I hate to end the week on a bit of a downer, but sometimes I just have to. At least, it’s depressing to anyone who is a proponent of science-based cancer care as the strategy most likely to decrease the death rate from cancer and improve quality of life for cancer patients. Unfortunately, in enough ways to disturb me, oncology is actually going in the exact opposite direction. I’m referring, of course, to the phenomenon of “integrative oncology,” a form of quackademic medicine that is proliferating and insinuating itself in academic medical programs like so much kudzu. The concept behind “integrative medicine” is that somehow it is the “best of both worlds,” in which the very best of science-based medicine is combined with the very best of “alternative medicine.” Sometimes, in a rather racist construct, it’s portrayed as combining the “very best” of “Western medicine” with the best of “Eastern medicine,” as though only “Western” medicine is scientific and “Eastern medicine” is mystical and magical. In reality, what integrative oncology involves is “integrating” quackery with medicine, pseudoscience with science, and woo with reality-based treatment, and I have yet to see any evidence indicating that diluting the scientific basis of medicine will do about as much good as diluting the remedies used as the basis of homeopathy. Certainly, it won’t make oncology stronger, only woo-ier.
But how widespread is the phenomenon? Pretty freakin’ widespread, I’m afraid. In fact, i was just reminded of how widespread it is by a recent systematic review out of the Ottawa Integrative Cancer Centre, the Canadian College of Naturopathic Medicine in Toronto, and the Ottawa Hospital Research Institute that appeared a month or two ago in Current Oncology. Basically, a naturopath named D. M. Seely and colleagues surveyed the “integrative oncology” landscape and found that there’s a lot out there. The purpose of the review was to summarize the research literature describing integrative oncology programs, and to do so Seely et al combed the medical literature and conference abstracts, looking for programs reporting combining “complementary and alternative medicine” (CAM) care and conventional cancer care. The results were summarized in the abstract thusly:
Of the 29 programs included, most were situated in the United States ( n = 12, 41%) and England ( n = 10, 34%). More than half ( n = 16, 55%) operate within a hospital, and 7 (24%) are community-based. Clients come through patient self-referral ( n = 15, 52%) and by referral from conventional health care providers ( n = 9, 31%) and from cancer agencies ( n = 7, 24%). In 12 programs (41%), conventional care is provided onsite; 7 programs (24%) collaborate with conventional centres to provide integrative care. Programs are supported financially through donations ( n = 10, 34%), cancer agencies or hospitals ( n = 7, 24%), private foundations ( n = 6, 21%), and public funds ( n = 3, 10%). Nearly two thirds of the programs maintain a research ( n = 18, 62%) or evaluation ( n = 15, 52%) program.
OK, it’s pretty dry stuff, but it indicates an unfortunately robust integrative medicine presence in oncology, and not just in the U.S. The disturbing aspect of this article is not so much the data contained in the abstract, but the commentary, which buys into every trope, exaggeration, and bit of spin used to sell “integrative oncology” to academics and thence to the masses. For instance:
The goals of integrative oncology are to reduce the side effects of conventional treatment, to improve cancer symptoms, to enhance emotional health, to improve quality of life, and sometimes to enhance the effect of conventional treatments6–8. Sagar and Leis describe integrative oncology as both a science and a philosophy that recognizes the complexity of care for cancer patients and that provides a multitude of evidence-based approaches to accompany conventional therapies and to facilitate health9.
Uh, no. Integrative oncology might proclaim those goals, but to call “integrative oncology” science reveals a gross ignorance of what actually falls under its rubric, which can include a hodge-podge that ranges from the seemingly reasonable and science-based (such as diet, exercise, and other lifestyle interventions) to the interventions that are at best highly questionable (such as acupuncture) to interventions that are based on nothing more than magical thinking (homeopathy, reiki). In fact, Figure 2 shows the frequency of different interventions found in integrative oncology programs. It’s a depressing figure to look at, as nearly half the programs offer reflexology and reiki, while 20% of programs offer homeopathy. I kid you not. Then there are tables listing the various programs, and they’re even more depressing to look at. Lots of big names are there, including Memorial Sloan-Kettering and M.D. Anderson, which are listed side-by-side with the woo-peddling Cancer Treatment Centers of America as though they were equivalent.
One notes also that these programs seem averse to doing something that pretty much every science-based program normally does, measure patient outcomes as a means of improving the program’s offerings:
Half the programs ( n = 16, 55%) in our sample reported consistently measuring patient outcomes as a means to evaluate the program. Of the remaining programs, 2 (7%) specifically reported not conducting program evaluations, and 11 (38%) were silent on that issue. A range of outcomes are assessed across the programs, including quality of life, cancer- and cancer treatment–related symptoms, well-being, survival, patient-identified concerns and benefits, and descriptions of patient experiences within the program. Some programs rely on researcher-developed questionnaires to assess patient outcomes; others rely on standardized measures. Most commonly, a baseline assessment is made when a patient is first referred to the program, with follow-up occurring after treatment or after a predetermined amount of time.
For evaluation purposes, 3 programs (10%) reported collecting data other than patient outcome data, including clinic volume, therapies used, reasons for referral, financial assistance requests, and client feedback on aspects of the program they liked or would like to see changed. Results of the evaluation programs are used to improve the treatment approach or to develop a case for expansion of the program; they are sometimes published in academic journals or presented at scientific conferences.
One would think, wouldn’t one, that it would be closer to 100% of these programs measuring patient outcomes. That’s what real cancer programs do: Engage in continual quality improvement, examining their outcomes and figuring out how to improve them. For instance, I’m involved in state- and nation-wide quality improvement initiatives for cancer care in general and specifically breast cancer care that our cancer center is involved in, where we track adherence to evidence-based guidelines and try to improve it. Of course, my cancer center is also involved in cutting-edge research, but it’s understood that not all cancer centers can do that. Most cancer centers will be focused on providing the best clinical care to cancer patients that they can.
Be that as it may, another telling indication of where these “integrative oncology” centers are coming from can be found in this passage:
The decision to offer specific complementary therapies is most commonly made based on evidence ( n = 12, 41%) and patient demand ( n = 10, 34%). Other reasons include clinical experience ( n = 3, 10%), recommendation from a conventional health care practitioner ( n = 2, 7%), recommendation from a complementary health care practitioner ( n = 1, 3%), availability of practitioners ( n = 1, 3%), and the ability to easily integrate a therapy into a hospital setting ( n = 1, 3%). The stated goals of all the included integrative oncology programs were closely aligned, collectively identifying common principles within the field, such as “whole-person,” “patient-centred,” “collaborative,” “empowerment,” and “evidence-based.” Further, each of the included programs had framed their goals in terms of providing high-quality supportive care alongside, and not in place of, conventional care.
Only 41% cited evidence? It should be 100%! Why spend the money to add a program to your cancer center’s portfolio of clinical programs if you don’t believe that there’s compelling evidence that it would make cancer care better and result in better outcomes for patients? One thing that did surprise me, though, is that only 34% cited patient demand. As I’ve written before with respect to the Bravewell Consortium and the Samueli Institute, it’s usually much higher, like 85%.
Of course, the growth of “integrative oncology” is driven far more by perceived patient demand than it is by science. Same as it ever was. This review only shows more evidence of the intellectual bankruptcy at the heart of this emerging “specialty.” These days, it is quackademic medicine triumphant and excellent evidence supporting how we boil down “integrative medicine” into 34 words.
49 replies on “The kudzu that is “integrative oncology” continues to insinuate quackademic medicine into oncology”
The reason that they don’t report patient outcomes like years of survival since diagnosis, is because the truth will out.
Releasing data that says “Patients only had X% of the mean survival rate of their conventionally-treated counterparts, but they felt really relaxed and self-affirmed for the short amount of time they survived” would hurt the bottom line. It would affect the most important feature of these Quack Shacks, the money they attract.
The decision to offer specific complementary therapies is [based on various factors]….
That was a rather strange paragraph. If I were designing that survey I would allow multiple answers, but it seems that only one of the 29 programs did. I would expect a majority of programs to offer multiple answers to that question–patient demand and availability of practitioners are two necessary conditions for offering such services, and neither of them excludes any of the other options.
I’m also suspicious of the nature of the “evidence” cited as the most common reason for offering CAM services. Some of that is likely to be True Believers citing dubious studies that make their way into the published literature, but I wonder how much of that is “evidence that people will pay for such services.” Or alternatively, people who know that that’s what the answer should be and so give that answer for the sake of appearance.
Even more disturbing is that two programs cited recommendations of so-called conventional practitioners as a reason for offering this program, while one admitted to following the recommendations of a CAM practitioner (whom you would expect to advocate such things).
but seriously, it’s Friday and many of us are thoroughly exhausted because of our hectic, complicated lives and thus, is ridiculous woo that both peripherally refers to a post’s title and could possibly lead to a needed laugh or two not EVER really OT @ RI?
“Gut healing Kudzu starch” – as an autism treatment- via the
AutismOne schedule attached PP from Culinary Reality Check by Sueson Vess et al.
It is a bit surprising to see this in Canada.
Normally healthcare programs are quite conservative here, and are analyzed obsessively for cost-efficiency before they are implemented. These days I work in a lab that receive sizeable grants for this purpose.
I guess this is another instance of wanting to mindlessly copy the US.
I have dealt with an integrative MD. Much of integrative medicine does not interest me, or him. If he wants to pursue something beyond my interest, I simply decline. Perhaps with a polite, “you know me, I’m a chemical kind of person.”
However, I would rather have a doctor that I can specify which modality I prefer, rather than some intolerant, monolithic ignoramus that is still struggling with counter-factual “mainstream” superstitions, and interfering with a studiously informed choice.
Here is an interesting anecdote about superstition based interference from the Riordans:
One of the nurses said that she had never heard of such a high dose [with IV vitamin C infusions, 30-100 grams] and she would not administer it “because it would kill the patient.” … To prove the safety of the I.V. C, the author started an I.V. infusion of 30 grams of vitamin C … on himself. He was seated next to the nurse with the I.V. pole between them. The infusion lasted an hour and all the time the nurse was saying “you are going to die”
Please. STFU and put the catheter in !
@ Kemist – not copying the US but hankering for the days of the security of Empire. Engerland is the true home of cancer woo, a pact between NHS oncology and ‘alternative treatment’ dating back as far as 1979. The ‘holostic’ approach has long been championed by hereditary buffon Charles Saxe Coburg Gotha – who Canadians, to their eduring discredit, still look to as their forthcoming feudal master.
(links hxxped to save Orac moderation inconvenience)
As a non-native speaker of English I obviously need to brush up on the meaning of the word “kudzu”. Here I thought that I was going to get an insight into the questionable use of this legume (Pueraria lobata) in oncology – sadly spreading from the TCM sphere and the believers of extrapolation from in vitro-experiments…
Oh look, it’s prn and his hard-on for IV vitamin C as a cure-all for all that ails the world. Must be a day ending in ‘y’.
@Denice – Ah, beautiful find! And kudzu is everywhere in the US, is it not? So free to find, and fabulous mark-up to be had!
Actual good news at Rancho elburto today, giving us some unexpected Friday energy. After little wifelet’s car accident two weeks ago, in which some idiotic manchild drove his van into our tiny car and injured it, the insurance company has written it off.
Normally that’s bad, but we’ve been given enough to go toward our small savings, and get us a used wheelchair accessible vehicle!
Watch out quacks and wooligans, I’ll be mobile soon, and living up to the anagram of my name.
It’s so wonderful to have a quack who not only uncritically embraces MY quackery, but indeed ALL quackery!
Why then consult a doctor ?
That’s like asking an engineer to mount detailed specifications for an electronics project and then choosing to make a garden gnome with wire and duct tape in your basement instead.
Congratulations. I shall take extra care if I’m ever strolling about the north-east, as unlikely as that is.
Has ATOS declared you fit for work yet?
Why then consult a doctor ?
I shop a la carte for value added, not just FDA/xxx approved snot advertised on TV. Medical oncologists simply have been the weakest link and haven’t had much to offer beyond misery, failure and expense after some basics. I have been more successful in finding advanced diagnostics and surgery from other MDs. I make do with other consults and research, far better than others do with some pharma ho MD, after the companies’ sponsored dinners and other corrupt incentive schemes.
Bear in mind, I am not rejecting pharmaceuticals per se, I buy select pharmaceuticals in boxes. I reject dramatically expensive, nasty, relatively ineffective or even contra indicated ones that I’ve been pressured on. I can see drugs in the world literature that can be made to perform better, that US oncologists are too busy, too indoctrinated, etc to notice. In fairness, they can’t even get their hands on some things I can. However I doubt they would know how to use them more optimally even if they did.
That’s like asking an engineer to mount detailed specifications for an electronics project and then choosing to make a garden gnome with wire and duct tape in your basement instead.
It would more like me asking asking an engineer for a 22 nm technology device and getting a truckload of North Korean discrete components, and attitude.
The Pharma Ho Gambit: like Shill, but with extra sexism!
PiE @7: This is an example of metaphor. Kudzu is a vine native to Japan which was introduced to the southeastern US (particularly Appalachia) for erosion control. Oops. It’s capable of growing 30 cm per day, and thanks to its root system (which is why it was planted for erosion control) it’s quite difficult to eradicate, so it’s now known as the vine that ate the South. CAM, like kudzu, spreads quickly and is difficult to eradicate. Thus, Orac’s metaphor.
Pharmacist-in-Exile – That is the same kudzu. In the southern United States it was planted to control erosion. What they failed to understand was a) that in that climate, free of anything that will eat it and without cold winters, it will grow to cover and smother anything around it, including trees; b) it’s very difficult to kill; and c) it doesn’t control erosion particularly well.
Orac uses it in the sense of a nuisance weed that spreads quickly and is difficult to kill.
In folklore it is said that if you stand still too long in a patch of kudzu it will grow to cover you. This was a basis for the Firesign Theatre album Eat Or Be Eaten.
Factoid about kudzu: Cattle and other ruminants will happily eat kudzu, and if you can figure out how to cut it, it makes pretty good hay. Goats can actually do a pretty good job of controlling kudzu given their ability to climb.
Thanks Adam. When “Pharma Shill” is used to explain **everything**, that may be a valid complaint. I am very slightly paraphrasing other experienced, mainstream MDs, with much better pedigree e.g. maybe 36 x 240 “caliber” concerning certain types of multidip behavior amongst some oncologists. Behaviors not held in high esteem outside a heavily sponsored meeting.
Fact is that marketing departments have spread money high and low, and some of their products, suck performance wise e.g. $100,000+ per uncertain net month extra with 5-12 months misery and iatrogenic risk in between. No thanks.
In fact I view this situation as another kind of human shield situation where far cheaper – better answers go begging because of excluded competition.
kudzu has a long and storied history in TCM ( Web MD) as a treatment for alcoholism and as a counter to the symptoms of a hangover ( and we all know what they are); additionally used for heart and circulatory problems ( high bp, irregular heart beat, angina) as well as for menopause, sinus problems, colds, flu, muscle pain, measles, polio, fever, skin rash, psoriasis etc. Used in IV for stroke caused by blood clotting.
Who knew? What can this miraculous essence NOT do?
I have previously only heard of it being used to thicken sauces in Japanese cuisine and as a ( TCM) woo remedy for upset stomach.
Quake in your boots, Big Pharma, you’re about to be strangled by the Vine!
Bamboo is the Northeast’s answer to the Kudzo’s introduction in the southern part of the United States:
Orac blogged about “Kudzo Jesus”two years ago and (crap), I *missed* some of Isabel’s comments, because I was offline on a trek through Alaska:
P.S. Just ignore any comments from “Chris”, our resident horticulturist. I’m the original Kudzo-Killing, Bamboo-Bashing specialist…capable of killing any plant by the laying-on-of-hands, with my brown thumbs.
prn: “Bear in mind, I am not rejecting pharmaceuticals per se, I buy select pharmaceuticals in boxes.”
That looks much less suspicious to the cops when they search your vehicle (as opposed to buying pharmaceuticals that come in glassine envelopes).
The thing is that the engineer might have good reasons to tell you to get discrete components or an SoC made by an obscure company for certain applications.
Ah, that might explain why it grew in Ontario then.
We Quebecers have no love for the monarchy.
’cause everything tastes better with misogynist sauce.
Our friend prn reminds me a little of two guys I know:
they pick and choose what meds they take and how often they take them. They disregard doctors’ advice unless there is an emergency or a script is needed.
” Oh, I haven’t had an asthma attack for a while so I don’t need this maintainance inhaler: I’ll just store the rescue one in the car.” ( doesn’t read temperature limits on rx)
” I’m not severely depressed- besides that med makes me feel ‘off’- I’m not myself when I take it. I’ll take it when I feel REALLY poorly. Not the new rx, the OLD one is better”.
Yes prn behaves in a way that is quite familar to me- as if to say, “I’m in control here”. However prn doesn’t have intermittent attacks of asthma or moderate depression- both of which have been experienced for decades and have never led to serious consequences.
He’s talking about colon cancer, I believe, with metastases.
It reminds me of something I witnessed at an antiques venue, many years ago, where an appraiser was trying to tactfully break it to a woman that her cherished family heirloom was in fact a nicely made but relatively recent copy.
After listening to him list the reasons why the item could not possibly be authentic, she finally snapped, “I think I’ll take it to someone who knows what he’s talking about!” and stalked off.
As Denice says, it’s all about being in control. And about having to prove that you’re smarter than some fancy-pants expert.
I did watch kudzu eat a car one year. It’s not as fast as people say – it actually took a few weeks.
[email protected]: Multisite and MDR metastatic cancer cases tend to have a strong, unmet need for control, biological control, not psychological, social, economic, regulatory or legal controls. Patients and doctors are often too hobbled in one or more ways to deal effectively with the overwhelming primary need, even on an experimental or individual basis. Fortunately, not me.
And about having to prove that you’re smarter than some fancy-pants expert.
When someone directly contradicts their own credible literature or has missed unusual, unrefuted papers and can’t even discuss them, I doubt their expertise and/or independence. 2-3 strikes, and they are likely done as experts in my eyes.
If a newbie lets their ego get in the way on a hot exponential crisis, they tend to crash and burn quickly. I have multiple metrics that the oncologists can’t begin to touch. Persistent experimental science with consistent application of known science and art, enables one to cut through clutter and be independent. Not this “consensus science” quackery based on a relatively few, ill concieved tests that studiously avoid threshold conditions (or control) with previously identified variables.
Wow, *persistent experimental science* links to a Youtube video. Dunning-Kruger anyone?
I’d probably wear gloves, too. There’s no telling where you’ve been.
Unfortunately the quackery of CAM is sneaking into a lot of colleges – I recently discovered that even UCONN has fallen prey to it.
I’m a sad panda.
[…] is a huge red flag for quackery. It’s almost always pseudoscience. Orac discussed “integrative oncology” quackery this week at Respectful […]
Narad: “…multiple metrics that the oncologists can’t begin to touch.”
Let me add a few examples:
Most mCRC patients suffer one or more acute episodes, or chronic impairments like permanent neuropathy for a pianist, heart attacks, GI perforations, grade 3/4 nausea (and vomit), grade 3/4 neutropenia, anemia, hand-foot syndrome, bleed outs, disintegrating teeth/bones, etc. Even worse is that many stage II and III patients suffer these handicaps for small incremental OS gains, when better results are available cheaper and without the dramatis.
I spend less on a multisite stage IV with all bad biomarkers than most people pay for their insurance premium or deductibles.
The initial MBTF / mean OS quoted for Folfox, Folfiri, Bev, Cet was less than 1.5 years where the population includes better biomarkers. This has exceeded a factor of two without the heavy stuff.
Any given chemo typically quits working for mCRC in 5-15 months. I’m still working with a low dose 5FU-LV backbone as the only “professional” oncology stuff after 3 years, despite cellular resistance to 5FU, oxi-, iri combos in met samples. Just gray literature and experimental applications on top of the 5FU-LV.
Leucovorin is not the only useful vitamin…
One answer to DK bs is physical reality that the pros simply can’t achieve. However, pseudoskeptiscism appears to be a form of DK around here.
I’m glad you are doing so well, I really am, but you have absolutely no idea if your progress has anything at all to do with the treatments you have chosen. That’s why we need clinical trials, to even out the confounding factors as much as possible. As I have pointed out before, you are running an unblinded, unrandomized, uncontrolled clinical trial with n = 1.
I have to wonder if this represents superior understanding, or a gross misunderstanding that has left experts speechless, and uncertain where to start in correcting your misconceptions. From the claims I have seen you make here in the past, I suspect the latter.
Kelly M Bray
Is that a step up or down from citing a creationist?
To be fair, it appears to be a video of Richard Feynman. On the other hand the video just explains how science works (hypothesis->experiment,…) and I don`t see the point since this is how mainstream medicine works as well.
Congratulations on your unintended windfall.
“Is that a step up or down from citing a creationist?”
How about a creationist Youtube video?
Here in Australia, we don’t have kudzu. Thank heavens. But we do have lantana, scotch broom, patterson’s curse, prickly pear cactus and blackberry.
And cane toads. We have *a lot* of cane toads, and I think the kudzu might be less of a problem. Cane toads strike me as a better analogy to woomeisters, because looking at some of the posts above, kudzu does actually have some small use. Cane toads are just toxic little [email protected]@ards that spread like wildfire, destroy the local ecosystems and have no known effective controls.
Thanks Dorothy and Krebiozen!
We actually managed to get one within ten minutes of starting the search. The sole used WAV dealership in our county (which is actually on the same business park as Other Mrs elburto’s workplace) had exactly what we wanted. Right car, right modifications, great condition (because it’s an ex-Motability* car), and it actually came in at £1000 less than our savings, so we don’t have to wait around for the insurance payout. Should be ready to collect in a couple of days.
@Krebiozen – Weirdly enough, I was not only switched from IB to ESA, but it happened within less than two weeks and without the dreaded Work Capability Assessment. To say I was astounded is an understatement, especially given that I know dead and comatose people who’ve been found “Fit for Work”.
@prn – Are spontaneous regressions, misdiagnoses, and medical anomalies not concepts on your planet? Here on earth all of those things are medical facts.
I’m sure most of us know of a friend/family/acquaintance who was given a dire prognosis about the path of a birth injury/congenital condition/acquired disease like cancer, but who beat all the odds anyway. The human body has plenty of surprises in store for science and medicine.
I know you desperately want to be a special, maverick crusader for ‘Health Freedumb’ but you’re really just another lucky b*stard who went into spontaneous remission.
*The Motability scheme allows people with disabilities who are in receipt of a certain state benefit, to use that money to lease an adapted vehicle from a dealership. They can also use the same scheme to lease scooters and powerchairs.
Contracts on cars last for three years or so, then the cars are traded back for new models. The returned vehicles are sold on to people like me, who prefer not to sign half of their disability payments over every month, and save to buy their own car instead.
The reason these cars are immaculately cared for is because the associated insurance policy is very harsh indeed. Also, these cars have a limited market so they’re priced to sell, and are sold without VAT (sales tax of 20%)
Those factors combine to give us our ‘new’ car that is eight years old, cost less than £3000, but looks like it’s just left the factory.
Cane toads strike me as a better analogy to woomeisters
I was hearing the other day about cane-toads spreading across farmland faster in some directions than in others, because they tend to expand along the paths of frequent cattle droves. The bullsh1t keeps them alive.
@elburto, that is great about the car.
@herr doktor, you prove my point about the cane toads!
Good news Elburto. One of my friends is currently at the tribunal stage trying to get the support she needs. I’m trying to see if I can work first, rather than hammer a time/intensity dependant condition trhough an ATOS assesment.
Yep – It’s everywhere! My organization’s “Integrative Medicine” component of our cancer center has:
– MD who is way into WOO
– Doctor of Acupuncture and Oriental Medicine
– Naturopath who is also an ARNP
– Massage Therapist
– RN who is a national figure in the “Healing Touch” realm
A while back I got into a heated discussion (argument) with one of them about the value of “Integration Medicine” that earned me a verbal reprimand from my director!
I find it interesting that more conventional practitioners are more likely to recommend someone than complementary ones. I would have thought it’s the other way around. It just goes to show that if a doctor isn’t familiar with the altmed, they’ll probably shrug their shoulders and say “what’s the harm?”. And of course maybe complementary practitioners are simply not directing people to integrative health care because then the person gets ebil SBM as well.
It doesn’t surprise me at all that integrative care is offered mainly because of patient demand. This is one of the areas where people need to learn that “customer is always right” is not actually true.
It’s interesting what one can sound like if one just changes some words. You really do sound like someone swearing at the modern world for not accepting your idea that belladonna is a cure-all and that the four humours aren’t being taken seriously by the ‘establishment’.
Last year prn was here railing at the medical establishment for not using dessicated thyroid, and criticizing conventional doctors for having no idea about treating thyroid disorders, and being “uncomfortable with dessicated thyroid”. That particularly amused me as I have worked with doctors who hold thyroid clinics, and have attended a number of meetings of doctors who regularly treat thyroid patients. They have heated discussions about the best way to treat thyroid disorders, cut-off points for treatment, when to use one treatment or another etc. etc.. I also know that the debate about synthetic thyroxine versus dessicated thyroid was decisively settled many years ago, which accounts for the lack of any recent research prn complained about. A little knowledge, especially when someone assumes that they are smarter and more curious than specialists, can be a dangerous thing.
I for one would shudder at the thought of using dessicated thyroid to control my TSH level for reasons of quality control and dosage.
Sleepless in Sherbrooke
And here I thought prn was a one-trick pony, what with the vitamins being brought up all the time.
Krebiozen, still pushing your T4 program and the TSH tin standard with a little self referential and circular appeal to authority? Were these conferences before or after the Syhthroid scandals intimidating researchers about equivalency results on generic T4 ? Have you even seen desiccated thyroid use ?
Sometimes it is hard to tell claimed MSM-EBM-SBM medicine from marketing based medicine. Pls note that experienced, conventional doctors from good schools have signed desiccated thyroid scripts without the insults here.
TSH could be a mediocre test designed to support a mediocre product as a “companion marker” as a sales tool. The bottom line is that all this “consensus science” based medicine fails on at least two counts: first is that it simply doesn’t do the job for a lot people who do get great relief on T3+T4, and most of all desiccated thyroid. Second is that if TSH is so wonderful and science founded, why has TSH cut off drifted from ~9 earlier to about 3.x these days ?
I don’t condemn others choice of T4, I criticize those who interfere with my choice.