Ridiculous cost of clinical trials hinder new bug repellant

[Erik von Nein]

But my point still stands as valid. It's VERY likely that the liver formula she takes is directly responsible for the beneficial effects she sees in relation to her AST, ALT levels and what have you. Is it good enough for proof over the entire spectrum of herbal medicine, or even for this particular formula? Of course not! But I never said it was even though I keep being strawmanned into these ridiculous extremes.

Then why bring up the example if you admit that it's not representative of anything? Sure, it's probable the treatment did have an effect, but to what extent or even whether it was the direct causation is not something you can make a conclusive statement about. It bears further research, which I haven't denied. If it turns out to be true, then that's great. I would welcome any new drug that would help improve the health of anyone, but I'm not going to jump on something that's fairly vague, nor on a personal anecdote. Like I said, homeopaths could, and have, claimed the same. That's the problem we're running into, and you see why the anecdote doesn't conclusively show anything, right?

[Justforfun000]

Erik Von Nein, you had some good posts I got sidetracked from answering...

So, your argument is testing is necessary, but not necessary for people to take the drug, because it's already "generally known" to be effective. Well, there's some vague references to "studies" showing that it could be. I wonder who funded these studies, what their criteria is and how they conducted them? Do you have these studies? Who is it "generally known" to? Because your claims are sounding as reasonable as homeopathic claims, including the personal anecdotes.

First off, you're instantly changing the argument from an herbal supplement to the status category of a "drug". I think we've covered enough ground to understand that I'm invoking the very real distinctions between many herbal products and pharmaceuticals. So based on that as an important consideration in relation to this, unlike an investigational drug, many of these herbal medicines have had centuries of traditional use for certain ailments and/or functions of the body.

I don't care how many times people here try to handwave this fact away as irrelevant, because it's NOT. It's not ultimately important in the scientific method and it's final evaluation of said substance, no, but it DOES demonstrate a known recorded history of effects on people, reasons why it was used and how it appeared to be effective in certain conditions as well as a clear indication of how likely it is toxic or dangerous. If millions of people were taking echinacea over the years and no causal relationship was ever linked to a shorter lifespan, cancer, or even statistically more diarrhea, then it is STILL a logical and probable assumption that it is relatively benign.

And for the record, do you see me posting on a homeopathic thread on this very page of SLAM? Can you find me ever suggesting it was effective? You will not because I have always thought it was quackery and the entire premise it is based on is illogical in the extreme. That is NOT the case with herbal medicine and the points I am raising.

I never said she couldn't use it. She can drown herself in homeopathic remedies for all it matters. That's not the debate at hand and you're going completely off the rails from what my point was, which is that your anecdote is not representative of any kind of real effect.

No that's not true. It is VERY respresentative of the likelihood of a real effect. A very clear causal link can be established to her biochemistry and her use of the product.

In any event, hyperventilating about how we're trying to say it's not right for your relative to take herbs for conditions is such a huge red herring it's insane.

I don't see how it's a red herring. It's completely germane to the argument at hand. It's either reasonable to a degree to think something might be effective, or it's not. Many here have espoused PRECISELY the idea that even my postings are an example of why people like me shouldn't have the right to make these decisions. That's what Aly said and Zod basically echoed him many times as well.

What we're saying is it's not right for you to spout off about how these herbs DO work for these conditions without any real testing and for you to advocate their use. The whole tangent about your relative is just about your level of evidence being insufficient for any conclusion. Tossing in an anecdote is only useful if you then provide further evidence that it actually is useful.

Now here is where you are coming close to strawmanning me as the others have done. I did not spout off how these herbs DO work, I have made it quite clear that it still is only SUGGESTIVE and other then my comment I conceded with the word "obviously", I have consistently maintained that qualification.

[Justforfun000]

Then why bring up the example if you admit that it's not representative of anything? Sure, it's probable the treatment did have an effect, but to what extent or even whether it was the direct causation is not something you can make a conclusive statement about. It bears further research, which I haven't denied. If it turns out to be true, then that's great. I would welcome any new drug that would help improve the health of anyone, but I'm not going to jump on something that's fairly vague, nor on a personal anecdote. Like I said, homeopaths could, and have, claimed the same. That's the problem we're running into, and you see why the anecdote doesn't conclusively show anything, right?

Oh I like you! You actually reach out and help each other come to an understanding as if we weren't enemies. It's quite refreshing.

Ok, now I didn't say it wasn't respresentative of anything. That's almost the same thing as saying it isn't significant in any way. That's not true and also not at all my distinction. Look, I understand the necessity of statistical percentage being done over large population studies, and especially over long periods. But sometimes this is overemphasized to a ridiculous degree when some things are really as simple as they appear. As a good example, vitamins are extremely complex in their relation to the human body and to make a definitive statement on their effect concerning longeivity is VERY difficult to establish with certainty.

When concerning yourself with something that has a more narrow effect on certain functions of the body, particularly things that you can measure through biochemistry in relatively rapid and consistent anlayzations, then the comprehensive standards of proof are far reduced in comparison. As again, a simple example. Back before it was isolated and purified as acetylsalicylic acid, Willow bark tea was used as a headache remedy or to bring down fever.

Simple causal effect from traditional usage led to the obvious direction of research that led to the confirmation that yes..it WAS effective for these conditions. Of course until the science was brought into the picture we didn't understand prostaglandins, or any of the other specificity concerning the method of it's actions, but all that was needed to see a simple enough probability was that willow bark tea contained something that helped headaches and fevers.

Now naturally one singular anectdote is at best interestingly suggestive of probability unless you put the person through a very specific battery of multiple tests that prove that substance has an effect on them. Don't forget that important fact however..you don't NEED multiple people to prove something is actually effective, it's just the best model for overall evaluation concerning all human beings.

So again, it's not irrelevant what my mother's results were. Nor is it irrelevant how effective my elderly lady friend's relief was by using devil's claw. To them, it was VERY relevant and logically, very suggestive.

I have never advocated homeopathy, or seen any convincing evidence that has supported it's use so anyone wishing to try tossing that accusation of quackery into my list is mistaken.

[Erik von Nein]

First off, you're instantly changing the argument from an herbal supplement to the status category of a "drug". I think we've covered enough ground to understand that I'm invoking the very real distinctions between many herbal products and pharmaceuticals. So based on that as an important consideration in relation to this, unlike an investigational drug, many of these herbal medicines have had centuries of traditional use for certain ailments and/or functions of the body.

And that's usually why they get researched in the first place, such as Aspirin being based on tree bark tea, yes. There have also been herbs used for treatment of diseases that have turned out to be wholely ineffective, as well. Like the article I linked to earlier. Saying that they've been used for centuries just means they are a good candidate for study.

Again, I wasn't making any distinction between pharmaceuticals and herbs. I was lumping them together into a generalized format, so I was trying to shift any debate. Apologies if you took it that way.

I don't care how many times people here try to handwave this fact away as irrelevant, because it's NOT. It's not ultimately important in the scientific method and it's final evaluation of said substance, no, but it DOES demonstrate a known recorded history of effects on people, reasons why it was used and how it appeared to be effective in certain conditions as well as a clear indication of how likely it is toxic or dangerous. If millions of people were taking echinacea over the years and no causal relationship was ever linked to a shorter lifespan, cancer, or even statistically more diarrhea, then it is STILL a logical and probable assumption that it is relatively benign.

Well, it gives a history, yes. Whether a substance is benign or not really doesn't address whether it's effective, though. Homeopathics are benign, but they're not effective. The history of use is more important, though, as it means it's use bears more study.

And for the record, do you see me posting on a homeopathic thread on this very page of SLAM? Can you find me ever suggesting it was effective? You will not because I have always thought it was quackery and the entire premise it is based on is illogical in the extreme. That is NOT the case with herbal medicine and the points I am raising.

No, nor was that what I said. I was comparing the use of anecdotes and uncited claims to the types of arguments homeopathic proponents use to show in part why you were getting such resistance.

No that's not true. It is VERY respresentative of the likelihood of a real effect. A very clear causal link can be established to her biochemistry and her use of the product.

No, a very correlated effect is noted. The reason why a sample size of one is never used is because we cannot draw any solid conclusions from it. You know what a hasty generalization is, right? There's a reason why scientific studies need large sample sizes, to help weed out any other possible effects. That's why anecdotes by themselves are useless.

I don't see how it's a red herring. It's completely germane to the argument at hand. It's either reasonable to a degree to think something might be effective, or it's not. Many here have espoused PRECISELY the idea that even my postings are an example of why people like me shouldn't have the right to make these decisions. That's what Aly said and Zod basically echoed him many times as well.

You are not qualified to make the decision because of your lack of formal training and debating techniques, this much is true. What they were talking about as far as "rights" had nothing to do with whether the decision was right or wrong, but more based on your qualifications. It was more that you do not have a right to prescribe something because of the aforementioned lack of qualifications. You are not a medical doctor and your studies are all self taught, where you use sources that are obviously suspect. Aly's deconstruction of your previous source shows that you don't have the qualifications necessary to make authoritative declarations about someone else's medication regimen.

As well, this rant was in response to my post where I said nothing about whether it was right or wrong for her to take these herbs.

Now here is where you are coming close to strawmanning me as the others have done. I did not spout off how these herbs DO work, I have made it quite clear that it still is only SUGGESTIVE and other then my comment I conceded with the word "obviously", I have consistently maintained that qualification.

This is what you said about your mother:

Just to put this into a little bit of a more real life personal perspective...my mother had to take Dilantin for years because of Trigeminal Neuralgia. She had liver enzymes that were climbing higher and higher. I told her about milk thistle mainly and better yet, a comprehensive formula with other reputed liver supportive herbs. An lo and behold, her liver enzymes normalized. Not only that, her HDL cholesterol rose (which has also been attributed to milk thistle in some studies).

Listening to you people, I should go to her and say "Who gives a fuck that you are getting any personal benefit from this product, it isn't really proof. They told me you're just wasting your money and you're an idiot."

That shows, to me, that you are saying that the herbs are working, especially with the "personal benefit" line. Also, you never cited your sources, which would have been helpful to have avoided the amount of debate we've already had.

If you meant something else you should have said in that post "This shows a probable cause and means further research" instead of what you said. If it was miscommunication, then that's that, but you see why everyone jumped on that, right? Especially with what I've already said about personal anecdotes?

[Erik von Nein]

Oh I like you! You actually reach out and help each other come to an understanding as if we weren't enemies. It's quite refreshing.

Heh. Well, you're welcome.

Ok, now I didn't say it wasn't respresentative of anything. That's almost the same thing as saying it isn't significant in any way. That's not true and also not at all my distinction. Look, I understand the necessity of statistical percentage being done over large population studies, and especially over long periods. But sometimes this is overemphasized to a ridiculous degree when some things are really as simple as they appear. As a good example, vitamins are extremely complex in their relation to the human body and to make a definitive statement on their effect concerning longeivity is VERY difficult to establish with certainty.

Vitamins are a poor example, as their effects have been heavily studied. We have a fairly strong understanding of their various roles in the body and in their use against some diseases. True, we don't know everything about them.

Things are rarely as simple as they appear, in any event. That three major things happened with your mother shows that you cannot pin it on any single source. That is why it is not representative of a useful study. Yes, her health improved when she stopped taking one treatment and started taking another another, along with assurances that this will most certainly help from a (I assume) trusted family member. This shows how complicated such a situation can be.

When concerning yourself with something that has a more narrow effect on certain functions of the body, particularly things that you can measure through biochemistry in relatively rapid and consistent anlayzations, then the comprehensive standards of proof are far reduced in comparison. As again, a simple example. Back before it was isolated and purified as acetylsalicylic acid, Willow bark tea was used as a headache remedy or to bring down fever.

The standards of proof never change. You need a clear causation pattern and excellent methodology, as well as good peer review. I think you meant to say that it is easier to demonstrate that X product has X effect when the effect measured is easy to identify.

Simple causal effect from traditional usage led to the obvious direction of research that led to the confirmation that yes..it WAS effective for these conditions. Of course until the science was brought into the picture we didn't understand prostaglandins, or any of the other specificity concerning the method of it's actions, but all that was needed to see a simple enough probability was that willow bark tea contained something that helped headaches and fevers.

Fair enough. No argument here.

Now naturally one singular anectdote is at best interestingly suggestive of probability unless you put the person through a very specific battery of multiple tests that prove that substance has an effect on them. Don't forget that important fact however..you don't NEED multiple people to prove something is actually effective, it's just the best model for overall evaluation concerning all human beings.

Yes, actually, you do, at least based on the standards set by the scientific method. Having one person say they got better when they took X product means only one thing; they got better. Was it the product? Was it coincidence? Was it anything else? We can't conclusively say until a decent scientific test is done. Like I said earlier, that I could even think of that many reasons calls do doubt what the actual effect was. That is has a history of being used for some conditions means that there is a strong possibility of it being the actual effect. However, like my homeopathic example, plenty of people claim to get better after taking their products. Or even in the article about government study of various herbal remedies demonstrated some of the ones commonly used for various ailments didn't actually have any real use.

So again, it's not irrelevant what my mother's results were. Nor is it irrelevant how effective my elderly lady friend's relief was by using devil's claw. To them, it was VERY relevant and logically, very suggestive.

Of course it was. To them. To homeopathic people it's very real to them, as well. But to us it doesn't mean anything. What it does mean is it could possibly have an actual effect. But we can't say for sure. So advocating a use of a product we don't have any conclusive evidence for is what most people are objecting to. The herbal history means it should be studied.

To paraphrase Dawkins at the end of his documentary "The Enemies of Reason" once it's been conclusively shown to work it stops becoming "alternative medicine" and just becomes "regular medicine."

I have never advocated homeopathy, or seen any convincing evidence that has supported it's use so anyone wishing to try tossing that accusation of quackery into my list is mistaken.

I'm not saying you're advocating homeopathy, I'm using it to show how your standard of evidence so far is similar to those who advocate it, especially with personal anecdotes and unsupported comments about "studies done."

Anyway, I'll be gone for a while. Sorry, but I'll respond later.

[Justforfun000]

Ok.. Erik Von Nein has some very good points to debate over that...for brevity I'll skip what I generally agree with.

No, a very correlated effect is noted. The reason why a sample size of one is never used is because we cannot draw any solid conclusions from it. You know what a hasty generalization is, right? There's a reason why scientific studies need large sample sizes, to help weed out any other possible effects. That's why anecdotes by themselves are useless.

I know this is the standard meme, but I still take issue with it because I don't think that it's fair to dismiss a singular person's body and their responses to something as useless.

If you take a single person and consistently paint their arm with a mixture of poison ivy and they break out in a rash, then a very logical and clear causal relationship can be linked to the product and the effect.

It is NOT reasonable to say that this anectdotal event is completely useless by itself. That's illogical. It's too evidential to be dismissed that blithely. Obviously we are well aware of poison ivy now, and no question would be had over this effect, but if it wasn't? It's still no different then a biochemical result that is consistently demonstrated by someone's bloodwork and their usage of a substance.

For simplicities sake in the bigger picture, yes it would be easier to say lets completely disregard anectdotal information and perform double-blind, placebo-controlled, randomized study before we make any firm determination. That is the best approach in the overall scheme of things when aiming for the medical journal of medicine. Absolutely. But anectdotal information is still important and suggestive. In fact, even studies are still evaluating the same kind of "anectdotal" evidence in truth. they are evaluating the person's individual responses and giving weight to their efficacy one way or the other. The only major difference is that they are statistically including larger groups of people which narrows the possibility of coincidence or individual fluke reaction to a substance to a very unlikely possiblity if it is reproduced in larger numbers.

The point is, each individual experience is COMPLETELY relevant. In fact 2 people out of 500 can still skew the statistics enough to warrant a claim of adverse effects. In this case we don't care about the 99+% percent that have no problem, we now focus the attention on the oddball ones and their reactions. In this case, we are actually seeing the same exaltation of a singular unusual response without corroboration, but in reverse. Do you see what I'm getting at?

You are not qualified to make the decision because of your lack of formal training and debating techniques, this much is true.

See, now I find this a very arrogant statement to make and it would be something I would expect from a doctor as an example, but as we all know, doctors are not always right, are they? Obviously medical education and training related to scientific research is extremely valuable and a gold standard to measure our highest consideration when it comes to medicinal claims and practioners of medicine.

But a lack of formal training in medicine, or debating techniques is completely irrelevant to my ability to not only understand, but accept a degree of evidence that is reasonable enough to still indicate probable benefit.

Do I need to be a medical doctor to understand that the phytochemicals in broccoli are likely to be preventative in cancer? Of course not. Just for the record, I've always been a medical buff. I find the human body fascinating. I read anatomy books for the fun of it... read treatises on the nature of Diabetes and how the Pancreas fails in relation to the disease, I consistently go to Medical News Daily and see what the current research is on things.

I am not and have never claimed to be as knowledgeable as a medical doctor, or a medical researcher. However, my limited level of knowledge is FAR from irrelevant or instantly deserving to be labeled as "unqulaified" to make medical decisions regarding me and my body, and that included NUTRITIONAL choices too which you have to be careful about because as Mike has intimated, these issues regarding herbal medicine and/or food related products skirt the line very carefully sometimes.

Aly is in the field of scientific research, and therefore his opinions and views are to be generally respected and given due consideration, but this alone does not deem someone qualified or worthy of qualification to make medical decisions. By that logic alone, Peter Duesberg as an eminent scientist that was considered one of the worlds foremost experts on viruses, would be immediately more "qualified" and therefore implied...as CORRECT to make decisions regarding people infected with HIV. As most here would be well aware of by now due to the scandal in Africa with Mbeki, he has been thoroughly denounced and relegated to the status of denialist and pseudoscientist.

With all of his qualifications, a singular person that read and understood the arguments against him after the opposing side of the medical fraternity got together, was STILL more qulaified to make decisions on their personal health. If they listened to Duesberg,.. deferred to him and his esteemed 'knowledge', they would be on their road to death as eventually happened to Christine Maggiore. 16 years of denial...losing her own daughter at the age of 3 and then her own life eventually.

Ironically HIV denialists are disturbingly close to the extreme sketicism that has been hinted at in this thread. It was a classic example of skepticism in medicine and science gone too far. Even though all of the correlation evidence was unequivocable, the nay sayers were stomping their feet and claiming that basic facts of science like Koch's Postulates weren't fulfilled, and many other claims that were not completely able to be proven and resolved at the time...but that was quite obvious to anyone with half a brain and the writing on the wall. Again..a similarly ironic similarity to some degree of skepticism in this thread.

I'm not denying or even suggesting that there is not, or has not been LOADS of quackery and pseudoscience in many branches of alternative medicine, but herbal substances are not so easily dismissed or lumped together. Some things have been shown to be worthless. Some have surpassed expectations and continue to show surprising benefit. Garlic is a simple food but yet it in itself has many strong protective and arguably directly curative effects on a variety of human issues.

Anyway, this is going on too long. Sometimes though you really need to have the space to completely flesh out your entire thoughts and arguments enough so they aren't so easily strawmanned. In any event, I'm very interested to see what you think in relation to what I've said in this particular post.

You are not a medical doctor and your studies are all self taught, where you use sources that are obviously suspect.

Ah ah...just a little caution...I got spanked on the use of the word "obviously"...in this case, you may want to reconsider such a strong position.

Naturally a company's personal promotional material is going to be considered biased at the very LEAST, but I started off at the very beginning of this argument...that really evolved from another thread...by citing OTHER supporting evidence that was far from "suspect". Inconclusive is a fair description, but lets not go too far.

Aly's deconstruction of your previous source shows that you don't have the qualifications necessary to make authoritative declarations about someone else's medication regimen.

No I cannot make authoritative declarations about someone else's medication regime. But neither can he. Even he doesn't have that degree of "qualified" authority as of yet if I am correct...Aly will correct me if I'm wrong and I'm sorry in advance if I am but to my last recollection you are in training still as a student and even then it wasn't as a medical doctor either...it was in the field of biochemistry I believe...

He can make some authoritative statements on some conclusions that have been evidenced & peer reviewed through the scientific method, yes, and as I said before, I would naturally give him the respect he's due and listen to his position with respect.

But as I said before...it's not that simple. Duesberg is a classic example. There are many others for the field of cancer reasearch to NARTH members on to every degree of potential error by being incorrect of the overall truth of facts. It's perfectly possible to be very RIGHT in the interpretation of a study, yet perfectly possible to be proven very wrong due to unkown factors or unseen circumstances that change the overall picture.

People have to be careful to not be too arrogant. The most intelligent and authoritative people I have come across in the grand scheme of science most often tend towards being the most humble about how little they know and how ready they are to admit the possibility that they could be wrong.

Anyway, I didn't bother individually arguing Aly's point's because I didn't even have the specific capability needed to argue on his particular turf. He's absolutely correct in what he said regarding the studies and their flaws...BUT as he did admit, there IS something sugesstive that's worth looking at from his point of view as a researcher..he simply feels that it's not enough to recommend or condone people self-medicating on such limited research. I understand, but don't completely agree for the main reason of demonsntrable likelihood of no harm in most cases that I am obviously referring to..and someone's individual criteria of what's enough to satisfy them and their personal choice in regards to health and whatever challenges they may be facing and deciding on at that time.

I think this is one of the longest singular posts I've ever made..I'm not sure if there is a limit but I'll continue any further comments if there's anything more on the above I want to comment on in another post...

Ack..I was going to go over this for spelling mistakes but just forgive me...lol.

[Justforfun000]

Justforfun000, Page Three wrote:
Just to put this into a little bit of a more real life personal perspective...my mother had to take Dilantin for years because of Trigeminal Neuralgia. She had liver enzymes that were climbing higher and higher. I told her about milk thistle mainly and better yet, a comprehensive formula with other reputed liver supportive herbs. An lo and behold, her liver enzymes normalized. Not only that, her HDL cholesterol rose (which has also been attributed to milk thistle in some studies).

Listening to you people, I should go to her and say "Who gives a fuck that you are getting any personal benefit from this product, it isn't really proof. They told me you're just wasting your money and you're an idiot."


That shows, to me, that you are saying that the herbs are working, especially with the "personal benefit" line. Also, you never cited your sources, which would have been helpful to have avoided the amount of debate we've already had.

If you meant something else you should have said in that post "This shows a probable cause and means further research" instead of what you said. If it was miscommunication, then that's that, but you see why everyone jumped on that, right? Especially with what I've already said about personal anecdotes?

This is why I should never post in haste. I should have learned my lesson fully a long time ago on my emotions getting the better of me. I was too brief, I never described until a later post the more specific example of how she took the product for a long period of time, stopped it and saw a rise in enzymes, started again and saw a reduction....

And yes I didn't list enough references or resources to support my position. As you can see by example to you, a person's individual empathy and tactfullness of communication affects my interest and ability to post comprehensive replies.

Some can shrug this off..many have thick skins or learn...in any event, on this board, it's the rules and the law of the land. I've accepted it and keep trying to swallow my tongue instead of just saying something like "Will you FUCK OFF you rude bastard and $*$&%^&". It's the accepted community here...in some ways it's refreshing..in others..it's disturbing at times and I do not enjoy being present or engaging in hostile exchanges. I'm a peaceful person by nature and don't seek out arguments in real life. I try to be polite and adaptive to other people that I live with, neighbour with, and indeed, even share the city with.

Still, the overall intellgience quotient of this board is exceptional and I highly respect the great majority of the members and particularly the progenitor of the site. We've clashed before, but I have to admit I've never won. lol. He's extremely intelligent and far more learned that I and I listen very carefully to his points now whenever he posts.

I painfully admit I was being a sulky bitch earlier and should have let the insults roll off my back and focused more on my posts and the comprehensiveness and accuracy of their content. I will try again to hold to that ideal. I forget myself now and then. I am emotionally human, not vulcan enough.

Ok, there is probably more I could comment on Erik but I've been so wordy tonight, I'll let it rest for awhile. Peace all.

[Simon_Jester]

Well, it gives a history, yes. Whether a substance is benign or not really doesn't address whether it's effective, though. Homeopathics are benign, but they're not effective. The history of use is more important, though, as it means it's use bears more study.

What's relevant is the combination of "history proves that this stuff is relatively benign" combined with "someone's actually done controlled studies of this stuff and it looks like there's some good shit in there." At that point, you know it has some kind of positive effect with a fairly high probability, and you know that it has little or no negative effect with a fairly high probability. Knowing that, Bayesian logic will be enough to take you through the last step.
________

No, a very correlated effect is noted. The reason why a sample size of one is never used is because we cannot draw any solid conclusions from it. You know what a hasty generalization is, right? There's a reason why scientific studies need large sample sizes, to help weed out any other possible effects. That's why anecdotes by themselves are useless.

I disagree with your word choice. That's why anecdotes by themselves are not very useful for making general decisions about entire populations. There's a difference.

This is, again, a Bayesian thing. If a substance's effect on one person has zero significance, then its statistical effect on a thousand or a million people is still of zero significance. For a study to tell you anything, the fate of individual cases in the study must still be at least somewhat relevant.
_______

On top of that, even the low relevance of single cases compared to clinical trials doesn't make single cases irrelevant in the absolute. My own personal case history may be beside the point if we're trying to prescribe a substance for use by many thousands of people. But it is highly relevant when making decisions about my own treatment regimen. You'd have to be out of your mind not to take individual cases into account when making decisions for those individuals.

For example, there's a kid in my family who used to throw up every time his parents give him cough syrup.

Now, think about this in the abstract: every few months, the patient has coughing fits. If we use an FDA-approved cough medication to treat the cough, he vomits. If this happens once or twice, it's probably a coincidence; it's the underlying disease making him throw up, not the cough syrup. But if it happens four or five times, and if it doesn't fail to happen (I don't have dozens of examples of giving him cough syrup and him not throwing up)... this should not be a hard call. At some point I can say with high mathematical confidence that there is some correlation between me giving him cough syrup and him vomiting, even if no such correlation exists in the public as a whole. The correlation does not deductively imply causation, but in inductive terms it's like a big frigging strobe light pointing at some kind of causal effect.

After about the fourth or fifth case of puking, the kid's parents rightly concluded that this was not a coincidence, that cough syrup made him throw up, and stopped giving him cough syrup. They have never regretted their decision. I like to think you would draw the same conclusion with a child of your own. I know any competent physician would.

But this directly contradicts the idea of individual cases being irrelevant. You'd have to be completely nuts to say "The FDA has proven that cough syrup does not cause elevated risk of vomiting in children, so little Timmy should take his cough syrup even if this is the 47th consecutive time he threw up within two hours of taking the cough syrup." Which is what deeming individual cases truly irrelevant would require you to do.

And please for the love of sanity notice that I'm not saying you would do that. I'm saying it would be stupid, and that it's a logical consequence of taking individual cases as completely irrelevant, but not that you have done it or would do it. Or that any other particular person would do it. I want to make that extra-clear because I've already been misunderstood by enough people for one week this week.

========

Ignoring that stuff on the kneejerk assumption that it's all crap, even the stuff that HAS passed multiple double-blind tests, isn't reasonable.

Oh bullshit. If something comes with the effective warning that its side effects are not fully documented? Then ignoring it in favor of something that's been thoroughly studied is perfectly reasonable. One has greater evidence supporting its efficacy than the other. This isn't rocket science here.

Did you miss the part where I said

And yeah, maybe it won't work. Sometimes people try things that don't work. As long as they don't cling to stuff that doesn't work at the expense of things that do work (AIDS patients taking "immune supplement herbal remedies" and not taking their retrovirals or something dumb like that), it's not the end of the world.

"Take your pills" and "eat your broccoli" are not mutually exclusive. No, the side effects of eating your broccoli have not been fully documented. Yes, for all we know eating your broccoli gives you a 0.2% increased risk of "Swell Up And Die Syndrome" or whatever. And yet if I'm at risk for heart disease, and I ask my doctor "would it be a good idea to eat more broccoli?" he's going to say "yes," or "probably," or "couldn't hurt." He is not going to say "Broccoli is not an FDA approved heart disease medication, therefore DO NOT TOUCH AARGH YOU PSEUDOSCIENTIFIC DUMBFUCK FUCKER OF RETARDED FUCKERY!" as he might reasonably do (for certain values of reasonable) if I was suggesting eating powdered rhinoceros horn or whatever.

I disagree. You guys were bawling out JFF over this idea of trying to use herbal stuff the FDA hasn't bothered to nail down yet before I even showed up, and the tone of the bawling didn't change until very recently.

Turns out we mock people for making stupid claims on here? Shocking, I know.

Yeah, but don't whine about how I'm derailing the thread by bringing up something you were already talking about before I got here.

You brought up an example that was unrelated to what was being discussed and that attacked points nobody was making, that's a derail by any reasonable definition.

On the contrary. You were bouncing up and down on the "thou shalt not use the herbal stuff because it hasn't been tested thoroughly enough" issue and I brought up "what about people who don't have time for the tests to finish, or who don't give a crap about the plausible risk level of side effects from something we already know can't be extremely poisonous?"

That's a condition that describes a lot of the seriously ill people who would actually have to make the decision of whether or not to use herbal stuff. So I think the question is pretty damn related. The fact that you don't feel like answering it doesn't make it irrelevant.

[PainRack]

Yes, but that evades the point. A lot of people would prefer to get these substances from plants in their diet as teas or spices (or even food ingredients) even if they are less effective per-dose than a purified pharmaceutical drug would be. A lot of people don't actually like the idea of using high-strength drugs at all, and not entirely without cause: high-strength drugs tend to have high-strength side effects.

And what if the therauptic effects can only be reliably achieved via drugs? IV Vitamin C is a classic example. Indeed, some of the brands out there of co-vitamins can only be done via "drugs" and not food.

[PainRack]

If plants commonly used as spices had major side effects, wouldn't we have noticed? I mean, it would be kind of hard to miss the entire nation of Greece dropping dead of garlic overdose or something like that.

When we're looking at something that we just invented, there's a very good chance that it'll make people swell up and die, because it's pretty much just a random new chemical. If you pick a random chemical out of the (very large) space of possible chemical compounds, most of them are either useless or actively poisonous to humans. Since we select drugs from the ones that aren't useless (the ones most likely to affect the body) a fair number of poisons will have to be screened out of the drug creation process (like thalidomide).

But if it's something people have been sticking in their mouths for the hell of it for thousands of years, giving you a large population to do statistical studies on, you already have a fair amount of data to go on. It may have side effects, but they've got to be subtle enough not to have a major demographic impact. In which case a sane person might decide "what the hell, I might as well take my chances with it, since it doesn't seem to be killing them."

There ARE known side effects to vitamins and minerals when used as drugs and replacements. Vitamin C for example and its effect on the urinary tract via crystalisation, not to mention the risk of renal damage. Vitamin A is another infamous example and the overdose effect is easily seen.

[PainRack]

There are problems with the way the whole drug approval process works. And there is some considerable ambiguity in the system as well, where we draw the line between "herb", "drug", and "food". Suppose someone eats a lot of broccoli because he has been told that it's good for his health and reduces his risk of heart disease and certain types of cancer. Is that a dietary choice? Or is it primitive unregulated self-medication based on untested quack therapies which have not been approved by the FDA?

So? Not every medical intervention requires approval by the FDA or alternate body. Exercise is a perfectly good example.

[Simon_Jester]

There ARE known side effects to vitamins and minerals when used as drugs and replacements. Vitamin C for example and its effect on the urinary tract via crystalisation, not to mention the risk of renal damage. Vitamin A is another infamous example and the overdose effect is easily seen.

Yes. I'm not in favor of the "cure your cold by taking more vitamin C than a shipload of Napoleonic sailors" school of disease treatment. You can definitely overdose on vitamins.

But if there's an herb that we know contains things which are genuinely useful- a compound with known anti-inflammatory properties, or that has a demonstrated positive effect on the liver, or whatever... taking some of it, to levels that we know empirically that people can eat without major health problems, strikes me as a reasonable thing to do.

So? Not every medical intervention requires approval by the FDA or alternate body. Exercise is a perfectly good example.

Exactly. That's my point: not everything that you are wise to do for the sake of your health involves a prescribed pharmaceutical. Sometimes that includes taking an intelligently selected herbal remedy if and only if you have logical reasons to do so.

Yes, you can screw yourself by taking random herbal remedies, or by taking herbal remedies and ignoring pharmaceuticals, or by taking enormous amounts of herbal remedies. But all those things are a restricted subset of the general act "take an herbal remedy." The greatest problem herbal stuff faces is that a fraction of its own support base is too dumb or fanatical to tell the difference between "take an herbal remedy" and "take an herbal remedy in a way that will injure or kill you." As is a fraction of its opposition.

[Justforfun000]

Simon Jester Wrote:

But if there's an herb that we know contains things which are genuinely useful- a compound with known anti-inflammatory properties, or that has a demonstrated positive effect on the liver, or whatever... taking some of it, to levels that we know empirically that people can eat without major health problems, strikes me as a reasonable thing to do.

It is so massively refreshing to have someone understanding and agreeing with me on exactly what I was trying to put across as my major point on this issue. Are you sure you aren't a bot?

[Erik von Nein]

If you take a single person and consistently paint their arm with a mixture of poison ivy and they break out in a rash, then a very logical and clear causal relationship can be linked to the product and the effect.

Yes, however, that's only altering one variable (the ivy), whereas in your example you altered at least three. One being the cessation of one treatment, the second being the assurances of another treatment from a trusted family member, and the third being the application of the third treatment. There are too many variables to conclusively say that the application of this treatment is what for sure caused the improvement. It could be, but it could also be placebo, it could be stopping the previous treatment helped the former, or it could be a combination of all three. That's why the personal anecdote isn't any kind of standard of evidence for the efficacy of a given treatment. You can use it to segue into a series of greater study and information, such as saying the historical use suggests some benefit, but you can't throw a personal anecdote and say with any certainly that was the cause.

I'm not saying that the herbal supplements didn't have an effect, I'm saying that her example alone is not conclusive of anything. Thus why I said it was useless. If it was followed up by further evidence then her example would be a personal story to lead into further discussion of the evidence. By itself it doesn't mean anything because you cannot say conclusively what caused the change.

I'd also like to say that if you did have better sources I would be perfectly happy to accept them and have no particular argument against your advocacy of this treatment. As it stands the evidence is poor so far.

It is NOT reasonable to say that this anectdotal event is completely useless by itself. That's illogical. It's too evidential to be dismissed that blithely. Obviously we are well aware of poison ivy now, and no question would be had over this effect, but if it wasn't? It's still no different then a biochemical result that is consistently demonstrated by someone's bloodwork and their usage of a substance.

What's poor logic is using one example to inductively conclude benefit from a product. It's call "hasty generalization." Yes, I realize you aren't necessarily engaging in poor reasoning, but that's what a single case means.

For simplicities sake in the bigger picture, yes it would be easier to say lets completely disregard anectdotal information and perform double-blind, placebo-controlled, randomized study before we make any firm determination. That is the best approach in the overall scheme of things when aiming for the medical journal of medicine. Absolutely. But anectdotal information is still important and suggestive. In fact, even studies are still evaluating the same kind of "anectdotal" evidence in truth. they are evaluating the person's individual responses and giving weight to their efficacy one way or the other. The only major difference is that they are statistically including larger groups of people which narrows the possibility of coincidence or individual fluke reaction to a substance to a very unlikely possiblity if it is reproduced in larger numbers.

Yes, exactly. While an anecdote might suggest a benefit, using large groups reduces the possibilities to a narrower conclusion. An anecdote, by itself, has no bearing on a product's effectiveness. Like I've repeated so often, placebo could be playing a big part, as could stopping the previous treatment. You don't know, and you still can't say for sure.

The point is, each individual experience is COMPLETELY relevant. In fact 2 people out of 500 can still skew the statistics enough to warrant a claim of adverse effects. In this case we don't care about the 99+% percent that have no problem, we now focus the attention on the oddball ones and their reactions. In this case, we are actually seeing the same exaltation of a singular unusual response without corroboration, but in reverse. Do you see what I'm getting at?

Not really. Mind being clearer?

Aly is in the field of scientific research, and therefore his opinions and views are to be generally respected and given due consideration, but this alone does not deem someone qualified or worthy of qualification to make medical decisions.

Let's skip to this quote, since it boils down what you've said already. You say that his personal qualifications, which, when it comes to scientific study and standard of evidence, is greater than your own, you claim that it alone isn't enough to make someone qualified for making medical decisions. So, what is?

Personal study can cover a lot of material, or a little. Or it might mean absolutely nothing. Like I've said before, homeopaths like to rail on doctors and degrees and appeal to their own personal authority. Saying "I've studied the issue, so I think I'm qualified to make medical decisions" is a poor statement. Again, that's why people jumped on you for saying it.

Also, using studies and research conducted by others means you are using someone else's qualifications to better your decision making. If you had launched into this by saying "X studies show X result" with some links to the studies and then suggested these be used in certain fields, this whole storm could have been avoided. Appealing to your own amateur studies and vague "research" while then declaring you know enough to prescribe treatments can be viewed as extremely arrogant, especially when the evidence of your personal studies were rather easily ripped apart.

By that logic alone, Peter Duesberg as an eminent scientist that was considered one of the worlds foremost experts on viruses, would be immediately more "qualified" and therefore implied...as CORRECT to make decisions regarding people infected with HIV. As most here would be well aware of by now due to the scandal in Africa with Mbeki, he has been thoroughly denounced and relegated to the status of denialist and pseudoscientist.

Holding a degree doesn't automatically make your right. However, the qualifications give you greater weight when it comes to a debate between someone with one and someone without one.

I've snipped the rest mostly because it boils down to saying the same thing. People with degrees aren't automatically right, but it gives them greater weight in a discussion. Obviously if they start spouting off on random nonsense they're being fools.

I'm not denying or even suggesting that there is not, or has not been LOADS of quackery and pseudoscience in many branches of alternative medicine, but herbal substances are not so easily dismissed or lumped together. Some things have been shown to be worthless. Some have surpassed expectations and continue to show surprising benefit. Garlic is a simple food but yet it in itself has many strong protective and arguably directly curative effects on a variety of human issues.

Which I haven't denied. What I was objecting to was your standard of evidence, which is meager. The anecdote and the flawed study are just two examples. The one Stark went after is another. The reason why so many people jumped on you was because your arguments were sounding similar to those made by herbal quacks.

Naturally a company's personal promotional material is going to be considered biased at the very LEAST, but I started off at the very beginning of this argument...that really evolved from another thread...by citing OTHER supporting evidence that was far from "suspect". Inconclusive is a fair description, but lets not go too far.

To be fair, the "suspect" part was the promotional material, which, as promotional material, is always suspect. Marketing is always out to cherry pick evidence, deny various negatives, and outright lie to get their product sold. There's known history for that, which is why it's never used.

No I cannot make authoritative declarations about someone else's medication regime. But neither can he. Even he doesn't have that degree of "qualified" authority as of yet if I am correct...Aly will correct me if I'm wrong and I'm sorry in advance if I am but to my last recollection you are in training still as a student and even then it wasn't as a medical doctor either...it was in the field of biochemistry I believe...

He can make some authoritative statements on some conclusions that have been evidenced & peer reviewed through the scientific method, yes, and as I said before, I would naturally give him the respect he's due and listen to his position with respect.

Herpetology, if I'm correct. Also, if I'm also correct, he has a bachelors in biology. However, Aly isn't claiming to be an authority in medicine and he's not prescribing a treatment.

But as I said before...it's not that simple. Duesberg is a classic example. There are many others for the field of cancer reasearch to NARTH members on to every degree of potential error by being incorrect of the overall truth of facts. It's perfectly possible to be very RIGHT in the interpretation of a study, yet perfectly possible to be proven very wrong due to unkown factors or unseen circumstances that change the overall picture.

Of course. No scientist claims to known the truth.

I've snipped the rest as I have no particular argument with them or I've already covered it above.

Anyway, I didn't bother individually arguing Aly's point's because I didn't even have the specific capability needed to argue on his particular turf. He's absolutely correct in what he said regarding the studies and their flaws...BUT as he did admit, there IS something sugesstive that's worth looking at from his point of view as a researcher..he simply feels that it's not enough to recommend or condone people self-medicating on such limited research. I understand, but don't completely agree for the main reason of demonsntrable likelihood of no harm in most cases that I am obviously referring to..and someone's individual criteria of what's enough to satisfy them and their personal choice in regards to health and whatever challenges they may be facing and deciding on at that time.

While the herbs don't have many negative effects (unless you happen to be allergic) the bigger problem was that you convinced her to go off a treatment she was already on. While it turned out well so far doing such can be a dangerous gamble that, without the proper training, is difficult to do without something going wrong. While a degree doesn't automatically make your right, like I said, it does give you the tools and information to make you qualified to make these decisions. Whether you use it or not is, as demonstrated, up to the individual.

Ack..I was going to go over this for spelling mistakes but just forgive me...lol.

Heh. No biggie. I've made plenty of mistakes, as well. Large posts are difficult to police for errors without some automatic spell checking.

[Erik von Nein]

What's relevant is the combination of "history proves that this stuff is relatively benign" combined with "someone's actually done controlled studies of this stuff and it looks like there's some good shit in there." At that point, you know it has some kind of positive effect with a fairly high probability, and you know that it has little or no negative effect with a fairly high probability. Knowing that, Bayesian logic will be enough to take you through the last step.

That's what I said? The studies he's posted haven't been very good, and what I said about the anecdote holds true. By itself you cannot draw any conclusion about it.

By the way, I've always been curious about your posting; why use dashes to break up seemingly random portions of your post?

I disagree with your word choice. That's why anecdotes by themselves are not very useful for making general decisions about entire populations. There's a difference.

This is, again, a Bayesian thing. If a substance's effect on one person has zero significance, then its statistical effect on a thousand or a million people is still of zero significance. For a study to tell you anything, the fate of individual cases in the study must still be at least somewhat relevant.

Yes, in the study. JFF's case was not in the study.

On top of that, even the low relevance of single cases compared to clinical trials doesn't make single cases irrelevant in the absolute. My own personal case history may be beside the point if we're trying to prescribe a substance for use by many thousands of people. But it is highly relevant when making decisions about my own treatment regimen. You'd have to be out of your mind not to take individual cases into account when making decisions for those individuals.

However, that wasn't JFF's argument. He brought up the anecdote as support for the general use of the product. Again, you can't conclusively show that the treatment by itself is what caused her to get better. That's why, in a debate about the effectiveness of a treatment, using an anecdote isn't worthwhile. What does it show?

Snip example

That, again, is an easier to identify reaction to a specific treatment. JFF's example is more complicated. But, yes, I will say they're not necessarily useless, they just do not make the cut of evidence of a direct effect. It suggests a causal relationship, it does not conclusively show it.

I know I keep bringing up homeopaths, but they have as many, if not more, anecdotes to the effectiveness of their treatments, but it's been shown to be almost entirely (if not entirely) placebo in effect.

And please for the love of sanity notice that I'm not saying you would do that. I'm saying it would be stupid, and that it's a logical consequence of taking individual cases as completely irrelevant, but not that you have done it or would do it. Or that any other particular person would do it. I want to make that extra-clear because I've already been misunderstood by enough people for one week this week.

I'll qualify the statement: In a debate about the effectiveness of a drug a personal anecdote is worthless, as no conclusion can be drawn from it.

They are not completely worthless. I'll admit to that.

[Stark]

Simon Jester Wrote:

But if there's an herb that we know contains things which are genuinely useful- a compound with known anti-inflammatory properties, or that has a demonstrated positive effect on the liver, or whatever... taking some of it, to levels that we know empirically that people can eat without major health problems, strikes me as a reasonable thing to do.

It is so massively refreshing to have someone understanding and agreeing with me on exactly what I was trying to put across as my major point on this issue. Are you sure you aren't a bot?

You have totally missed the point, but you're being pathetically tribal ('he's on my side of the fence yay'). Nobody is saying chemicals from herbs aren't sometimes beneficial - the issue is your totally broken mindset for declaring something 'useful'. I've even expressly stated this in the past, but you're so desperate for hugs and support that you've apparently ignored it.

This is massively annoying and, again, feeds right back into that 'credulous idiot' attitude I commented on.

[Erik von Nein]

Okay, for some discussion on why anecdotes can be useless in a debate: Harriet Hall over at Science-based Medicine shows how personal testimonies can be influenced by many factors, and how causation/correlation can be confused.

[Mayabird]

Dimethyl sulfoxide would be my guess as I've heard it used as a key to get other drugs through the skin, Mayabird.

YES! THANK YOU! That was bugging me. I kept thinking, "Four letters, starts with a D, I can figure it out backwards when I get 'em right. Lessee...DHMO? No, that's just goddamn water. DMHO? WTF?" Yes, DMSO.


Back to the flamewar, then.

[Simon_Jester]

By the way, I've always been curious about your posting; why use dashes to break up seemingly random portions of your post?

I try to use dashes to separate 'sections'; if I'm going to say one thing in two paragraphs and then another thing in another two, I put a dash in between to break up the resulting wall of text. It's more useful on another forum where I have the same habit, because I tend to write (believe it or not) even longer posts there.

I also try to do the same thing to separate my responses to multiple posters. Unfortunately, it all depends on whether I happen to think of doing it or not, and sometimes I do it in the wrong places, so I can see why the overall effect seems random. But it's not strictly random, because there's an underlying intent... imperfectly realized.

However, that wasn't JFF's argument. He brought up the anecdote as support for the general use of the product. Again, you can't conclusively show that the treatment by itself is what caused her to get better. That's why, in a debate about the effectiveness of a treatment, using an anecdote isn't worthwhile. What does it show?

I recognize that you can't, strictly speaking, rule out the possibility that the herbals might as well have been sugar pills because they didn't actually have an effect just from the anecdote. It could be that her blood chemistry cleared up and stayed cleared up because of the power of positive thinking; it really could. And it could just be coincidence that her blood test results started rising when she went off the herbals and fell again when she went back on.

But I have two problems with trying to dismiss the anecdote outright, and especially with doing so contemptously:
- This is not purely a question of the effect of the herbal on mother-of-JFF, because there is at least one study result. I lost track of where the issue of the quality of the study was raised, and that's a legitimate question, but an anecdote that would be irrelevant in isolation may nonetheless serve as a useful illustration of a technique that's already been found to work by a study.
- JFF's argument never really hinged on the effect of a specific herbal treatment on his mom. He brought it up, but even if we could somehow travel back in time and establish that he was really giving his mom sugar pills all along and that somehow she experienced an extended years-long placebo benefit from them, it wouldn't really change anything.

If this were the linchpin of his entire case, if he had said nothing more than "they worked for my mother," then yes, that should be thrown out entirely. But he has made many other arguments about biochemistry*, about various controlled studies, about reasons why even a highly effective herbal treatment would be slow to make it past the FDA, and so on. The only reason to spend so much time focused on his anecdote is that it his weakest argument, one that can be dismissed as an outright fallacy without needing to be refuted as a matter of fact the way claims about a study result would.

*Which I am not competent to judge, but don't think are honestly dismissable; I'd think that if they were one of our expert dismissers would have already done so.
____________

You have totally missed the point, but you're being pathetically tribal ('he's on my side of the fence yay'). Nobody is saying chemicals from herbs aren't sometimes beneficial - the issue is your totally broken mindset for declaring something 'useful'. I've even expressly stated this in the past,

You've definitely called his mindset broken; no question there. I went through your posts looking for where you explicitly said something along the lines of "I'm not saying chemicals from herbs aren't sometimes beneficial."

Mixed in with about a dozen posts laden with contempt and insults, the only thing I found was:

Holy shit you just don't get it.

This isn't a crusade against traditional medicine. It's a rejection of USELESS medicine (and potentially dangerous etc) which is why testing is important. Nobody really gives a FUCK if it's an ancient chinese solution to athlete's foot or whatever - only RESULTS matter. You know what happens to 'alternative' therapies when they're proven to work?

THEY'RE NOT ALTERNATIVE ANYMORE. They're actual, factual, testable and reliable therapies.

Championing 'alternative' medicine appears to be a tribal crusade here, dividing medicine into regular medicine and alternative, secret-of-the-ancients medicine you have to have an open mind to use. In reality, there are useful therapies, and useless therapies, and that's it. Testing is needed to determine the safety and efficiacy of a therapy.

For an "express" statement, that's a pretty roundabout way of saying that herbal stuff works sometimes.

Moreover, you seem to have missed the point of why he even gives a crap about any of this stuff being "traditional" in the first place. Hint: it's NOT because he thinks it proves the stuff is all that effective.

[Justforfun000]

I just got in and it's really late, I will have to wait until hopefully tomorrow I can get a chance to respond to everything..if not I may have to wait until I get back from out of town...but I wanted to clarify one very imporant thing. Where you said:

Erik Von Nein Wrote:

While the herbs don't have many negative effects (unless you happen to be allergic) the bigger problem was that you convinced her to go off a treatment she was already on. While it turned out well so far doing such can be a dangerous gamble that, without the proper training, is difficult to do without something going wrong. While a degree doesn't automatically make your right, like I said, it does give you the tools and information to make you qualified to make these decisions. Whether you use it or not is, as demonstrated, up to the individual.

You misunderstood me somehow. I never had my mother come off a treatment she was on. The Dilantin is the orthodox drug she was taking for her Trigeminal Neuralgia. It tends to be hard on the liver and it's common for enzymes to be elevated. So she took the Liver formula to PROTECT her liver while she was taking the drug. Same premise as someone who drinks a lot can theoretically benefit from these supplements. NEVER would I suggest going off orthodox medical treatment. In this case it was complementary in nature. That's all.

And btw...the reason I say above that she "was" taking it, is because luckily she is in a very long period of remission which does happen with the condition and so she doesn't need the Dilantin at all for the time being...I'm praying the episode lasts, but it's very rare for it to extend beyond two years and even rarer to disappear forever..but it IS possible. *Cross fingers*.

Will follow up on this as soon as I have a chance.

[PainRack]

Yes. I'm not in favor of the "cure your cold by taking more vitamin C than a shipload of Napoleonic sailors" school of disease treatment. You can definitely overdose on vitamins.

But if there's an herb that we know contains things which are genuinely useful- a compound with known anti-inflammatory properties, or that has a demonstrated positive effect on the liver, or whatever... taking some of it, to levels that we know empirically that people can eat without major health problems, strikes me as a reasonable thing to do.

And.... how do you know that if said components aren't tested?
You simply cannot say "well, people have been eating this for thousands of years, it should be safe." Vitamin C demonstrates that no, it isn't. A? Same thing.
The Atkins diet? Oops. Not safe too based on nutritional studies of other components.

The list goes on and on.

Exactly. That's my point: not everything that you are wise to do for the sake of your health involves a prescribed pharmaceutical. Sometimes that includes taking an intelligently selected herbal remedy if and only if you have logical reasons to do so.

EXCEPT that said exercise thingy? Supported by massive realms of evidence and study. Indeed, you still have exercise physiologists, sport scientists, doctors and whatnot arguing what is the optimum level of activity for various health related activities and the benefits and costs of various sports and activities. Look at running for the perfect example.

Without study, you won't know whether something is effective or not, neither will you know how good it can be or the risks and harms.

The counter-argument that everything that is health related requires regulation by the FDA before it gets prescribed by doctor is risky to human health is clearly bogus.There are any other number of health related interventions which are NOT regulated by the medical authorities and routinely recommended. However, the corollary, that because you don't need regulation= safe and effective is NOT true. It similarly does not mean a subject is not deserving of study and the risks/benefits of an intervention are in favour of a person.
If we are to use running as an example, running is a common intervention for improving cardiovascular health, weight loss and even building up muscle and bone density. Yet, different techniques tailored to a person individual condition exist, you need to achieve certain indicators before medical benefits are achieved. For example, heart protection? 30min a day in scattered intervels of 5-10min, sufficient to elevate your resting heart rate afterwards.Weight loss? You need over an hour. Then there's also the issues of VO2 max for improving cardio fitness and the corresponding points with regards to cardiovascular health.
But....... run too long? Oops. Knee and other bone problems. Elevation of arthritis. Joint and tendon problems.
Similarly, not everyone can run effectively. There's also the problem of heart problems. Or exercising too intensely.

And the studies are contradictory and require meta analysis to provide guidelines and input so health practioniers can tailor their advice.

If this were the linchpin of his entire case, if he had said nothing more than "they worked for my mother," then yes, that should be thrown out entirely. But he has made many other arguments about biochemistry*, about various controlled studies, about reasons why even a highly effective herbal treatment would be slow to make it past the FDA, and so on. The only reason to spend so much time focused on his anecdote is that it his weakest argument, one that can be dismissed as an outright fallacy without needing to be refuted as a matter of fact the way claims about a study result would.

Except that no one DISAGREEs that herbal medicines can be beneficial. If you do recall, the original objections to those claims was his fallacious biochemical claims about how herbs are "safer" than drugs and have less side effects even while attempting to subscribe to scientific studieis. That and statistical irrelevance and small, limited sample sizes. This isn't the first time he brought up milk thistle and the posters here have never objected to him copying the Mayo clinic claims for it. It was his philosophy, his mindset and mentality that has ALWAYS been the linchpin for rebuttal.

Furthermore, if herbs are effective, even if its working as a co-adjuvant, then modern science would have no problem in actually taking and using that to work AS drugs. Because herbs don't give you accurate dosages or control over effectiveness than pills. That's one of the arguments against medical usuage of marijuana as opposed to Marinol. Same active ingredient, but different philosophy.

Moreover, you seem to have missed the point of why he even gives a crap about any of this stuff being "traditional" in the first place. Hint: it's NOT because he thinks it proves the stuff is all that effective.

No. You missed the point why the board is attacking his "traditional= proven usuage of safety and claims for effectiveness".
Traditional products is NOT a measure for safety or effectiveness. Arsenic anyone?

You misunderstood me somehow. I never had my mother come off a treatment she was on. The Dilantin is the orthodox drug she was taking for her Trigeminal Neuralgia. It tends to be hard on the liver and it's common for enzymes to be elevated. So she took the Liver formula to PROTECT her liver while she was taking the drug. Same premise as someone who drinks a lot can theoretically benefit from these supplements. NEVER would I suggest going off orthodox medical treatment. In this case it was complementary in nature. That's all.

http://www.medicinenet.com/liver_blood_tests/page3.htm
Dilantin alters the test results due to the pharmockinetics. If the results aren't actually going upwards all the time and correlated to clinical results such as ascites, it could be there isn't any actual liver damage.
WORSE. Your herbal concoction could be lowering the enyzmes levels by actually metabolising the Phenytonin before it goes active or something, meaning your mom is having a lower effective drug dosage, meaning reduced pain relief. That or the drug could had been delayed passing out through the body.....
I'm not saying this is what is going on because I'm not a pharmacist, but just taking test results alone is not indicative of anything.
And the stuff I'm talking about is actually something I cribbed up when studying about grapefruit and the effects it has on Ara C.

[Simon_Jester]

Yes. I'm not in favor of the "cure your cold by taking more vitamin C than a shipload of Napoleonic sailors" school of disease treatment. You can definitely overdose on vitamins.

But if there's an herb that we know contains things which are genuinely useful- a compound with known anti-inflammatory properties, or that has a demonstrated positive effect on the liver, or whatever... taking some of it, to levels that we know empirically that people can eat without major health problems, strikes me as a reasonable thing to do.

And.... how do you know that if said components aren't tested?
You simply cannot say "well, people have been eating this for thousands of years, it should be safe." Vitamin C demonstrates that no, it isn't. A? Same thing.
The Atkins diet? Oops. Not safe too based on nutritional studies of other components.

The list goes on and on.

"Does not have horrible egregious side effects" !- "safe to eat in unlimited quantities."

I know, believe it or not.

But if you restrict your consumption of something to a level that millions of people restrict it to without egregious side effects, it seems unreasonable to be worried about the prospect that you will suddenly suffer egregious side effects.

Ginseng is not thalidomide; if ginseng had any such effect at the level people actually consume it at, the effect on mortality rates would have drawn notice. I'm sure you can eat too much ginseng, but I'm equally sure that you can eat ginseng without eating too much of it.

Likewise, you can get vitamin C without getting too much- eat an orange or something. Modus tollens alone gives me plenty of evidence that eating an orange, or even eating an orange every day, won't kill you. Eat ten oranges a day and nothing else, and yes you will probably suffer health consequences. Eat nothing but steak every day, likewise, I agree.

But it's possible to deduce safe dosages at least in part from knowing what large groups of people have done in the past without suffering obvious negative consequences.
___________

Without study, you won't know whether something is effective or not, neither will you know how good it can be or the risks and harms.

Yes? And?

I thought I already said, repeatedly, that one would only consider taking anything if there is evidence that it helps and considerable evidence that it does not harm, or does not harm nearly as much as it helps.

The evidence that it helps HAS to come from a study, preferably from multiple studies. The evidence that it doesn't hurt SHOULD come from a study, but for relatively common items such as garlic it can also come from modus tollens: if garlic consumption at normal levels were seriously bad for your health, we'd expect it to be visible just from looking at the mortality statistics. People would wonder "hey, why do Greek-Americans seem to drop dead of colon cancer more often than Irish-Americans?" and would most likely notice the garlic thing. Just as we figured out that smoking can kill you, we'd have figured out that garlic can kill you.

If garlic has any noticeable side effects, it beggars the imagination that those effects would occur at the levels people normally eat them at. In which case you have a safe upper bound below which eating garlic for the sake of your cholesterol or whatever can reasonably be deemed safe.

And yeah, check with your doctor before you start eating garlic or whatever. Fine. I believe I mentioned that before.
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The counter-argument that everything that is health related requires regulation by the FDA before it gets prescribed by doctor is risky to human health is clearly bogus.There are any other number of health related interventions which are NOT regulated by the medical authorities and routinely recommended. However, the corollary, that because you don't need regulation= safe and effective is NOT true.

Yes. I'm sorry if I didn't make it clear that I consider that obvious before. All I'm saying is that if you've already got the advantage of millions of people trying something, and continuing to try it, without suffering conspicuous side effects of the sort that attract attention even when no one is specifically running studies to look for them... using that substance as a partial treatment for a serious medical problem* is a lot less risky than it would be if we were talking about a randomly chosen chemical.

*When you have a specific reason of biochemistry to expect it to work
________

Except that no one DISAGREEs that herbal medicines can be beneficial.

I would not have been able to deduce that from looking at the first three to five pages of this thread, except by inferring that surely no one would decline to mention a thing that they disagree with.

I'm sorry; I haven't been a regular on this forum long enough to internalize that this must be true. I am still accustomed to interpreting a solid wall of disagreement as reflecting disagreement across the board, which is not true here.

But until quite recently, no one was actually coming out and saying "yes, some of these herbal medicines can work." That's all I've been trying to get at: that the fact that they can work and that, in some cases, at reasonable dosages, you can be at least moderately* confident they don't have the kind of horrific side effects that make extensive testing of completely new and utterly untried pharmaceuticals vitally necessary.

*Not perfectly. But again, if ginseng were like thalidomide people would have noticed. They might well not notice in premodern times, but it strains belief that the medical community would miss such a thing in modern times.

[Erik von Nein]

Snip explaination

Ah. I see.

But I have two problems with trying to dismiss the anecdote outright, and especially with doing so contemptously:
- This is not purely a question of the effect of the herbal on mother-of-JFF, because there is at least one study result. I lost track of where the issue of the quality of the study was raised, and that's a legitimate question, but an anecdote that would be irrelevant in isolation may nonetheless serve as a useful illustration of a technique that's already been found to work by a study.

Which is what I've said previously. So, we have no particular argument here. As far as the study talked about it was the promotional material JFF posted that Stark took issue with. The other study I was talking about Aly ripped on in the first page.

- JFF's argument never really hinged on the effect of a specific herbal treatment on his mom. He brought it up, but even if we could somehow travel back in time and establish that he was really giving his mom sugar pills all along and that somehow she experienced an extended years-long placebo benefit from them, it wouldn't really change anything.

Well, it most certainly would change the use of the anecdote. But, no, I realized this. His standard of evidence so far isn't very good, and this is just another example of that same trend.

If this were the linchpin of his entire case, if he had said nothing more than "they worked for my mother," then yes, that should be thrown out entirely. But he has made many other arguments about biochemistry*, about various controlled studies, about reasons why even a highly effective herbal treatment would be slow to make it past the FDA, and so on. The only reason to spend so much time focused on his anecdote is that it his weakest argument, one that can be dismissed as an outright fallacy without needing to be refuted as a matter of fact the way claims about a study result would.

Which is why I mentioned the low standards with his posting of the sources he did have. Using promotional material and a study Aly pointed out the deficiencies in shows this. I quoted him from when he first brought it up and where he said "Listening to you people, I should go to her and say 'Who gives a fuck that you are getting any personal benefit from this product, it isn't really proof. They told me you're just wasting your money and you're an idiot.'" I took issue with his insinuation that her improvement is proof. It's something suggestive that it could have benefit, but it alone isn't proof, which is something we've all gone over already.

Where he to find the studies from the promotional material that show evidence of what he's talking about and are properly executed then I would have no problem conceding that it's assumed benefits are real enough.

You misunderstood me somehow. I never had my mother come off a treatment she was on. The Dilantin is the orthodox drug she was taking for her Trigeminal Neuralgia. It tends to be hard on the liver and it's common for enzymes to be elevated. So she took the Liver formula to PROTECT her liver while she was taking the drug. Same premise as someone who drinks a lot can theoretically benefit from these supplements. NEVER would I suggest going off orthodox medical treatment. In this case it was complementary in nature. That's all.

And btw...the reason I say above that she "was" taking it, is because luckily she is in a very long period of remission which does happen with the condition and so she doesn't need the Dilantin at all for the time being...I'm praying the episode lasts, but it's very rare for it to extend beyond two years and even rarer to disappear forever..but it IS possible. *Cross fingers*.

Will follow up on this as soon as I have a chance.

I see. Never mind my argument about that, then.

[PainRack]

I know, believe it or not.

But if you restrict your consumption of something to a level that millions of people restrict it to without egregious side effects, it seems unreasonable to be worried about the prospect that you will suddenly suffer egregious side effects.

Ginseng is not thalidomide; if ginseng had any such effect at the level people actually consume it at, the effect on mortality rates would have drawn notice. I'm sure you can eat too much ginseng, but I'm equally sure that you can eat ginseng without eating too much of it.

And? TCM for example featured various herbs and concoctions that had too much arsenic or mercury compounds in them. Consumption of them as a health tonic would certainly had led to adverse health results...... one that would not had been easily noticeable to the general public or scholarly authorities.
Indeed, medicine is now facing similar problems from SSRIs and other drugs.
Its entirely possible for a compound to have potentially adverse reactions without the population being aware of them and proof of traditional usuage is not proof of safety. Huo YuanJia and his potential poisoning via the use of TCM is a modern day example of this.

Likewise, you can get vitamin C without getting too much- eat an orange or something. Modus tollens alone gives me plenty of evidence that eating an orange, or even eating an orange every day, won't kill you. Eat ten oranges a day and nothing else, and yes you will probably suffer health consequences. Eat nothing but steak every day, likewise, I agree.

Except that modern complementary therapy for Vitamin C as promoted by Linus DOES pose the side effect of crystalisation and potential urinary tract problems!

If you wished to have the complementary treatment of Vitamin C you are exposing yourself to this issue.

As TCM shows, its entirely impossible to postulate safe dosages for traditional medicines based on long usuage.

Yes. I'm sorry if I didn't make it clear that I consider that obvious before. All I'm saying is that if you've already got the advantage of millions of people trying something, and continuing to try it, without suffering conspicuous side effects of the sort that attract attention even when no one is specifically running studies to look for them... using that substance as a partial treatment for a serious medical problem* is a lot less risky than it would be if we were talking about a randomly chosen chemical.

*When you have a specific reason of biochemistry to expect it to work

I believe this thread already has the example of a TCM which is currently being explored to treat cancer. And traditional doses of arsenic isn't something we think of as good, right? Why is it that TCM practioners didn't cotton on to this problem until after contact with Western Science?

*Not perfectly. But again, if ginseng were like thalidomide people would have noticed. They might well not notice in premodern times, but it strains belief that the medical community would miss such a thing in modern times.

Say what? Even in the nineties, there were still tons of medical and nursing practices which was done because of tradition instead of benefits.
Let me see..... oooh. I know. Talcum powder and bathing. Its been now researched that the use of talcum powder and daily showering worsen the risk of bedsores. There goes the nursing community decades long practice, and indeed, CURRENT practice of encouraging people to cleanse themselves regularly to protect the skin. Ditto to soap and water.
Let's use an even more modern example. Heparin Saline.
http://findarticles.com/p/articles/mi_m ... _81218984/
So, heparin saline is just as effective as normal saline. To make matters worse, there's growing evidence that excessive use of heparin saline can lead to over-heparisanation and cause a medical problem.

And this stuff has been in use for DECADES.

[Simon_Jester]

And? TCM for example featured various herbs and concoctions that had too much arsenic or mercury compounds in them. Consumption of them as a health tonic would certainly had led to adverse health results...... one that would not had been easily noticeable to the general public or scholarly authorities.

Yes. Happily, we now know arsenic and mercury are poisonous, even if this was not known (or known but somehow not internalized) by premodern medicine in the East or West, we had the same problems; over here mercury was a popular treatment for syphilis for a long time.

I think we're actually in fairly close agreement about the facts of the case, but are approaching them from very different angles. Many traditional remedies are useless, and many more are actively harmful. Some are worthwhile and can be taken at low enough doses that significant side effects at those levels would show up in mortality statistics, let alone in clinical trials. Others might be worthwhile but we can't make any reasonable estimates of safe dosage levels.

I would support the use of an herbal remedy only:
If it's taken at a dosage low enough that we can easily find evidence of safe use, either because of a specifically constructed study or because vast numbers of people have been taking it at that level during the modern era without detectable health consequences. Arsenic, mercury, tobacco, and massive overdoses of Vitamin C all fail this test, even though all have been passed off as medicine by well-intentioned quacks.

If it has a demonstrable positive effect found in scientific studies, preferably multiple studies with impeccable methodology. Homeopathic remedies fail this test, even though they pass the previous one. So does, for example, powdered rhinoceros horn.

If in addition to the demonstrated positive effect, there is a demonstrated mechanism for positive effect, one that a qualified doctor can look at and evaluate intelligently: "This herb contains X,Y-whatchamacallitide, which has thus-and-such effect on the pancreas" or something along those lines. Off the top of my head I can't think of anything that passes the last two tests, but fails this one, but I'm sure something of that sort exists.

If the treatment in question is first run past an expert physician who can be presumed to know the ways it might interact badly with some other detail of the patient's health situation: "Yes, normally broccoli is good for your heart, but in the case of people with your unusual disease it's likely to give you a horrible rash. Try something else, such as X, Y, or Z."

If, in addition to all this, the treatment is NOT used as a substitute for other, better established treatments, but rather as a supplement or complement to them.

That's a very restricted subset of traditional medicine, locked into the framework of modern medicine's canon as tightly as possible. I would hope that you find such a set of restrictions satisfactory.

Except that modern complementary therapy for Vitamin C as promoted by Linus DOES pose the side effect of crystalisation and potential urinary tract problems!

If you wished to have the complementary treatment of Vitamin C you are exposing yourself to this issue.

This fails my first test; we know from experience that taking several hundred times more Vitamin C than your normal daily needs will hurt you. Therefore, the safe dosage is clearly well below that extreme level, even if some fool does not realize it yet, even if the fool is also a Nobel laureate.

Even before this was known from experience, it would still fail the first test, because you cannot use past experience with safely taking 100 or 200 mg of Vitamin C per day to justify taking five or ten grams of the stuff.

I believe this thread already has the example of a TCM which is currently being explored to treat cancer. And traditional doses of arsenic isn't something we think of as good, right? Why is it that TCM practioners didn't cotton on to this problem until after contact with Western Science?

Because Western science contains a crucial insight that neither traditional Chinese medicine nor traditional European medicine has: the bit where you gather statistics on large numbers of people taking the stuff to see what happens to them. Apparently this is an extremely hard thing to think of if you don't already know about it; beats me as to why.

The fact that something has been used in traditional medicine is not enough to get it past the conditions I describe above in and of itself. I'm aware of the gaping hole in traditional medicine (both mine and that used on the other end of my ancestors' continent), and try to close it by using only those of its recommendations that scientific medicine has come close to confirming. I do not, under any circumstances, consider longstanding traditional use to be evidence of a positive effect. At absolute best, I consider it to be negative evidence indicating (but not guaranteeing) the absence of a negative effect.