My social networks, the Internet and my guilty pleasure, Words with friends, flooded me with ads featuring this year’s best deals during the holiday season. Since I was a medical student, the artificial intelligence algorithms that curate my ads have selected various health and wellness-related devices and subscriptions for me. Oddly enough – and I’m not sure what this indicates on my Google search history – I have been confronted with a preponderance of promotions from what I like to call pseudo-medicine.
Neither evidence-based nor standard, pseudo-medicine refers to ideologies and practices related to health and disease, but which fall outside the realm of scientific medicine. Basically, pseudo-medicine, as its etymology of Greek nicknames because the “lie” or “deception” relies on medicalized language and so-called physiology to encourage consumers to buy a product. These practitioners are rarely actual doctors, but more often naturopaths or other self-proclaimed health experts, and almost always call themselves “Dr.” First name.”
A product recently peddled on a naturopath’s website claimed his method could cure most cases of irritable bowel syndrome (IBS) in less than seven days. Its secret is a false claim that – and I’m paraphrasing – most medical practitioners are unaware that the primary cause of IBS is small intestinal bacterial overgrowth (SIBO). And its product – spoiler alert, not the antibiotic Xifaxan (rifaximin) – claims to solve this problem. In reality, while SIBO is most certainly one of the contributing etiologies to IBS, it is by far not the most common cause. In fact, the best estimate of SIBO in IBS patients appears to be at four percent, measured by jejunal aspiration. This is an example of medical misinformation and gives false promises to IBS sufferers. Regardless of the scientific validity, some patients may actually benefit from some relief from this product. Forty percent of patients with irritable bowel syndrome respond favorably even to a placebo.
While the self-proclaimed “cure” for IBS is based, however vaguely, on physiological studies, other, more outlandish products exist. For example, another naturopath (who is not a doctor) markets her tea to treat a disparate variety of illnesses. Referring to stress responses, inflammatory cytokines and the hypothalamic-pituitary-adrenal axis and linking them to the development of cancer and autoimmune diseases, she believes coffee is toxic to the body. She says that by switching from coffee to tea – especially her own – one can avoid the deleterious effects of the obviously toxic substance coffee. Once again, this is medical misinformation that stands in stark contrast to the extensive research linking coffee to a a host of positive health outcomes, including longevity.
Both Dr. SIBO and Dr. Tea are guilty of using medicalization to sell their products. By invoking SIBO and stress responses, they seem to be taking inspiration from Western biomedicine and its scientific foundations. To the medical ear, such rhetoric is considered pseudoscientific gibberish. But for those who are not medically informed, using seemingly medical verbiage lends a certain legitimacy. However, this approach is misleading because it deliberately targets a target audience with little health literacy in order to sell a product.
An additional concern is the safety of these products. As unregulated as they are, these supplements are not under FDA oversight and have no enforceable way to evaluate their safety or even their actual composition. Additionally, there are no studies on the potential toxicity of interactions with other medications. Conversely, there is ample evidence from independent groups revealing the high levels of contaminants found in supplements.
I recently took a survey from an ad that promised to diagnose me with serotonin or dopamine deficiency based on a ten-question survey. Based on the results, the company, which was independent and claimed to promote wellness in a natural way, would then provide me with a monthly supply of the spent natural chemical. Given that dopamine deficiency is the hallmark of Parkinson’s disease and serotonin deficiency is an oversimplification and gross misunderstanding of depression, I was intrigued and amused. So I filled out the questionnaire and was – to my immense surprise – judged to be deficient in serotonin. I decided against receiving a twenty dollar monthly fee for serotonin syndrome delivered to my door, but I imagine others without medical training would be less discerning. These people may fall victim to this scam and be at risk of significant harm.
Fortunately, many products like SIBO pills and anti-stress tea come from small start-up companies with a limited number of subscribers. The same principle, however, applies to certain larger individuals and groups. Dr. Axe, for example, is not a doctor. Rather, he is a naturopath whose website devoted to “medical” topics and health store receives significant online traffic. He too is known for his medicalized language and his invocation of pathophysiological mechanisms that do not pass the medical “sniff test” but seem legitimate to an untrained ear. Joseph Mercola, a well-known vaccine critic, proponent of homeopathy for autism, and, of course, seller of myriad homeopathic supplements and remedies, is also guilty of such false advertising.
I have already written about Dr. Oz, another person guilty of such medicalized manipulation to an arguably more egregious degree than others, given that his credibility is bolstered by his extensive, legitimate, and impressive education and training as a cardiothoracic surgeon and professor of surgery at Columbia University. In addition to his past involvement endorsing medically unfounded supplements, he is also a promoter of homeopathy and Reiki.
Unfortunately, the patient populations these individuals are targeting may be those with chronic symptoms that are difficult to diagnose and treat. These include disorders like irritable bowel syndrome, fibromyalgia, chronic fatigue and pain syndromes, post-concussion syndromes and migraines. One doctor’s website claims it can treat a number of unrecognized diagnoses, such as electromagnetic hypersensitivity syndrome, which has been refuted several times by double-blind sham stimulation trials and is considered to represent a nocebo response. Another little-known disorder it claims to treat is broken mom syndrome, described as fatigue, stress, pain and other symptoms after giving birth, which is probably at least a normal postpartum adjustment. partum or, at worst, major depressive disorder with peripartum onset.
Patients with these diffuse, nonspecific symptoms, lacking objective findings, often fall through the cracks or are actively rejected by the healthcare system. Therefore vulnerable and desperate, they are ready to try anything. It is therefore particularly shameful that these patients are being targeted by people who claim to know all the answers and hold the panacea in their hands, despite a lack of evidence to support their claims.
This same shameful approach is commonly used to market products touted as “cures” for autism spectrum disorders. These are pseudo-medical groups that claim to be able to “reverse” autism and give false hope to desperate parents by oversimplifying and distorting preliminary research. This has become so prevalent in autism spectrum disorders that the Food and Drug Administration (FDA) has warned parents to be wary of such fictitious claims. Cancer patients are also being targeted, and the FDA has warned companies and consumers about “fake” cancer treatments.
Such public admonition is essential because widespread pseudo-scientific propaganda is truly a matter of life and death. A recent survey revealed that nearly forty percent of Americans believe that cancer can be cured only through alternative therapies. In fact, those who choose such therapies and forgo conventional therapies see their risk increase by 250 percent. risk of death. Since a large percentage of the population does not trust the advice given by the Centers for Disease Control, the FDA, and other government-sponsored health institutions, federal condemnation of pseudoscience, while necessary, is not not sufficient.
Fortunately, some doctors are also taking the initiative to educate the public. Zubin Damania, MD (no relation) is a staunch advocate of evidence-based medicine and an activist against pseudoscience. Using his pseudonym and internet celebrity name, ZDoggMD, Dr. Damania spoke at length on this topic. For example, he recently produced a video highlighting how purveyors of pseudoscience have MTHFR mutations misused and misinterpreted.
It’s very easy in the age of technology, social media, widespread distrust in health care and “fake news” allowing anyone to claim expertise on a subject and proclaim themselves an expert. With a little marketing skills, quasi-medical amphigoria, and a “cure” to sell, I could easily establish myself as Dr. John. Then I could sell my magic panacea for fatigue, brain fog, chronic pain, gastrointestinal disorders and headaches, based on my own individual analysis of the most recent research than other doctors.” don’t know” or “don’t want you”. Be aware!” However, this approach is truly selfish and does a great disservice not only to the medical system, but also to patients with real symptoms and individual suffering. It offers false promises and reassures patients who actually need help. comprehensive biopsychosocial care.
And so, I reincarnate the biblical jeremiad for our purposes and our warning: beware of practitioners of pseudomedicine. They come to see you in a doctor’s white coat but are in reality just simple salespeople.
Contributing writer
Dartmouth Geisel School of Medicine
John Damianos is a fourth-year medical student at Dartmouth Geisel School of Medicine, Lebanon, NH Class of 2020. In 2016, he graduated from Dartmouth College with a Bachelor of Arts in Linguistics and Neuroscience and a minor in French. He enjoys playing tennis, cooking, and studying Byzantine chant in his free time. After completing his medical degree, John would like to pursue a career in internal medicine, eventually specializing in gastroenterology.
