Category: Medicine

Gluten sensitivity: is it a thing?

First off, there is most certainly a real medical condition called celiac disease. It involves a measurable immune reaction to foods that contain gluten. Gluten is a protein-starch complex (but often described in non-technical and medical writing as just protein) found in some grass seeds, such as wheat, rye, and barley, but not others like rice and corn. It is not found in any foods other than those made from these specific grains.

Celiac is apparently found in about 1% of the population.

Some medical authorities and lay people also assert the existence of “Non-Celiac Gluten Sensitivity” (NGCS). As you might expect, this describes people who are sensitive to gluten in some way, but not through the (partially) known mechanism of celiac disease. To quote a BBC article by “Doctor Chris” van Tulleken, “Although many people who do not have coeliac disease claim to suffer gut symptoms like bloating and nausea when they eat gluten – and even other things like “brain fog” and tiredness – these have not been linked to any physiological changes that can be measured and hence used to make a clinical description and diagnosis.”

Someone with my background wonders if a claimed syndrome that has such a wide variety of symptoms which correlate to nothing measurable might be a result of pareidolia, the tendency of the human brain to find patterns in noisy data, even when no such pattern is real. Examples of what I have just named “pareidolic diseases” include Morgellon’s Syndrome, chronic Lyme disease, and Candidiasis/Yeast Allergy. They share having relatively common, non-specific symptoms (e. g. fatigue, stomach upset) and not being detectable by any lab tests, even when (as with Lyme disease) there is a well-known, effective test available.

Dr. van Tulleken’s “Trust Me, I’m a Doctor” team conducted a study to test the reality of NCGS. The found 60 people, some of whom claimed to experience NGCS, and put them on a gluten-free diet including (experimenter-supplied) gluten-free pasta, but for two weeks (randomly selected?) of the study period, each was given pasta containing gluten instead. The team then analyzed the subjects’ reported symptoms, and also performed lab tests to show inflammation and IgE (antibody) levels. The study was double-blinded, in that neither researchers nor subjects knew in which two week period the subjects were eating gluten until after the study concluded. The subjects acted as their own controls by experiencing both with- and without-gluten diets.

The results: subjects did in fact report feeling fewer gut-related symptoms like bloating during the gluten-free weeks. Variation in other symptoms (e.g. tiredness) was not statistically significant. There was also no significant correlation between gluten-free diet and the lab values being measured.

Dr. van Tulleken does state in the linked BBC article that it’s likely at least some subjects knew which weeks they were eating gluten-containing pasta. And as he concedes, this can easily explain the slight variation in the digestive symptoms.

A weakness he apparently did not realize in his analysis: the two pastas are very clearly made with different recipes. It’s perfectly possible that the gluten-containing pasta that was used has some other difference from the gluten-free one that explains the gut symptomology, perhaps an herb or a preservative that some people are really slightly sensitive to. It’s  possible that the gluten-containing pasta just has less fiber (for one possible example), and that the additional fiber in the gluten-free food aided the subjects’ digestion. Dr. van Tulleken doesn’t provide the recipes/brands for the two foods, making it hard to speculate beyond that guess.

Also, the subjects were eating food they selected and purchased themselves, aside from the pasta. Since as far as one can tell from the BBC article they weren’t asked to record their consumption, it wouldn’t be difficult for this dietary variation to randomly cause one group to score higher on some symptoms.

I’m surprised that Dr. van Tulleken did not report whether the self-diagnosed NGCS sufferers showed greater incidence of gut symptoms than the non-diagnosed. If NGCS is real (and not universal in the population) then a difference between NGCS patients and the rest of the subjects would certainly exist.

It is not stated in the article, but I suspect Dr. van Tulleken’s group does not plan to publish these results in a peer-reviewed journal, which seems to me to be disappointing. I’d love to read in more detail about the protocol and results.

As published, the results seem completely compatible with NGCS being a pareidolic disease. They are also consistent with NGCS being a real syndrome, but with only a small effect (at least in the experimental circumstances). Note that with its weak protocol and small sample size (n=60) it isn’t strong evidence for anything.

I suggest that Dr. van Tulleken’s group or someone else repeat the experiment but with the subjects eating identical diets (entirely supplied by the experimenters, ideally, not just gluten-free with the subjects buying their own food). However, each subject would be required to swallow 10 identical capsules per day. For the “control” period the capsules would contain a non-gluten protein. For the “experimental” period, the capsules would contain gluten proteins. That would make it impossible for the subjects to detect which weeks include gluten from the flavor/texture of their food, and also eliminate the possible effect of other ingredients in the two different pasta recipes.

You’re fat because toxins

So I bought some groceries today, and this store has ads on the back of its receipts. I got this one.

phountain

So this … establishment is claiming that overweight (but only between 10 and 40 pounds of it?) is caused by both toxins and acid?

No.

I suppose, in some cases, overweight could be caused by real toxins. Say they cause dropsy. You just can’t remove toxins by bathing your feet in water and minerals. This is clearly the “Ionic Foot Bath” scam. They literally claim that the system draws toxins out through the soles of the feet–that is, some of the thickest, most impermeable skin the body has. It’s literally a con game. The bath shown above (illustrated better at the linked article) contains a water-based solution that turns black after you submerge your feet in it. The claim is that the discoloration is the toxins dissolved in the water. The truth is that the water changes color whether or not you put your feet in! It’s just iron compounds created the apparatus itself.

The acid part sounds like traditional pH quackery, which attributes various diseases and syndromes to the body’s being too acid or basic (pH imbalance). As Dr. Steven Novella explains here, the body just doesn’t work that way. If you’re “too acid” you’re in immediate danger of death, not just overweight.

With some trepidation I checked out their web site. Phountain Health is a pretty full-service stuff-not-actually-shown-to-work company. The first item on their site is a “Detox Body Wrap”. They sell dietary supplements, a “Vitamin D sun bed”, alkaline water, dietary diatomaceous earth (which is literally dirt they recommend you eat), and many other things. Oddly, no foot bath seems to be listed. They do list cryotherapy.

You should be ashamed of yourselves, Stop and Shop. That’s two of the three remaining major grocery chains near my home, what with Best Yet Market‘s homegrown pseudoscience.

Torment your children and maybe kill your neighbors in the name of “natural”

Yeah, that’s an inflammatory headline. And it’s true.

A “Naturopathic Doctor” named Heather Dexter didn’t get her children vaccinated and refused to treat them for pertussis (whooping cough) She originally bragged about this at her own blog at likemindedmamas.com, but has now deleted that article.

Read the above-linked article by Scott Gavura, or the one by Dr. David Gorski. This woman permitted her children to get a life-threatening illness, and refused to give them effective treatment even when both her husband (their father) and her own father were begging her. Instead she gave them worthless nostrums like Olive Leaf Extract and worthless therapies like enemas (!) and foot massages. That’s already enough to make me despise her.

Now consider two things:

  1. She sent her infected children out to play with other children! She home-schools, but her son went to gymnastics class and they all played at the school playground. Any child who has a weakened immune system (say, because of treatment with certain drugs) or was simply unlucky and wasn’t protected by vaccination, could get this terrible, painful, potentially fatal disease.
  2. Dexter is a “doula”. This word has no legal definition, but typically means a person who assists a mother during labor and childbirth in non-medical ways. This means that she was potentially exposing newborn infants, who can’t be vaccinated, to pertussis.

It’s clear from her writing that she doesn’t even acknowledge how bizarrely irresponsible she was being.

Regular readers of this blog will remember my previous posting about naturopathy, in which I criticized a naturopathic “doctor” I called Rick. Rick is at least two steps above Dexter. He most certainly would not leave pertussis untreated or risk its spread. And Rick has now stopped practicing naturopathy to take up the honorable profession of teaching. (If he’d stop calling himself doctor because of his wizard school degree, it would be better, but I give him credit for doing the right thing.)

As for Heather Dexter: she’s a horrifying potential killer who is so far in denial she doesn’t even know it. Disgusting.

Facilitated Communication leads to sexual assault

Let’s start with the key point: Facilitated Communication (FC) is nonsense. In FC, a person who can’t communicate by speech, use a keyboard even with mechanical or electronic help, or otherwise produce words, is helped (facilitated) by a person who holds his/her hand and moves it toward what is perceived to be a desired letter. It’s described here: http://www.asha.org/policy/TR1994-00139.htm#sec1.3. There are variations on the technique as I described it, but they all involve a facilitator sensing subtle muscle movements by the person they’re assisting and using that to pick letters or symbols.

Also, it is nonsense–did I mention that? Facilitated Communication is identical to Ouija Board readings or automatic writing. Psychology and neuroscience class them all as ideomotor response. It is the “facilitator” who is communicating, not the person ostensibly being assisted. This has been tested by (for instance) setting up experiments in which the facilitator knows something that the assistee does not. In all such (well-designed) experiments, the results of the test have the “speech” produced match the facilitator’s knowledge.

The facilitators do not appear to be consciously faking. Like Ouija Board users, they’re unconsciously moving the other person’s hand. And because this is an unconscious process, they can produce messages they would never consciously write in their own names. FC has led to charges and convictions of child abuse, for instance. Recently one Dr. Steven Laurys claimed that FC (by speech therapist Linda Wouters) demonstrated that a brain-damaged patient was fully conscious but couldn’t control his own body enough to communicate. To his credit, Laurys did further tests that did indeed demonstrate the the patient was not communicating at all.

Now for the latest bizarre tragedy caused by belief in FC. Dr. Anna Stubblefield, a professor of Philosophy at Rutgers, has just been convicted of sexually assaulting a man who has cerebral palsy. She claims that he is not mentally disabled and that they fell in love, despite his lack of speech, by communicating through FC. A jury has found that “D. J.” is mentally incompetent and cannot therefore give consent. D. J. is not paralyzed and can move his arms, although his condition makes him less dexterous. It isn’t clear from the story (and in fact isn’t clear in many FC cases) why he couldn’t simply point at an alphabet board, if he really was mentally capable of literacy.

Apparently Stubblefield had sex with him multiple times.

Realize that any messages Dr. Stubblefield received were from her own brain–just not the parts that normally are thought of as “the conscious mind.” In other words, she literally fell in love with herself (or more fairly, with the story she was telling herself) and then had sex with this disabled man.

She was the chair of a respected university’s philosophy department at the time, but somehow didn’t manage to learn the central lesson of science, and of the skeptical movement: doubt your own judgement. A true tragedy.

Quietly Doing Nothing

Whenever I listen to the local news radio station, I hear ads for Quietus®. Quietus is a remedy for tinnitus. Tinnitus is a condition in which a person hears sounds, often roaring, humming or whistling, which are not perceptible to anyone else. In severe cases these sounds can interfere with hearing and understanding speech or enjoying music, or even prevent sleep. In many cases there is little medicine can do for tinnitus sufferers.

Medical conditions that can’t be easily cured by medicine are a natural target for medical nonsense. Quietus is (in the writer’s sole opinion) a fine example of something that couldn’t possibly work but is making money for its makers.

Quietus is a “dual homeopathic” medication. This means it has two supposed ingredients. However, most homeopathic medications in fact contain literally nothing. Homeopathy is an antiquated and unscientific pseudo-medical system based on these premises:

  1. Like cures like–that is, treat a disease with medication or medications that cause the same symptoms, and
  2. The smaller the dose, the more powerful the effect of medication.

Both are silly, but the second is what makes it impossible for homeopathic “drugs” to work. In most cases, commercial homeopathic remedies are diluted so much that none of the so-called active ingredients are actually present!

Quietus’ web site contains a page titled “Quietus® Homeopathic Treatment A Study by Dr. Thomas Latino, Ph.D.” The contents are not a study in any academic sense, however, just a description of the product’s ingredients and their traditional uses.

Quietus contains:

  1. Apis Mellificais which is obtained by soaking honeybees in alcohol.
  2. Aristolochia Clematis, also called “birthwort”.
  3. M. Chamomilla, German chamomile.
  4. Lachesis Mutusis,  venom from the African Bushmaster.
  5. Thuja Occidentalis or arbor vita, more commonly known as white cedar or eastern white cedar (although it is not a botanical cedar).
  6. C. Officinalis (presumably the pot marigold, Calendula officinalis).
  7. K. Phosphoricum, which they also refer to as “Potassium of Potash”. This is chemical gibberish, presumably they mean just “potash”, which is potassium phosphate (and which some homeopaths call “Kali Phosphoricum” to make it sound more technical or mystical or techno-mystical or something).
  8. Salicylic Acid, a chemical found within some plant tissues (most famously willow bark).

[sic] for all the above organisms–in biology species names don’t start with a capital letter, but Dr. Latino consistently writes them incorrect. “Thuja Occidentalis” should be Thuja occidentalis, for instance.

It’s interesting reading the above-linked “Study” page because it says right at the top, “Homeopathic potencies accredit their strength and efficacy to the electromagnetic signatures of the original substrate. These are scientifically created dilutions and successions of medicines such that generally not even a molecule of the original substrate or medicine is present in the medicine.” They admit up front that their product has no active ingredients but claim that “electromagnetic signatures” of these nonexistent chemicals somehow cure tinnitus. I don’t think you’ll find any physicists or chemists who can identify what “electromagnetic signatures” even means in this context.

Notice the weird melange of ingredients, very typical of magic-mongers. It includes extracts from living things (an animal and several plants), a very simple chemical (potassium phosphate), and an organic molecule (salicylic acid).

The key single thing to notice on the “Study” page is this: the author doesn’t list any claims that any of the ingredients help tinnitus. Even accepting at face value all the claims of homeopathic effects listed, they’re for other, not-obviously-relevant disorders including asthma, pain, cancer, and arthritis! Want to see a classic example of misleading language? The author writes, “Derivations of C. Officinalis are administered to elderly patients to treat tinnitus and cardiac related disorders and have been found to have effective implications when taken to counteract swelling and other conditions that may adversely impact the workings of the inner ear.” Note that Dr. Latino does not claim this nostrum works for tinnitus! He says only that it is used for that complaint. (What the heck are “effective implications”?)

The author of this “Study” is Dr. Thomas Latino. PubMed reports that Dr. Latino has zero medical publications. A more general web search finds the same “Study” that’s on the Quietus site was also published by The Hearing Journal in 2010. HJ appears to be an industry trade magazine. It is certainly not a peer-reviewed, scientific publication. He is stated to be “a consultant” and no details are given of his degrees, or professional experience, anywhere that I can find. His only other publication that I can locate is promoting another homeopathic nostrum, this one for sciatica.

But surely the makers must have some evidence it works? Well, all they give is a bunch of testimonials. Anonymous testimonials. Testimonials are very convincing–we humans are easily persuaded by stories. Trouble is, testimonials are easily found for all manner of quack nonsense, including copper bracelets curing arthritis, Laetrile curing cancer, and stump water curing warts. To show that a medical treatment works, you need controlled and blinded experiments or carefully-conducted epidemiological studies, which simply don’t exist for this ludicrous treatment.

In conclusion: this stuff can’t possibly work (again, it has no ingredients), they present no meaningful evidence that it does work, and the only effect it’s likely to have is moving money from the sufferer’s wallet to the seller’s. Not recommended.