Are you iron deficient?

How are you feeling today? Tired? Is it your active lifestyle wearing you down? Or is it a sign of something more serious? Complaints about fatigue seem ubiquitous. Perhaps it’s a product of a culture with little downtime. Yet from a medical perspective, fatigue can’t be dismissed with a simple instruction to “get more sleep”. When approached in the pharmacy, I take the perspective that anyone actively seeking advice on treatment probably needs a medical assessment. That’s not something I can offer, but I try to impress upon patients the importance of finding the cause, rather than reaching for any quick fix that may be for sale. (Energy drink, anyone?) And I can use the opportunity to discuss the appropriate role of supplements for treating fatigue. Continue reading

It Takes a Village – Skepticism in this Small Town

In my last post, I introduced myself as a pharmacist in a small-ish town, eager to combat the growing acceptance of pseudoscience into the mainstream.  I love living where I live for a multitude of reasons.  But I’ve found it rather challenging to wave the flag of skepticism.  I have no problem displaying my preference for science-based medicine at my workplace, but outside of work a rather large road-block has emerged – social isolation.  While I have found a few kindred spirits in a public health nurse and a high school science teacher, they, too, remain relatively quiet about their skepticism.  I decided a few months ago to push the boundaries, and learned the hard way why others have been forced to keep quiet. Continue reading

Science-based health advocacy and the end of “Registered Holistic Allergists” in Canada

Photo of the GSR-120

Caution! The GSR-120 is an uproven allergy treatment

As the trend of fake food allergies and fake food intolerances has begun to permeate pharmacy practice, I’ve become much more attuned to allergy pseudoscience. As I have pointed out before, there are scientific ways to diagnose and treat allergies, and then there are the methods used by “alternative” health practitioners, which are neither accurate nor effective. It’s not only naturopaths – there is a wide field of different practices, all claiming the ability to identify and treat allergies. These methods lack scientific substantiation – some prefer to redefine the word allergy:

A Holistic Allergist uses a new definition of allergy: “A bioenergetic counteraction to a given substance resulting in abnormality”.

It’s strategy first documented in Lewis Carroll’s Through the Looking-Glass:

“When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.” Continue reading

Homeopathy: Not good, not medicine

Caution: Straw Man Arguments Ahead

Every time I think I can take a break from homeopathy, something pulls me back to the topic. Today it’s an unbelievably poorly reasoned defense of homeopathy, in, of all places, the British Medical Journal. Glasgow-based general practitioner Des Spence writes,

It was an intentional overdose. To prove a point I poured about 30 tiny tablets into my mouth and crunched them down. Because scientifically, I do not believe that these homeopathic pills have any active ingredient.
Today, homeopathy is medicine’s whipping boy, repeatedly and systematically beaten to the ground. Yet despite explaining that the tablets are just placebos, homeopathy always gets up to take another beating. Some homeopathy is funded by the NHS, through general practice, and in the few homeopathic hospitals. This fact enrages the growling commissars of evidenced based medicine who want homeopathy purged from the NHS.

“Growling commissars of evidenced based medicine”? Perhaps he’s referring to health professionals (like me) that believe that health interventions and treatments should be evaluated based on a single, scientific standard. And that publicly-funded health systems, like the National Health Service (NHS), should fund what works. Treatments that are not medicine, but are are vitalistic belief systems without evidence of efficacy, don’t make the cut. Continue reading

A wrong way and a right way to discuss vaccine safety and effectiveness

Any resemblance to your child is completely intentional

Once again I’m blogging about vaccines, and antivaccinationism. Few health interventions that are both demonstrably effective and remarkably cost-effective seem to stir such opposition among a small but vocal few. I have noted before the remarkable statistic that vaccination has prevented more Canadian deaths in the past 50 years than any other health intervention.  Yet as long as there have been vaccines, there has been those that oppose them. I’ve spent quite a bit of time outlining the tactics and tropes of the antivaccine movement as well as considering ways in which health professionals and science advocates can improve the way they respond to antivaccinationism.

Rebutting anti-vaccine rhetoric is an unrelenting struggle, but an important one. As I’ve described in prior posts, viewing anti-vaccine material for only five to ten minutes increased the perception of risk of vaccination, and decreased the perception of risk of omitting vaccines, compared to viewing neutral websites. It also lowers vaccination intentions. By changing perceptions of safety, the willingness to vaccination decreases. One of the common themes in anti-vaccination content is raising questions about safety and effectiveness. It’s also the least obvious way to subtly sow concerns about vaccines.

A common way to embed anti-vaccination sentiment in messaging that professes to be science-based is to question the tactics and messaging of pro-vaccination, public health advocates. Continue reading

A Strong Message to Pharmacists about IgG Food Sensitivity Testing

From the Canadian Society of Allergy and Clinical Immunology:

The Canadian Society of Allergy and Clinical Immunology (CSACI) is very concerned about the increased marketing of food-specific immunoglobulin G (IgG) testing towards the general public over the past few years, supposedly as a simple means by which to identify “food sensitivity”, food intolerance or food allergies. In the past, this unvalidated form of testing was usually offered by alternative or complementary health providers, but has now become more widely available with direct-to-consumer marketing through a nationwide chain of pharmacies. Continue reading

Oil of Oregano – No substitute for the pertussis vaccine

Oil of Oregano-Today’s Snake Oil

One of the terms that you’ll see used to describe health quackery, scams and pseudoscience is “snake oil”. Snake oil was a real product, sold in the early 19th century as a cure-all elixer in the “patent medicine” era. Popularized in movies, the snake-oil salesman would pull into town, and start the hard sell for his product that was promised to CURE everything from aches and pains to sore throats and dislocations. The original products apparently did contain snake, but soon other products appeared on the market that didn’t even contain any snake – they were an assortment of ingredients concocted to smell medicinal and seem medicinal, but had no therapeutic effects. These small-town sideshows would hype the products and try to sell as much as possible. In 1905 an article in Colliers exposed the patent medicine industry for what it was – health fraud. The Pure Food and Drugs Act (in the USA) followed, and eventually, modern drug regulations emerged as we know them today.

Case closed? Not quite. As a consequence of regulators worldwide implementing lower regulatory standards for supplements and natural health products, snake oil is back on the shelves. I highlighted this recently when I somewhat facetiously asked Is there anything the Natural Health Products Directorate Won’t Approve? After all, when sugar pills are approved as an insect repellant, how much more ludicrous can you get? But I was proved wrong, when Dianne Sousa pointed out that Health Canada has also approved homeopathic rabbit anus as “safe and effective”. Continue reading