A good example of very bad science (pseudoscience): homeopathic migraine medication

Surprise! I call it “birthday cake,” but it’s just a cheap candle shoved in a Twinkie. Like this combo, a recent article published in the Journal of Alternative and Complementary Medicine has all the trappings of science, without all the burden of the effort needed to actually achieve good science. Photo from [2].
Good timing! The company – Boiron –  that produces that same homeopathic sleeping pill that we overdosed on in Friday’s lecture also recently published a TERRIBLE study of their migraine “remedy.” It’s a great example of how bad science can seem legitimate by making its way into a journal.

The abstract for the study is available online [1].  The study is presumably available if your institution has a subscription to this journal.

The abstract alone is sufficient to understand just how bad a piece of research this is Quoting from the authors, “This was an observational, prospective, open, nonrandomized, noncomparative, multicenter study.”

  • Translation:  we employed no controls (the homeopathic preparation was compared against neither an intentional placebo, nor again an existing effective migraine medication already known to work. Also, there was no randomization of who got the homeopathic preparation, who got the placebo, and who got actual migraine medication. We designed the study to intentionally leave the door wide open for bias.

In addition, the authors state, “Physicians were given complete freedom in terms of treatment prescription; thus, prescriptions were individualized for each patient.”

  • Translation: no attempt at blinding, the gold-standard of all scientific research, was made, allowing for physicians to know what they are giving patients and thus influence outcomes.

This is a great example of (1) bad science being (2) published in a journal (albeit a very poor one) which will (3) then lead adherents of homeopathy to point and say, “See?! It’s published, just like real science!”

This publication is to real science what shoving a lit match into a twinkie and handing it to your friend is to baking your friend a birthday cake.

[1] http://www.ncbi.nlm.nih.gov/pubmed?term=danno%20homeopathyDanno K, Colas A, Masson JL, Bordet MF. “Homeopathic Treatment of Migraine in Children: Results of a Prospective, Multicenter, Observational Study.” J Altern Complement Med. 2012 Sep 14.

[2] http://immodestproposals.blogspot.com/2009/06/your-daily-photo-burn-one-down-edition.html

The Parallel Universes of Science and Anti-Science

A real skyscraper, and its distorted reflection created by the windows of a nearby skyscraper.
The real skyscraper on the left is built with the laws of Nature, determined by careful experimentation and critical thinking over hundreds of years. If one were to instead use the rules of design apparent in the distorted mirror reflection of the real skyscraper, the distorted twin could not stand in the real world. Photo from Ref. 1.

Finding Parallel Worlds

In the series “Star Trek: Deep Space Nine,” a well-crafted transporter modification is capable of hurling the crew of the station into a “mirror universe.” Everyone who exists in the known universe also exists in the mirror universe, but there they are not the same people. Major Kira Nerys, a member of the Bajoran Militia who fights for Bajoran freedom in the known universe, is instead Intendant Kira Nerys who serves the enslaving Alliance in the mirror universe.

Science fiction writers dream of parallel universes, and wonder at what it would be like for mirror people  to meet one another. If they are truly mirrored, and are biological copies of one another, what differences would then be found by considering the exclusive sums of their unique experiences?

I have often dreamed of parallel universes, both in my science fiction-fueled fantasies but also in the real language of quantum physics. What if the universe I know is just one of many possible universes, separated only by the spectrum of quantum probabilities inherent in every interaction between my subatomic constituents? These thoughts interest me, but ultimately only insofar as they can be tested and have real consequences outside of science fiction.

Distorted Mirror Universes

I have learned, however, over the past decade of the existence of real multiple parallel universes. They are not quantum dreams, but rather political and social realities that are attempting to redefine the very meaning of “reality” so as to save something that they, in their universe, define as “value” and “culture.”

One need not look far to find these parallel worlds. You don’t need a transporter accident or a Large Hadron Collider to find and observe them. Sometimes you need only go so far as an accredited university, like Liberty University or Life University; sometimes, you need only pick up a book or turn on the radio, so as to read or hear the words of people like David Barton; sometimes you need only subscribe to a blog from organizations like The Heartland Institute or The Discovery Institute.

These places and people define a parallel universe, one that mirrors, with distortion, the real laws of nature. In these distorted mirror universes, they use scientific or academic language, but no actual science or academics. These universes often are set up as equal but opposite to the real world; their proponents claim they are just as good or better than the real world, and that living in them is just as good or better than living in the real world. To the builders and shapers of these parallel universes, their reality is just as valid as the reality of the natural world. So . . . why wouldn’t you want to go live in that universe instead of the real one?

It’s all about USEFULNESS

While it is true that the belief in a single reality governed by a single set of consistent laws is, in fact, a belief (that is, I cannot prove to you that there is only one reality with a single set of consistent laws), that belief is distinct from all other beliefs because of a single property: USEFULNESS. The belief that my reality is the same as your reality allows you and I to agree that what happens in my view also happens in your view. We can agree on things (at least, fundamentally). We can agree that apples fall from trees, that ice melts at zero degrees Celsius under conditions of standard temperature and pressure, and that when I punch you in the arm it hurts you in a way that is similar to that experienced by me if you were to punch my arm. Being able to accept the belief that there is one reality with one set of governing laws allows you and I to make progress – that is, to develop a single and transferable library of knowledge that can be expanded and always consistently applied to create new knowledge.

If we cannot agree on such things – if we believe the world is purely subjective or a product of one’s own will or imagination – then the above cannot be true. Apples might rise in your universe but fall in mine. When ice melts, it does so for you at a different temperature on the Celsius scale at standard temperature and pressure. When you punch me in the arm, you believe that it doesn’t have the same biological consequences as when I punch you in the arm. There can be no laws of physics. There can be no chemistry. There can be no biology (or empathy . . . which then leads down the road to sociopathy . . . ). In a world where subjectivism rules, chaos follows. There can be no progress. There can be no single body of transferable knowledge, since all experiences will be different even given the same initial conditions.

Science and the scientific method are built on the assumption of objectivism – that there is a single objective reality upon which we can all agree, in so far as we can study the natural world and determine the its rules. You and I, under identical conditions, will observe and report identical things (within the tolerances of measurement uncertainty, of course). Without that assumption, science falls apart. Science is the means by which the single, transferable library of knowledge is generated.

Please note that, at no time in the above discussion, has using science required that there be nothing “supernatural.” One is only required to follow an fundamentally objectivist belief system to then successfully use science. At heart, you don’t have to be an atheist, or a deist, or a religious fundamentalist, or any other “-ist” except “objectivist.” No other “-isms” except “objectivism” are required – no “materialism,” no “socialism,” no “conservatism,” no “liberalism.” You can be those things, and still practice science as long as you are following objectivism. The supernatural is allowed – but science cannot explain it, because by definition anything outside the natural world cannot be measured or quantified and falls beyond the scope of the scientific method.

The photograph at the top of this post was chosen on purpose, because it illustrates in a single image exactly the argument I will advance here. The skyscraper on the left is the real deal – it was built with materials from the natural world, using principles based on the laws of physics and chemistry; its environmental regulation systems are designed based on the principle that biological organisms like people require a certain range of humidity and temperature in order to work and live comfortably. That building was only possible because, at heart, those who developed the laws upon which it is constructed made the assumption that there is a single reality.

If objectivism were a useless assumption then it would bear no fruit  and would itself be USELESS. Because objectivism is USEFUL – it allows the laws of mechanics, thermodynamics, and electromagnetism to be determined, all of which are needed to make a skyscraper –  it generates progress.

The skyscraper on the right is a distorted reflection of the real deal. If you used the distorted rules of design and form and mechanism apparent in the view on the right, and tried to make that happen in the real world, chances are that the skyscraper so built would collapse or decay very quickly. In other words, if one takes a distorted view of reality, teaches it to others, and then applies it in the real world (where it is not USEFUL), then chances are good that it will fail and become USELESS, being cast aside for more USEFUL ideas.

The notion of USEFULNESS is at the heart of science. It’s why science is so successful as a way of knowing. Tastes may change in art, music, social convention, and politics, but so far as we know the laws of physics, chemistry, and biology are unchanging and timeless. They apply just as well a million years ago as they do today. Try applying U.S. political assumptions in Russia; try convincing Leonardo Da Vinci that Jackson Pollack had it all right; try getting J. S. Bach and Black Flag to agree on the definition of “profound music.” Science is useful because it provides a regular structure on which to create and innovate. The laws of mechanics explain how to understand and generate sound; on that, music for all tastes can be created. The laws of chemistry and quantum physics define how to create color and texture in paints; on top of that, beautiful schematics of the human form or frenetic explosions of shape and color can be built. The laws of biology define the way in which adaptation and reproduction influences survival and how the environment challenges adaptation and reproduction; on top of that, vast social systems can be built.

The Making of the  Distorted Mirror

When scientists fight against the forces of anti-science, they do it in the spirit of “correcting the record.” In a world where objectivism rules, this would work; reasonable minds would be forced, in the end, to agree that one party is right (their description is consistent with objective reality) and the other is wrong (their description runs counter to what is known of objective reality).

However, fighting the forces of anti-science this way misses the point of what those forces are doing.  The forces of anti-science are not conducting their battle in the real world, in the objective reality; they are conducting a battle using the rules of a world THEY created. They are fighting a battle in their world, where the notion of a single objective reality does not apply. Recognizing this fact is the key to making a first step is truly battling the forces of anti-science.

A scientist might, for instance, argue based on the laws of physics that building a skyscraper like the one in the reflection above is ludicrous; any reasonable person can see that it won’t stand, that it’s a threat to the lives of the people who would go to work in it. But that argument misses the point; the point is that the anti-engineers who have proposed building the skyscraper on the right have done so according to the following propositions:

  • There are at least two objective realities (in the language of the forces of anti-science, “two opposing views”); their rules work just fine in their reality, our rules work just fine in ours, and intelligent people can decide for themselves which reality is the correct one. You get your facts, I get mine. No one has a monopoly on the truth.
  • It is enough to think about these things to come to a decision; logic and reason are sufficient forms of evidence, without the need for observational and physical evidence.

Once you understand that these are the rules of the anti-science game, you can begin to develop strategies to deal with it.

Let’s explore these propositions a bit further, to see how they lead to a distorted view of the world. These propositions have little to nothing to do with real science, of course; they have to do with values and cultures. These propositions allow the construction of a mirror universe comfortable to values and cultures, without regard to facts about the natural world. They allow dogma and misunderstanding to become the founding principles of the mirror universe.

By dogma, I mean statements like, “X is true because it must be so” (or, ” . . . because I want it to be so”). By misunderstanding of the laws of the real world, I means statements like, “The law of Natural Selection cannot be true because it leads to atheism,” which is a misunderstanding of the actual implications of the law of Natural Selection. The second type of statement goes hand-in-hand with the first. For instance, consider this typical set of dogma and misunderstanding that is used to construct things like Intelligent Design and Creationism:

  1. God must exist. [dogma]
  2. The Law of Natural Selection eliminates completely the need for God to exist. [misunderstanding]
  3. Therefore, the Law of Natural Selection must be wrong. [hypothesis]

Note that no evidence is required to formulate the hypothesis made at the end. The hypothesis is based on an assertion of dogma and a complete misunderstanding of a law of nature. Disconfirming evidence – evidence that rejects the hypothesis – will then be ignored and confirming evidence (supporting the hypothesis) will be trumpeted. That is pseudoscience. One obtains a distorted version of reality wherein the Law of Natural Selection is cast aside and replaced with something else, such as Intelligent Design.

Creating the mirror universe based on the above line of argument is a way of establishing a place where other hypotheses, which feel comfortable, can be preserved. For instance, consider a related hypothesis formed as follows:

  1. God is the only source of ethical behavior. [dogma]
  2. The Law of Natural Selection eliminates the need for God to exist. [misunderstanding]
  3. Therefore, the Law of Natural Selection leads to unethical behavior. [hypothesis]

If one’s view is that the absolute above cannot be violated, then it would be more comfortable to live in a universe where the subsequent hypothesis is true.

Here is another one:

  1. Ancient humans led better lives than modern humans. [dogma]
  2. Ancient humans used to collect plants in the swamp and consume them for medicine. [misunderstanding]
  3. Therefore, swamp plants collected by ancient humans are better medicine than mainstream medicine. [hypothesis]

This is a popular left-wing distorted mirror universe. Ancient humans DID NOT, by any measure, lead better lives than modern humans. Ancient medicine was a crapshoot, because nobody understood the cause of disease until the 1800s. Those plants that were consistently found to be useful, far beyond placebo, then became “mainstream medicine” – that is, medicine that works. Everything else is just plants that we eat, digest, and poop. However, people spend billions of dollars every year on “alternative” medicine – expensive plants that have no actual proven medical benefits outside of quack claims by people like Dr. Oz.  Basically, billions of dollars are spent making expensive poop.

The forces of anti-science are not about making progress, or being useful (in the sense of advancing the species through a growing body of reusable and timeless knowledge), but about preserving a world view that is comfortable to many people. But, that world view may be based on at least distortions, if not outright misunderstandings, of things like physics, chemistry, and biology (not to mention math and statistics). The reason it persists is not because it works, but because it feels good.

Examples of Distorted Mirror Universes

Here are some examples of mirror universes that you can go experience, if you so choose.

  1. Creationists offer their own tours of the Grand Canyon. They are prohibited from directly using the language of religion to explain the creation of the canyon, so they instead use fancy words that sound like science but actually are references to the creation of the canyon by the Noah Flood. It’s very hard to know that they are not talking about real geology, but their own geology they have created to fit the events in the Bible. More information is in Ref. 2.
  2. Basically any book by David Barton. Barton distorts historical documents, or invents fake historical events and documents, to conform to his dogma that the U.S. is a fundamentally Christian nation. He’s continually debunked by actual historians, but that’s not the point. The point is that those who devoutly listen to his “Wallbuilders” radio program are doing it so that they can live in the comfortable parallel universe where the U.S. is a Christian nation that can ignore the beliefs of all other people and can even expel people for holding the wrong beliefs.
  3. An event hosted by the Discovery Institute. They have flashy movies, handsome spokesmen who smile, and they use sciency words. They present biology as a debate between to equally correct but opposing groups of people, those who adhere to the “dogma” of the Law of Natural Selection and those who adhere to Abrahamic religious principles. They won’t mention outright that their arguments are based on religion, but they invent a controversy where none actually exists in science and then push that controversy on public and private schools.

What to do?

This is a hard question. Once you realize that there are parallel universes where objective reality holds no sway, you must abandon the tactic of only ever arguing as if you all live in the same objective reality. That won’t work for all people.

What might work? Our goal can only ever be to welcome people back to reality. Here is some advice:

  1. Never talk down to people.  Let them explain why they think their universe is the correct one. Let them know that you value their beliefs and that you want to understand their beliefs.
  2. Don’t let the conversation become one-sided. A conversation is, by definition, two-way. Don’t let them dominate by only ever talking about their views, and you should avoid the same. If it’s not a conversation – if, instead, it’s a conversion – then both people will walk away feeling more mistrustful of each other.
  3. Your best selling point on objective reality is to sell the benefits of living there. You have many. Medicine, technology, safety, health, longevity, freedom . . . the list goes on. There is bound to be something that appeals to them.

We all begin in objective reality. Our many experiences transport us from that reality to others, where we may remain for a time or forever. There is nothing wrong with some of those universes; in fact, living in some of them for a time may give us a deeper and more useful and practical insight into the natural world. But there are those parallel worlds, the distorted mirror universes, where thire established belief systems can cause real damage in the natural world. There are distorted mirror universes whose inhabitants seeks to overturn real science and real learning and replace them with something darker and less useful (or entirely useless). They do it in the name of saving values or culture; their end will be to destroy progress (as I defined it above), to bar the doors of the library of human knowledge and direct people elsewhere.

The only way to serve objective reality is to welcome more people back into it. You will never shatter the distorted mirror universes – their laws are impervious to evidence – but you can increase your population in the real world and hope for the best.


[1] Photo by vpickering. http://www.flickr.com/photos/vpickering/6110142493/

[2] http://www.earthmagazine.org/article/creationism-creeps-mainstream-geology

Unethical Diet

A number of my students in CFB/PHY 3333 [1] decided to write research papers about the hCG Diet. I was particularly interested in their papers because an acquaintance of mine told me last year that they had decided to try the diet. At the time, I did not know what it was and thought little of it. After reading the research papers my students produced, I became more worried.

The hCG Diet was invented by an endocrinologist named Albert T. Simeons [2]. He combined a 500-calorie restricted diet with the Human Chorionic Gonadotropin hormone. The claim is that the hormone negates the feelings of hunger induced by a dangerously low calorie diet, while also forcing the body to burn stored fat instead of protein for energy.

A number of studies have been done to assess the claim. Some of those studies claimed that the diet worked, and others find no benefit of combining hCG and a 500-calorie diet over using a placebo and the same 500-calorie diet [3]. How do we decide who is right? One group of authors did a “meta-analysis” [4] of these publications and assessed scores to the studies based on  the quality of the research (e.g. was a given study randomized-controlled or not?). They set in advance a score of 50 (out of 100) as the cutoff for higher-quality analyses. They found that of the 14 studies that scored above 50 (all of which included randomly controlled trials), 1 of the 14 found confirming evidence supporting the claims of the hCG diet. The others all found disconfirming evidence. The weight of reliable, scientific evidence is strongly against the effectiveness of the hCG diet.

From this we can conclude the following:

  1. Any doctor that prescribes the hCG diet is not making a decision using evidence-based medicine. Medicine without evidence supporting its claims is quack medicine. The doctor is, at the very least, not keeping up with the research in their own field and at worst is willfully ignoring evidence.

But it gets worse. The Food and Drug Administration has strong words [5] regarding the sale of hCG as a diet supplement:

The Food and Drug Administration (FDA) is advising consumers to steer clear of these “homeopathic” human chorionic gonadotropin (HCG) weight-loss products.  They are sold in the form of oral drops, pellets and sprays and can be found online and in some retail stores. [5]

FDA and the Federal Trade Commission (FTC) have issued seven letters to companies warning them that they are selling illegal homeopathic HCG weight-loss drugs that have not been approved by FDA, and that make unsupported claims. [5]

Not only is the hCG diet not science-based medicine – selling hCG products for the purpose of the diet is ILLEGAL. What about physicians that prescribe them? According to a news report by local Dallas WFAA [6],

HCG is FDA-approved for fertility treatments — not weight loss. Doctors, however, can prescribe HCG legally for an “off-label” use. [6]

So it’s currently legally okay for a doctor to use hCG in a way not intended, which is ethically murky. (Note: the above article claims that the “science is unclear” about the benefits of hCG, but this is likely because if you just count the number of studies there are equally many that find and don’t find benefits. WFAA was ill-equipped to understand good experiments and bad experiments, and likely misunderstood completely that the weight of reliable evidence is AGAINST the benefits of hCG).

From this, we can conclude that any doctor who prescribes this is practicing  unethical quack medicine. It might not be illegal to use hCG for a purpose not intended, but it flies in the face of evidence-based medicine. Evidence-based medicine is the only reliable kind of medicine. Everything else is wishful thinking or lies.

I tried to explain to my acquaintance that hCG has been clearly shown to be no more effective than placebo. I also tried to explain that the FDA has warned companies selling hCG for weight loss that they are conducting an illegal activity. However, they were adamant. They had lost weight (they were on it three times in the last year, gaining weight back after each time), they had heard anecdotes that said it worked, and that they had their beliefs and that science had its beliefs. Pretty much the spectrum of denial. This acquaintance of mine is a very bright person, so it pained me to know that they couldn’t be convinced of the evidence. They were actually willing to pay for the placebo effect (and said as much).

As a scientist, it’s hard to listen to that.


[1] http://www.physics.smu.edu/pseudo/

[2] http://en.wikipedia.org/wiki/Human_chorionic_gonadotropin

[3] Published studies of hCG and weight loss:

CARNE S. The action of chorionic gonadotrophin in the obese. Lancet. 1961 Dec 9;2(7215):1282–1284.

LEBON P. Treatment of overweight patients with chorionic gonadotropin. J Am Geriatr Soc. 1961 Nov;9:998–1002.

Stein MR, Julis RE, Peck CC, Hinshaw W, Sawicki JE, Deller JJ., Jr Ineffectiveness of human chorionic gonadotropin in weight reduction: a double-blind study. Am J Clin Nutr. 1976 Sep;29(9):940–948.

Young RL, Fuchs RJ, Woltjen MJ. Chorionic gonadotropin in weight control. A double-blind crossover study. JAMA. 1976 Nov 29;236(22):2495–2497.

Shetty KR, Kalkhoff RK. Human chorionic gonadotropin (HCG) treatment of obesity. Arch Intern Med. 1977 Feb;137(2):151–155.

Greenway FL, Bray GA. Human chorionic gonadotropin (HCG) in the treatment of obesity: a critical assessment of the Simeons method. West J Med. 1977 Dec;127(6):461–463. [PMC free article]

Asher WL, Harper HW. Effect of human chorionic gonadotrophin on weight loss, hunger, and feeling of well-being. Am J Clin Nutr. 1973 Feb;26(2):211–218.

CRAIG LS, RAY RE, WAXLER SH, MADIGAN H. Chorionic gonadotropin in the treatment of obese women. Am J Clin Nutr. 1963 Mar;12:230–234.

Miller R, Schneiderman LJ. A clinical study of the use of human chorionic gonadotrophin in weight reduction. J Fam Pract. 1977 Mar;4(3):445–448.


SOHAR E. A forty-day-550 calorie diet in the treatment of obese outpatients. Am J Clin Nutr. 1959 Sep–Oct;7:514–518.

HASTRUP B, NIELSEN B, SKOUBY AP. Chorionic gonadotropin and the treatment of obesity. Acta Med Scand. 1960 Sep 21;168:25–27.

Veilleux H, Fortin Z. Effets gonadiques et extragonadiques, chez l’humain, de 3500 U.I. de HCG (gonadotrophine chorionique humaine) en doses fractionnées. Vie Med Can Fr. 1972 Sep;1(9):862–871.

Gusman HA. Chorionic gonadotropin in obesity. Further clinical observations. Am J Clin Nutr. 1969 Jun;22(6):686–695.



[4] Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G (September 1995). “The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis”Br J Clin Pharmacol 40 (3): 237–43. PMC 1365103.PMID 8527285

[5] http://www.fda.gov/forconsumers/consumerupdates/ucm281333.htm

[6] http://www.wfaa.com/news/health/HCG–Popular-Diet-Now-Faces-Legal-Controversy-139739033.html