceutical Drug Now Exceeds $2.5B. Scientific American. Retrieved from http://www.scientificamerican.com/article/cost-to-develop-new-pharmaceutical-drug-now-exceeds-2-5b/

NCCIH. (2008). The Use of Complementary and Alternative Medicine in the United States. Retrieved February 7, 2016, from https://nccih.nih.gov/research/statistics/2007/camsurvey_fs1.htm#most

NIH. (2004). Colloidal Silver. Retrieved February 7, 2016, from https://nccih.nih.gov/health/silver#hed2

The Society of Homeopaths. (2016). ABOUT HOMEOPATHY. Retrieved January 28, 2016, from http://www.homeopathy-soh.org/about-homeopathy