Quack Therapies Spread Because They Don’t Work

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Mathematical biologist Mark Tanaka of the University of New South Wales (Australia) wanted to know why ineffective health therapies, often called “quack therapies”, spread and develop reputations for working. He and other researchers interested in that paradox worked on creating a model of why people often try therapies and medicines which have no evidence of working and how they become more popular despite their ineffectiveness.

The headline to this article must seem counterintuitive. The very idea certainly seemed bizarre to me until I understood why its likely true after reading Quack remedies spread by virtue of being useless in NewScientist magazine.

Why does an ineffective therapy for an illness become more popular because it doesn’t work? It’s primarily because it didn’t kill patients, many of those patients recovered for other reasons, and when people who knew about their recoveries got similar illnesses, many of them tried the same ineffective therapies and had similar results. Even more perversely, as quack therapies don’t work it means people stay sick longer and thereby talk about the quackery with more other people, thereby convincing them to give it a try:

Under a wide range of conditions, quack treatments garnered more converts than proven hypothetical medicines that offer quicker recovery, Tanaka found. “The very fact that they don’t work mean that people that use them stay sick longer” and demonstrate a treatment to more people, he says.

This reasoning implies that the quackeries didn’t have immediate deadly consequences, a good thing for the people who tried them. Frankly, it can be very hard to know what treatments work and what ones don’t work without investing large sums of money and time into doing well-designed studies that can take years to gather results.

What is particularly frightening about this is that both quack therapies and “well-tested” therapies may sometimes be believed to work but in fact they can be like band-aids that cover up the symptoms of a problem only to later cause the death of a patient. Given the complexity of determining whether a therapy or medicine really works, even reasonably designed drug and therapy studies done by well-intentioned researchers can come to the wrong conclusions. It’s possible that the therapy being investigated may appear to work, the patient may appear to recover, and then years later many of those patients develop a recurring illness or other medical problem that was caused by the seemingly effective treatment.

A case in point is Hormone Replacement Therapy (HRT) that was believed for decades to help post-menopausal women with health problems. The treatment was developed starting in the 1960s. By the 1990s, the American Heart Association and other medical groups believed that it had been well-studied and was safe and beneficial. Doctors began to prescribe it widely. By 2001, 15 million American women were taking HRT medications.

But after decades of increasing popularity, longer-term studies started to show that HRT was actually quite adverse for long-term health. In 1998, a study was released that tied HRT to elevated risks of repeat heart attacks. In 2002, another study concluded that HRT raises risks for heart disease, stroke, blood clots, breast cancer, and dementia. You can read more about the HRT debacle in Do We Really Know What Makes Us Healthy?.

In the near future, we’ll be bringing you more information on a debate that is starting to go widespread about the use of vitamin D. Vitamin D is being recommended ever more widely as a possible way to reduce risk of heart attacks, multiple sclerosis, diabetes, autism, and other diseases. Yet there’s a school of thought that seems very well-informed that argues that vitamin D actually suppresses the immune system and its seemingly beneficial results are caused by a short to medium term drop in inflammation symptoms like pain and fatigue, but that the long-term effect will be adverse because the immunosuppression increases long-term health damage by allowing the proliferation of latent bacterial infections that cause much damage years later.

It’s not clear to us what the truth of the vitamin D debate is, but it looks to have the potential to turn into a debacle even bigger than the HRT mess, a cure-all that addresses a lot of illnesses, or some mixture of the two. Since we can’t be sure what the truth is, we’ll be presenting multiple sides of the vitamin D debate in future articles.

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Further Reading

Quack remedies spread by virtue of being useless

Do We Really Know What Makes Us Healthy?

  1. Ted Hutchinson
    May 6th, 2009 at 04:49 | #1

    But we can all use our common sense when it comes to understanding the Vitamin D3 issue.

    Does our common sense inform us that our DNA evolved while we lived a more outdoor life than is currently the case?

    Does our common sense tell us that it is more than likely that the natural level of Vitamin D that our bodies naturally achieve when we live outdoors naked and that allows human breast milk to flow replete with vitamin D is possibly the level our DNA evolved to work best with|?

    If that NATURAL level of Vitamin D is associated with a lower level of chronic disease incidence isn’t this a sensible level to regard as the optimal level for optimum health?

    If it were the case that people with level of 25(OH)D of 60ng 150nmol/l or above had a higher incidence of disease or a worse prognosis when diagnosed they this would surely be reflected in the research.

    • Cameron
      May 6th, 2009 at 13:30 | #2

      Thanks for the link to that chart, it makes a good point.

      I agree, common sense and a lot of studies say that D3 helps health in many ways and that we likely have lower vitamin D levels because of reduced sun exposure from spending a lot more time indoors.

      However, common sense can be wrong. When it is, it can be very difficult to figure out the truth of the matter. I’m not coming down on either side of this debate because frankly I find both sides have good arguments and that common sense factor does sway me, too.

      One of the best explanations for the view that vitamin D supplementation can cause health problems that I’ve run across is an article The Truth About Vitamin D: Fourteen Reasons Why Misunderstanding Endures. It’s really long, but makes some very good points and is extensively footnoted. One of the points is that lowered serum 25(OH)D levels are a symptom of an illness, not a cause. Determining cause and effect in medicine can be really difficult as there are so many interrelated factors and unknown variables. The articles also points out that many studies done regarding vitamin D health effects never measured the blood 1,25(OH)D level, only the 25(OH)D level. This is claimed to be significant because the researchers backing this theory claim that a lot of the people who have low levels of the inactive form 25(OH)D also have very high levels of 1,25(OH)D which is the activated form of vitamin D.

      The people behind the alternative view of vitamin D argue that there is a problem with the way vitamin D works in the bodies of many people because of chronic infection by what are known as L-form bacteria. The L-form bacteria are reputed to produce proteins that block the vitamin D receptor. They could be more widespread for some reason than they were in the past. For example, our current practice of medicine or longer lifespans may allow these bacteria have more time to spread within individuals and increase success of spreading between people, too.

      Some molecular biologists are claiming that both the proteins from L-form bacteria and vitamin D in the unactivated form 25(OH)D (also called 25D) block the vitamin D receptor, all of this without activating the transcription of some immune system genes that the 1,25(OH)D activated form (also called 1,25D) of vitamin D would trigger.

      Even the commonly held belief that rickets is caused by vitamin D deficiency may not be accurate.

      We’re going to try to explain the essence of the vitamin D debate in a more concise fashion in a future article while providing links to arguments from both sides. Frankly it’s really hard to know what the truth is about this matter, but as vitamin D supplementation is becoming extremely common and it is being added into more and more foods, it is really important to figure out what the truth is quickly.

  1. May 21st, 2009 at 01:38 | #1

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