Snake oil comes in many guises, most of which exist to reduce the contents of one’s purse.  Last week an Associated Press writer detailed how the government spent $2.5 billion of our money to test various so-called alternative health remedies, most of which would be considered snake oil by mainstream medicine, and came up virtually empty handed.

Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine. The lone exception: ginger capsules may help chemotherapy nausea.

Acupuncture and some of the hands-on manipulative therapies fared a little better.

As for therapies, acupuncture has been shown to help certain conditions, and yoga, massage, meditation and other relaxation methods may relieve symptoms like pain, anxiety and fatigue.

The article didn’t give a rundown of every alternative or non-mainstream therapy tested, so I don’t know what they all are, but I can add one to the list if it wasn’t tested in this $2.5B testorama.  I would add the use of HCG for weight loss.

Many practitioners are using injections of human chorionic gonadotropin (HCG) injections coupled with an extremely low-calorie diet to help their patients lose weight.  Many practitioners and many patients swear by this regimen.  But, a number of randomized, double-blind, placebo-controlled studies have shown that the HCG regimen is no better than placebo.

But if this is so, how come so many patients and practitioners believe so strongly in this HCG/diet combo?  Simple answer.  Because it works.

But if it works, why is it a worthless regimen?  Because it doesn’t work any better than placebo.

If you go to a doctor who tells you that he/she is going to start you on an extremely powerful weight-loss program that involves multiple injections along with a stringent diet composed of specific foods to be eaten on a rigid time schedule (especially if these foods add up to only 500 calories per day), you will come away convinced that you are going to do well.  Especially after you’ve paid the bill, which is considerable in these HCG centers.

If you go in for all the injections and scrupulously follow the diet, you will lose a fair amount of weight pretty quickly.  And you will develop and unshakable believe that this regimen did the trick for you.  You will tell your friends, all of whom have witnessed your rapid weight loss, and they, too, (at least those who can afford it) will go to the same practitioner and fork over for the treatment.

Problem is this treatment works the same if the patients are given a salt-water shot or an HCG shot.  There is no difference in outcome.  The HCG doesn’t do diddly.  It’s the fact that you get a shot that makes the difference.  If you simply went on the 500 calorie per day diet you would lose the same.  But it’s the magic of receiving the shot, especially after being told (as most are) at the practitioner’s office that the shot will help overcome the hunger of being on a drastically calorically-reduced diet.  And it does.  But it doesn’t matter if it’s a saline shot or a dose of HCG.  It’s the magic of having something done.

Which is why in the $2.5 billion tests, the manipulative therapies worked and the others didn’t.  There is something about having a procedure done that makes you feel like your getting a more powerful treatment.

I can’t tell you how many people came in to see me when I had a regular medical practice who demanded a shot because they were convinced that shots worked better than oral medications.  For some things they do, but for most, they don’t.  But you couldn’t convince most of my patients of that.

There are a few of what many would consider alternative medicines that do work.  I posted on one that does here.  But, as the large conglomeration of studies reported on by the AP showed, most don’t.

As you might imagine, the report of the failure of most alternative therapies was like catnip to mainstream physicians, researchers and writers.  They were absolutely giddy with joy.  Here are just a few representative comments:

Well, since I’ve been bagging on the alt-med nonsense lately, I simply couldn’t pass up this headline.  And folks… the headline says it all… “No Alternative Cures Found”… Zilch… Nada… Zip… Zero!  Despite their inability to understand the most basic aspects of science and the associated math, I think that zero is a number that even alt-med woo-meisters can grasp 🙂

(Woo is the derogatory term these mainstreamers have come up with for any treatment or therapy not taught in traditional medical schools or developed by Big Pharma.)

I never thought I’d see it, but I have. After an a decent article on the infiltration of quackademic medicine into American medical centers and a very good article on cancer quackery, Marilyn Marchione of the AP has done it again:

AP IMPACT: $2.5B spent, no alternative med cures…

I’ve documented the woo funded by NCCAM on multiple occasions. I mean, NCCAM is funding studies of that woo of woos, homeopathy, fer cryin’ out loud! I”m [sic] glad that the mainstream media is finally noticing.

One more.

Here’s a shocker for you: after a decade and 2.5 billion (with a b, folks) dollars spent, a government study shows that almost no alternative medicines worked.

So, they used actual scientific testing processes instead of anecdotes, and found that most of these simply don’t work. Like I said: shocker.

… the studies have shown that most of these remedies don’t work. And will this change the minds of their advocates?

HAHAHAHAHAHAhahahahahahaha! Oh man, sometimes I crack myself up.

This is just one more arrow in our quiver, but the alternative medicine believers will continue to move the targets around. Stay vigilant, and remember: people waste money, people get sick, and people die because of this antiscientific thinking. That’s why testing this, publicizing it, and fighting the misinformation is so important.

Believe me, this is just a small sampling of what I came across on the internet when I searched for links to the AP article.

Hostile and condescending as the tone of these remarks is, the people who made them are pretty much on the money.  These treatments need to be evaluated in the harsh glare of double-blind, placebo-controlled studies.   Now they have been, and, just as with the HCG regimen for weight loss, they’ve been found lacking.

But that’s not necessarily the end of the story.  We don’t know the details about these studies.  Was there just one study for each alternative therapy?  Or were there multiple studies, each of which demonstrated no effectiveness?  If just one, then the above criticisms may not be valid.

Absence of evidence is not necessarily evidence of absence.  Just because we can’t get a positive result in one study doesn’t mean there isn’t a positive result to be had.  Science is the continual testing of hypotheses until the evidence is overwhelming that the hypothesis is valid or it isn’t.  But even overwhelming evidence doesn’t always prove out in the long run.  Newton’s laws were held to be valid after centuries of testing, then Einstein came along.

What interests me so much about the glee with which these mainstreamers greet the failure of alternative medicine (at least the failure shown by $2.5B worth of research) is that the vast majority of these same folks believe in the notion that people are overweight because they eat too much and exercise too little, an idea that scientifically holds little water.  A myth, really.  But they all believe it because on the surface it seems to make sense to them.  All the scientifically valid arguments that, say, Gary Taubes makes fall on deaf ears.  (Here is a video of a recent lecture Gary gave to doctors at Dartmouth.  Do you think any of them were moved to give up their antiquated views by the science presented?  It’s highly doubtful.)

And while most of the people pooh poohing woo are doing so, they are out pushing statins for all their worth.  And statins – other than for a small group of people – have the same efficacy as the alternative medicines they are so quick to disparage.  Let’s see, how did that one writer put it?  “…Zilch… Nada… Zip… Zero!”

That’s right.  The category of drugs that are the top selling drugs worldwide have no efficacy in terms of reducing overall mortality, at least as shown by randomized, double-blind, placebo-controlled studies, in any group except men under the age of 65 who have been diagnosed with heart disease.  This doesn’t mean men under 65 who have elevated cholesterol, but men under 65 who have actually been diagnosed with heart disease or who have had a heart attack.  And even in that group, the efficacy is questionable.

The mainstreamers such as those quoted above don’t question the effectiveness of statins even though at least $2.5 billion has been spent to test them and found them lacking, but readily discount alternative medicines simply because they don’t fit with their belief system.  Based on the evidence at hand, I wouldn’t give people Echinacea, shark cartilage and all the rest because the studies show they don’t work better than placebo, but for all the same reasons, I wouldn’t give a patient a statin either.  In fact, I would probably give the Echinacea before I gave the statin because, as far as I know, no one has died taking Echinacea, of which the same can’t be said of statins.

If alternative medicines are going to be held to scientific standards, so should be pharmaceuticals.  Snake oil is snake oil no matter what its bottle it looks like.

76 Comments

  1. Dr Eades
    I agree with your comment on the nature of research into allopathic medicines, and also on the value of some faddish treatments.

    That being said, i have connected with natural medicine of one kind or another for over 20 years and can provide anecdotal evidence for its efficacy. I currently work as the librarian in an institution teaching a degree in Naturopathy and Homeopathy.

    It is important to be aware of the parameters of some of these studies (and I haven’t had time to read the report yet). These studies are often flawed in many ways. For example, herbal remedies must be used in the correct preparation, the correct dose, and at the correct time to work well.

    Mainstream studies with echinacea may use preparations from parts of the plant not usually used by herbalists, in doses too small to be effective and at a time in the illness when they won’t work. Echinacea preparations need to be made from the roots of the plant, be strong enough to tingle your tongue, and taken early enough to support the immune system (it won’t stop a cold in its tracks).

    Herbalism isn’t snake oil and has a long history of efficacy. Most modern drugs are based on plant extracts – and don’t always work as well as the whole traditional medicine, which is always more complex than the ‘active’ ingredient.

    On closer inspection, one might also find that other natural modalities do more than provoke a placebo response. it is well known that homeopathy, chiropractic and herbal remedies are effective for animals when professionally applied. It is more difficult to argue the placebo effect in these cases.

    I agree completely. That’s why I wrote that absence of evidence isn’t evidence of absence.

  2. Another mega-great post! I know I blow hot and cold over this or that enthusiasm, but my current thinking is that the essential supplementations are:
    * D3 (as you and others advocate)
    * Fish oil (a no-brainer these days)
    * Kelp extract as a source of iodine (check out Heart Scan blog over the last couple of months)
    I’m constantly amazed by the number of goitres (correct non-seppo spelling, please) I see these days. When I lived in India among the Tibetans large goitres were common. These days, the goitres I see aren’t this huge, but see less shocking examples all the time. Culprits: snake-oil advice like cutting right down on salt, and use of sea salt instead of iodine-fortified table salt.
    Have been using iodine fortified salt deliberately and liberally these few months and have noticed that my eyebrows have lengthened on the outer sides, which for some reason has been cited as a curious sign of improved thyroid activity. (True??) Been using kelp extract of late, and feel wonderful.
    I still take vitamin C, but one should really get lots of lemons and limes, juice in soda water (seltzer in your dialect?) with ice. Divine. Better than a pill any day.

    BTW, a couple of nights ago, me and an old friend heard Stephen Hough live at the Opera House, playing Tchaikovsky’s 2nd piano concerto in the rarely heard Composer’s Cut version. Have heard it before (Peter Donohoe, about the only other player who does it), but the second movement has just got to be T’s best piece. Magic. Recommend Donohoe’s recording on EMI, where the violin and cello obbligatti are played by Nigel Kennedy and Stephen Iserllis. We didn’t get such luxury casting the other night, but Hough was dazzling, even better than Donohoe live.
    Michael Richards

    It is true about the eyebrows and iodine deficiency.

  3. Dr. Eades, I agree with you on a great many things, but on this one I believe you’re wrong. I’ve lost 164 lb. using HCG in a number of sessions over the last couple of years. Sometimes I’ve used shots, mostly I’ve used a sublingual mixture taken morning and night. I’ve never failed to lose an average of 1 lb. or more per day during my HCG sessions, sometimes over the course of 30-40 days at a time. On my initial course of HCG, I lost 47 lb. in 35 days. In my first 2 courses combined, over a period of 14 weeks (including a 3 week break in the middle) I lost 90 lb., going from 404 lb. to 313 lb., right now I’m at 238. My Dr. took me off of blood pressure medicine after my first course (I’m pretty consistently at around 115/75 or 120/80 now), my lipids are excellent, and I maintain using a low carb/paleo type regimen. You may well call that a placebo effect, and you’re welcome to that view; I know what my body felt like during this process, and I disagree. In particular, I know that there’s absolutely no way that I could have gone weeks at a time on 500 cal. per day without something to keep my hunger down. When I stopped taking the HCG I became normally hungry again. Placebo? All in my mind? Okay, whatever. Also, I realize that calories in/calories out doesn’t completely apply, but it’s hard for me to see how I lost an average of 1 lb. per day for extended periods while losing minimal muscle mass.

    I was obese for the first 45 years of my life, literally since I can remember, and morbidly obese for all of my adult life. My life is completely different today. If that’s all mental, then call me a very happy idiot, and thank God for placebos.

    I figured I would get a comment or several such as this. How do you know you wouldn’t have achieved the same results if you had taken a shot of saline solution and been told that it was HCG? The answer is that you don’t know. It’s not I that am wrong here. I’ve never used HCG on patients, and I’ve never taken it myself. But I am aware of most of the weight loss regimens around, however. And I do read the medical literature. There are at least a half dozen double-blind, placebo-controlled studies (the gold standard of scientific research) showing that HCG works no better than placebo. So, if anyone is wrong, it’s all those researchers performing all those studies. I’m just reporting what they found.

  4. I hear you, and I guess I don’t mind being the inevitable comment, simply because I’m so happy with the weight that I’ve lost. I really don’t know that I wouldn’t have lost the weight under the same regime of saline solution, I never tried it, and at this point I’m not too eager to experiment – I don’t care if it was cosmic rays or aliens, I’m just ecstatic to be so much lighter, and looking for ways to be healthy and maintain.

    In re. the double blind studies, my thoughts may resonate with you, given your understandable frustration with the numerous studies over the years that purported to show various effects (or lack thereof) of a low carb diet while using diets that you wouldn’t consider to be truly low carb at all. My understanding is that the only studies conducted of the HCG protocol were done in the early 1970’s during the first craze for HCG clinics, and that none of those studies came anywhere close to using ATW Simeons’ protocol on the basis that he presented it. If that’s true, then those researchers performing all of those studies were, in fact, wrong, as you say. I haven’t heard of any valid studies (or even invalid ones) conducted since Simeons’ HCG protocol was exhumed in early 2007 in the book “The Weight Loss Cure “They” don’t want you to know about” by Kevin Trudeau, who I freely acknowledge is a huckster of the worst kind. I know that you were just using HCG to make a general point, but if you do come across any recent, valid studies please mention it online, as I’d love to find out about them.

    I’m not a biologist, endocrinologist, physician, or anything close – my graduate degree’s in a completely different field (i.e. I’m not a gullible moron). The only reasonable explanation that’s made sense to me is that, per Gary Taubes in GCBC and in all three of his online presentations that I can find, obesity is due to a dysfunction of the body’s fat storage mechanism. Simeons theorized that the protocol worked via the effect of HCG on the hypothalmus and its part in the body’s fat regulation process. Maybe, maybe not, I don’t know, and since he worked in a clinical (rather than research) setting in the 50s and 60s, he didn’t dig down to find out.

    One question I do have – acknowledging that calories in/calories out isn’t an accurate reflection of how the body works – is how my metabolism doesn’t slow tremendously, per Taubes and everybody else, after weeks of what would have to be perceived by the body as famine conditions. I don’t know that saline solution would produce the same effect and, as I said, at this point I’ve no personal interest in finding out.

    I don’t mean to dis you in any way with my comments; I love your blog and the work that you’ve done, I have all your books, and this is the way of eating that I’m using going forward for all sorts of reasons. This subject is just one that hits close to home, and based on personal experience, I have a different view. Thanks.

    Believe me, I understand how you feel about all this. And, who knows, maybe the HCG really did work for you. When I say that I mean that it worked above and beyond its placebo value. I’m sure that in the studies of HCG some people did well while others didn’t. Overall, the average outcome was not significantly better than placebo, so it’s not a therapy one could (with good conscience) recommend to everyone. But you could very well be one of the ones who does respond positively. Here is a meta analysis of a number of studies of the Simeon’s protocol. Sadly, it worked no better than placebo – at least in this series of studies.

  5. Nicely written, Mike and good points about “absence of evidence isn’t evidence of absence. ”

    Do you have any thoughts on homeopathy? Fairly regularly I use a homeopathic remedy for my sinuses, kali bichromicum. As far as I can tell I get no side effects from it and it does seem to work. Of course, if you gave me a salt pellet and called it k. bichromicum I might have the same result. But I might not. If I understand correctly, homeopathy used to be the main form of medical treatment in the U.S., in the 19th cent.

    They spent $2.5B on alt. meds., but they’re still pushing the food pyramid. Cheers.

    Jim

  6. Hey Mike,

    I have a friend who swears his arthritic and overweight (is there any other kind?) Labrador has been transformed by glucosamine – and on my last visit, there certainly seemed to be evidence in support. I guess this could just be an interesting variation on the placebo effect, and dogs are not hairy humans, and an anecdotal, n=1 tale is of little use, and I have another human friend who says it didn’t help him at all … but still – I guess if you want to believe, like all those often poorly controlled studies that claim wine is good for you … you will!!

    Cheers,

    Malcolm

    As I mentioned in the comment a couple of comments ago, the studies of anything show positive and negative results. It’s the average that’s ultimately looked at before a therapy is recommended to the masses. Maybe some people – or dogs – respond well to glucosamine while others don’t. You pays your money and you takes your chance.

    Also, unlike with drugs that have fairly narrow therapeutic windows, natural products can be taken in large doses. Who knows what doses the studies used. This is one of the problems with studying alternative therapies, especially herbal or supplement therapies. It’s impractical to test every possible parameter testable then repeat all these numerous times in an effort to be certain that the product either works or doesn’t. You choose a common dosage and test it. Then, invariably, someone will say, Well, no wonder it didn’t work – it wasn’t the correct dose. Or, it came from the wrong part of the plant, or it came from a plant grown in the US and the only ones that work are from plants grown in the soil of India or countless other reasons. This is one of the things that frustrates those in mainstream medicine trying to test these natural remedies: they feel as if they’re always trying to hit a moving target.

  7. How about comparing the Rx drug Plavix to aspirin. Plavix costs a fortune compared to aspirin. Is Plavix more effective, or does it have less side effects to justify its cost over aspirin?

  8. Thanks for another great post!

    Speaking of “alternative medicine,” I often remember an old patent medicine bottle some friends had. I don’t remember what the product was. All I remember is that it claimed to cure a whole host of ailments, including “phthisis”—of which I had never heard—and boasted, “Makes children fat as pigs.” My how times have changed!

    I use few alternative medications—and zero mainstream medications—but I do take echinacea, which works well. I’m fully aware it might be placebo effect. But whatever it takes….:-)

  9. Man, this post reminds me of how, in the low carbohydrate circles, studies are constantly bashed, and then as soon as one is found that supports low carbohydrate, it’s trumpeted as evidence. It’s like you’re playing god of the gaps with alternative medicine.

    I’m trying to read between the lines here. Do you support alternative medicines like homeopathy, herbal “remedies”, etc? Or is this post really about how you are angry at how it seems hypocritcal of the medical community to come down on alt-med, when it promotes things that don’t work?

    You seem to be making a lot of excuses for alternative medicine, unless I’ve got you wrong here. “They can do all the tests they want, but it won’t REALLY prove that they don’t work. 10, 100, 1000 more studies won’t prove that a teacup isn’t really out there orbiting the sun!”

    Why should I believe in ANY of these supposed alternative medicine ideas? They’re the ones making the claim, it’s up to THEM to provide the evidence. Basic burden of proof.

    As one person joked, “If alternative medicine worked, it would just be called ‘medicine'”.

    PS: A great podcast for this kind of stuff is Quackcast. Check it out.
    PPS: “anecdotal evidence”, brilliant oxymoron if I ever heard one…

  10. I, too, have been put off by how some of these studies, which supposedly yield no results, have been conducted (as Annette stated above). Studies aside, though, for most people who are suffering, anecdotal evidence (their own) is sufficient and no amount of scientific “evidence” will convince them otherwise. I hate to admit that I am one such person. I was plagued by some odd bronchial condition that would recur monthly. I was in college and was visiting Brown University when it first hit. It seemed to be a chest cold, and after much coughing, it finally abated–until the next month, and the many months after that. I was desperate for relief and no doc could tell me what it was or what was causing it. My friends dubbed it “Rhode Island Disease.” I’d hack and hack, and get laryngitis for a few days; ten days later I’d be almost normal, until two more weeks passed and the next round would begin anew. One afternoon, it was coming upon me once again, and I dutifully bought the usual cold remedies to see me through (not a cure, I know, but at least some relief). One of my professors went to his office and brought back a bottle of echinacea. I reluctantly tried it. It worked, within hours. And RID never came back. Could I ever be convinced that this was a placebo effect? Nope.

  11. I grew up in a family that supported crunchy granola “health food” (what is today considered by the mainstream to be a healthy diet, low fat, grain based, largely vegetarian…) and also a lot of these alternative therapies. There is even a yoga instructor and reiki practitioner in my family. I grew up being taught to rely on these methods, and it took me a long time to admit to myself that they weren’t working for me. I’m not real keen on modern medicine either, but I have to admit, albuterol inhalers work a lot better than cups and cups of tea to help me combat an asthma attack. Now that I see that the emperor is indeed naked, I feel terribly angry and victimized by all the crap I was taught. I love my family, but they all seem very deluded to me now. I am in a no man’s land where I no longer believe in the alternative medicine I grew up with, but still do not fully trust modern medicine. I’m very skeptical now, and that has also complicated getting things properly treated — like my asthma. I’m kind of glad I at least had the placebo comforts of these alternatives when I was young, poor and uninsured. But I really wish I had not been given misinformation to begin with.

  12. Wow. Snake oil does have a bad rep in the U.S.

    I noticed that the label on the bottle said “Rattlesnake Oil”. According to http://www.scientificamerican.com/article.cfm?id=snake-oil-salesmen-knew-something, snake oil might have a better reputation in the U.S. if the bottle contained Erabu sea snake oil due to much higher levels of omega-3 fatty acids.

    “Fats That Heal Fats That Kill” by Udo Erasmus also mentioned research on the effectiveness of Chinese snake oil.

  13. I would recommend highly Jerome Frank’s book “Persuasion and Healing” if it can be found. Written back in the 60’s. Outstanding piece of work.

    tony

  14. “If alternative medicines are going to be held to scientific standards, so should be pharmaceuticals. Snake oil is snake oil no matter what its bottle it looks like.”

    So true! It is truly amazing what frauds so many medical modalities are.

  15. I watched a PBS Scientific American ( hosted by Alan Alda) on alternative medicines recently. It didn’t mention this study but the timing was blatant. One thing they did was walk through a natural health store and the “expert” with Alda told him (us) what each supplement was purportedly used for, and how worthless it was.

    One that fell on their hit list was CoQ10. They had nothing good to say about it, yet I had just read your section in PP Lifeplan on CoQ10 that mentioned its use in other countries (Japan) and all the studies done on it.

    I took it as yet another example of what a badly done program it was (for example, their entire debunking of chiropratic – and it was a large segment – focused on one disgruntled ex-chiropractor who brought absolutely zero scientific evidence with him).

    I would be interested to see if CoQ10 was included in this study, or if this study was as sloppy as the TV program.

  16. I think we should take the woo-meister’s ammo and throw it back at them, ie, we need some sort of new term for statinators incorporating this woo business. Hmmm, stoo-inators? stat-woo-meisters? woo-inators? stoo-meisters? statin woo mongers???

    ok, I’ll get back to you on this….

  17. Regarding the HCG, who cares if it’s all in my head? At least it’s no longer all in my hips, belly, thighs, and hips!!!

    I was VERY skeptical at first. You know my story. I gained about 45 pounds after menopause, even though I was following my standard low-carb (usually close to zero-carb) eating plan. No matter what I did, the weight would not budge. I hit menopause 4 years ago, and have been struggling with it ever since. (I’ve been eating low-carb for more than 10 years now, and had been maintaining at my pre-menopause weight for a couple years.)

    Then Missy (yes, she’ll probably pop in here pretty soon) approached me about HCG.

    So I tried it. I used the homeopathic drops (I know, I don’t believe in homeopathic drugs either). It was only $21 for a bottle, and I figured heck, I’ve spent more than that on other supplements (L-carnitine, etc.) that were supposed to help, why not this.

    I do NOT do 500 calories a day. Here’s a typical day. I have black coffee first thing in the morning (along with 10 drops of the HCG). Then I have a whey protein shake, usually with a shot of heavy cream. Lunch is 6 to 8 ounces of leftover meat from last night’s dinner and maybe a salad (though usually not); I do another 10 drops of HCG a little while after lunch. I have another shake in the late afternoon, and dinner is the same as lunch, except with more meat. Sometimes I have a veggie, sometimes I have a bit of sweet potato. I do my last 10 drops of HCG before I go to bed.

    This is not lean meat, either. I’m talking 10-ounce ribeyes. If it IS lean meat, like pork tenderloin or chicken breast, I often make cream sauces (heavy cream added to the cooking liquid, usually wine, and I saute with bacon fat) to slather over it.

    I’m definitely eating way more than 500 calories a day.

    I’ve now lost 25 pounds since late March. 25 pounds!

    I couldn’t care less if it IS the placebo effect. The fact is that I’ve eaten this same menu before, except WITHOUT the HCG, and I don’t lose a pound. I maintain or even gain. With the HCG, I lose.

    Simple as that.

  18. many people take a short-sighted approach when considering what has “worked” for them. of course some claim daily prayer and church attendance “work” for them, bringing them happiness and a sense of faith. i can respect a man’s faith, but i dont have to give him my intellectual respect.

    if you feel praying to your god to help you loose weight actually worked for you, all the power to you, but you do yourself a disservice by insisting that the results are proof positive of a scientifically valid reason. people get the results mixed up with the proof.

    we know that the placebo effect is a powerful and proven factor in any number of medical processes. the studies on knee-surgery in the UK with placebo surgical procedures gave conclusive evidence that our minds can be tricked and can induce health back to areas fraught with problems.

    its too bad we arent spending more money on harnessing the power of placebo effects to aid medical science. after all its about helping people return to health, if thats done by a surgar pill and faith, no harm no foul. the problem is, it would require tacit admission by th medical community (and big-pharma) that they practice medicine as both an art and a science.

  19. One more thing to add.

    I started out doing 500 calories a day along with the HCG, but I was ravenous. That’s why I upped my protein and fat intake. I’ve also tried going very low on the calories at times, WITHOUT the HCG, and I was equally ravenous. So, there’s no way I could stick with 500 calories a day, HCG or not.

    Yes, I lost 25 pounds using HCG, but I GAINED lean body mass. When I tried going very low calorie in the past, I always LOST muscle mass.

    Again, I can’t say for sure if the reason for my success is the HCG. But who cares? I’m now 25 pounds lighter and back in size 12s instead of size 18s. I’m thrilled.

    And I’m thrilled for you.

  20. Re: Taubes newest talk (online)

    At least Gary was invited to Dartmouth to give the talk in the first place. Too, some of the questions at the end indicated a degree of interest and credulity, though I thought the comment about Fen-Phen being an “off label use” (during the intro) was distasteful. You could also tell that that guy didn’t believe a word of it, especially when he asked the question about intestinal flora. So you have the young guy who’s railing against the system, and the old guy who thinks that obesity is all about intestinal flora. I guess that just proves that in the end, you win when the old guard dies out or retires.

    What annoyed me in that talk was the pager constantly going off and the people walking on and off camera. I realize that you are an important Doctor, but please put it on “vibrate”. It’s the respectful thing to do for the rest of the people in the room.

    Agreed!

  21. Dr. Mike,

    I have been taking HCG – homeopathic formula – out of pocket maybe $100 – since Feb 1st of this year. I have lost 50 lbs, and have taken several breaks. I’m actually in a maintenance phase right now, and I have been for nearly 3 weeks.

    For the record, I have tried all kinds of prescription meds to help me lose weight in the past, and just because I was told I wouldn’t be hungry, I was hungry. It didn’t matter that I was told that I wouldn’t be hungry. Diet aids usually MAKE me hungry instead of not. HCG is the first thing I have found that acutally does help with hunger. It actually kept the evil craving at bay and the ones that I did have to creep in, were managable, unlike before. Secondly, with HCG, I have noticed other things beside weightloss. My skin became noticeably tighter quickly. Even as I was losing weight and inches very quickly, my skin would just get tighter. Thirdly, I actually gained muscles without excercising. I used the calculations in the original Protein Power book. I have lost 77 lbs of fat and gained 20 lbs of muscle without excercising. I have lost a total of about 90 inches with my 50 lbs of weight loss.

    I, also, want to say, that I first started with Protein Power in 1999. I am a firm believer of the program and the science behind it. I, of course, strayed to gain weight. I had started back on Protein Power last fall, and lost 17 lbs, but it was a very slow 17 lbs. Plus, I can remember many scientific articles that say, low carb does not work. I think it is all who is doing the study and what they are looking for with the study. Each of us are our own science projects. For me, HCG works. I know many others that it has worked for. I don’t believe that it is all mental or a placebo affect. Many skeptics start using it, and are surprised when it works. As I said, I usually have the opposite affect from “diet” aids.

  22. On the general theme of misplaced confidence in therapies, let me follow up on the prior reference to thyroid deficiency.

    Dr Eades has mentioned several times that menopausal women have a hard time losing weight, even on a strict low carb diet, without attention to hormones. I assume that means thyroid/estrogen /and anything else. Having had some experience with this recently, I can attest this was true in my case.

    Before elaborating, however, let’s put this issue in context. I would estimate conservatively that weight loss concerns affect women more than men by a factor of 2 to l. I’ll estimate the same with respect to age — the over 45 crowd outnumbers those under by 2 to 1. That means that middle aged women are at least half the population of those seeking to lose weight. And by Dr Eades own observation –even on a great diet — that effort could prove totally unproductive without endocrinology as initial treatment. And how much emphasis is this given for the HUGE segment of the population to which it’s relevant? Very very little. (This is a subject to which even Gary Taubes gave short shrift; although obviously every topic can’t be reviewed in one book.) And the medical community seems to treat thyroid supplementation, in particular, as if it were prescribing heroin.

    Now to my recent experience: after 6 months on low carb, I gained about 2 pounds (I’m 53 years old; close to normal weight). Experimenting, I cut my carbs close to zero for a while, and realized I was getting really really tired. With some reading I suspected a thyroid issue and had myself tested at Kaiser Permanente (my regular doctor whom I almost never see). The tests showed TSH and T4 at the extreme end of the reference range and T3 below. I made a strong pitch to my doctor for Armour Thyroid, and even though she never uses it for other patients, agreed to the prescription.

    The bizarre part is when I saw the amount she had prescribed — 15mg per day! Forest Labs says a normal maintenance dose is 30 to 120, so she went for all of 25% of a low normal dose! Kaiser hands out HRT prescriptions like candy mints (you get them from the nurse practitioners) but Armour Thyroid seems to be treated like nitroglycerin, at least to this doc. And I’m not sure she would have given it to me at all were it not for the fact that my LDL is high, for which I refused a statin. (For those unaware, high LDL can be a symptom of hypothyroidism).

    I’m now struggling with the question of whether I should keep trying to nudge along my current GP, or start over with one of the “integrative medicine” docs of which we have several around Washington,DC. Would appreciate any thoughts from Dr E or others on the Board. Thanks!

    My vote is for checking with another physician. I have seem enormous improvement with Armour thyroid. You might also consider taking some iodine supplements.

  23. Dr Eades, I wish every condescending close minded practitioner and researcher (all x millions of them) would be required to read and respond to your comments.

    I have several times commented on blogs (such at sciencebasedmedicine.com and others) that scorn alternative medicine. I am careful that my comments are not based on anecdotes or assertions but with citations of studies showing efficacy of such substances as saw palmetto or echinachea.

    Each time my remarks are either a- ignored, b – scorned because I might have found the references from an organization that either supports some forms of alternative medicine
    or may actually be a supplement company (such as vitasearch.com) which compiles supplement and lifestyle studies from research centers all over the world). I NEVER have had one response that attempted to either rebut my comments with evidence or acknowledged that there was at least some merit in the evidence I presented

    I know from reading your blog that you encounter this all the time. While recognizing that there is no magic bullet to pry open peoples’ closed minds, I wish you would do a post sometime – if you haven’t already – on what are the best strategies to use to change the medical/health complex culture to be open to evidence in a non dogmatic way (I guess the debate in D.C going on right now over national health care and comparative effectiveness research is one such opportunity)

    That would be one heck of a post if I could come up with it. Changing closed minds is a tough – and usually thankless – proposition.

  24. This reminds me of a speach I heard at a respiratory therapy conference earlier this year. One of the doctors gave a speach about how beliefs will not die, even when confronted with scientific evidence. The doctor gave a personal example of car buying. He was in the market to buy a car and had done extensive research about which was the best model. He used all the usual outlets such as Consumer Reports, insurance agency statistices, etc. He had his vehicle all picked out when a friend told him that he’d had the vehicle himself and it was terrible. Because of that one item of anecdotal evidence, the doctor was unable to bring himself to buy the vehicle even though all his evidence told him it was a sound decision.

    How true, how true. This is why word of mouth advertising is the best and word of mouth criticism is the most potent.

  25. Snake oil might have some real benefit — I here it is high in Omega 3. At least until they start farming it and feeding the snakes corn fed mice 🙂

  26. Thank you for this post. I found it interesting. I am taking the liberty of passing it about to my friends, who may become acquaintances after I so do. The problem still remains of convincing physicians, my physician in particular, and others of the problems with the interpretation ΔE = E(in) – E(out) since I am sure that my physican is both too busy and and too brainwashed to listen to Mr. Taubes’ talk.

    I also found it amusing that the add at the bottom of email, since I use a freebie for email from Yahoo, advertised software to measure and track dietary calories

  27. Excellent blog. The UK is going through a similar thing with ‘alternative’ therapies. It really sucks, especially given the opportunity cost (i.e. what else we could be doing with the money).

    Regrading the value of the ‘medicine’ versus a placebo, if both work equally well, proving a placebo effect, then perhaps we shouldn’t be asking whether a product works or not, but whether people believe in it sufficiently and whether this produces a real beneficial effect. If it does, it could still be argued that this fake medicine is still a medicine to be prescribed because of the end result. The annoyance is that in such a system we couldn’t just prescribe placebo’s because people would stop believing if they found out. On these lines, couldn’t we do a study on the most powerful placebo’s/non-medicines and weigh these phantom placebo benefits against benefits of ‘real’ drugs when doing a cost-benefit analysis of where to spend tax payers money? I guess I am just saying that the masses are so deluded that perhaps we can use this information to our advantage?

    Lastly, did you know some real snake oils do seem to have a beneficial impact. The real problem seems to be that fakes were being peddled as the real thing and as fix-all cures.

  28. Hi,
    I have always felt that many many drug and procedure studies are not valid because they fail to have active placebos. In a trial, people know if they get sick from the medicine that they must be getting the active medicine and this introduces placebo bias.
    Great work,
    Many thanks

  29. Isn’t it obvious that the great cure-all, the one therapy that works for almost everything, is placebo? The power of mind and attitude rules! And in combination with something that actually works…it’s a one-two punch!

    So why no studies on the placebo effect itself? How about a test where half of the people are given a salt water injection and told that it is some new miracle drug, and then the other half is given the saltwater injection and told that it is a saltwater injection, just a placebo. There are lots of permutations on this, and of course, this kind of thing is pretty cheap. Which might be the problem.

  30. Yep, add me to the list of happy idiot folks in disagreement with you on this. I’ve been, in the past, a consistant contributor to the Protein Power forum and followed the Protein Power plan in hopes that it was my answer. I was completely frustrated that following it wasn’t getting me what I was hoping for. I felt very strongly that eating that way was correct, yet ineffective for weightloss ~ for me.

    HCG is effective. 80lb loss in less then six months. It doesn’t HAVE to be expensive ($21 a month). I feel for the folks who are so desperate to lose weight feel that the solution is only available through an expensive clinic that’s taking advantage of them with that. Unnecessary. Homopathic version of it is available..and cost effective. I’ve taken both, shots and homopathic, and to be honest with you BOTH are equally as effective.

    I have influenced quite a few members that I’ve grown to know their struggle with weightloss, just as I have experienced over the years on just Protein Power lifestyle plan alone to try out the hcg and see what they think, feel, experience. Hands DOWN it’s effective. EACH and EVERY former PP member has had their own success and are working their way toward their goal. NONE of them have gone through a clinic.

    If you’ve not prescribed it, nor needed to use it for yourself..then all I ask is that you keep an open mind to it and not label it as a ‘snake oil’. Just as I don’t ‘buy into’ what conventional medicine offers, I don’t the same with alternative. I never have. That’s why at first I was pretty darn skeptical with hcg, but it proved it’self to me. That’s all I could ask for.

    The beauty of this is that because WE are so versed in Protein Power and the lifestyle that we can use that as the plan to keep the weight OFF. Use the hcg with a modified protocol that’s not a starvation diet to get it off, and then switch to Protein Power to maintain. Best of BOTH worlds! There is a marriage here between using hcg and protein power lifestyle that shouldn’t be overlooked….and I don’t know how to emphasis that stronger?

    I must say Dr. Eades, your sounding ALOT like those folks who think eating low carb is rubbish. Since when do you base your opinion on “reporting what they found”??? That surprises me actually.

    Hcg will be apart of my process of achieving my desired weightloss goal…just as I know that living the protein powered lifestyle needs to be adhered too to kept it off as well.

    Don’t shut the door on this yet Dr. Mike.

    I did with this just as I do with the low-carb diet. I depend upon what well-conducted scientific studies demonstrate. I started with low-carb dieting because it was effective for both me and then a boatload of patients. I told anyone who would listen about the virtues of low-carb dieting, but was constantly asked ‘Where are the studies?’ When the studies finally started rolling in, they confirmed what I had found in myself and in a large clinical practice. In the case of HCG, when the studies came in, they didn’t confirm what many people had found in clinical practice, which leads me to believe that there is a placebo effect taking place. Or that it works for some, but not for others, averaging out to no effect over a large number of patients. If it were a single study showing HCG to be ineffective, I wouldn’t think much about it, but there are at least 20 studies out there all showing the same thing. Knowing that, I wouldn’t recommend it to my patients who were contemplating its use despite the fact that you and a number of others had achieved great success with it.

  31. I do wish more promising supplements had been tested, like vitamin D for various conditions, methyl jasmonate or IV vitamin C for cancer treatment, curcumin for cancer prevention, or various ratios of the oil-soluble vitamins for heart disease.

    I doubt that most of these things were tested, but they – like the baby with the bathwater – will be included in the minds of many.

  32. Ursa Major,
    I noticed that you said you “maintain using a low-carb/paleo type” diet. I’m curious as to how you ate during the HCG therapy? I expect something similar…

  33. Interesting post! I have a few friends who recently did that HCG diet and lost a lot of weight. A 500 cal/day diet will do that for you!
    They refused to listen to logic or read any of the studies. It was funny, but scary. The food list was the funniest part to me. Melba toast and sweetn’low. Icky.

  34. Of all the entrenched opinions, the ‘calories in vs calories out’ opinion seems to be one of the most deep rooted becuase, on the face of it, it is so simple and appealing. I have tried to convince people that fat-accumulation has more to do with hormones than hamburgers – but to no avail.

    I figured Taubes’ excellent video would challenge a few opinions, but people seem to be aggressively dismissive of alternative hypotheses concerning obesity. Astonishingly, many (intelligent) people I have discussed this topic with, simply feel they don’t need to address Taubes’ points, read his literature or watch his presentations, because it JUST HAS TO BE ‘calorie in vs calorie out’.

    Check out this exchange: http://www.ukclimbing.com/forums/t.php?n=360210

    It makes you wonder how the human race has progressed as far as it has.

    A lot of pinheads on that forum. Esp Serpico.

  35. On one side of the scale there is traditional medicine, which although they are gleefully denouncing alternative theraphies, they are still guilty of the same narrow mindset they poke fun of – turning a blind eye to antiquated studies and the lack of supporting evidence. On the other side is holistic medicine, sometimes thought to be more progressive, open minded to new concepts and and taking a more enabling approach toward health care – or are they just old fashioned because they are steeped in tradition and also overlook the lack of good clinical research, maybe relying a little too much on the power of our own beliefs to achieve a desired result. Should we commend them for trying though? Traditional medicine certainly hasn’t won over our hearts when you realize you end up with more troubles than when you began your medication. And what about the medical establishment changing their mind every two minutes; butter is bad, margarine is good, now butter is good, its the margarine that’s bad, eggs are bad, now eggs are good, canola oil is the best… now it’s not so good…

    As far as I’m concerned, acupuncture, herbal remedies, and bio-identical hormones all fall under the same umbrella. I always felt it is better to err on the side of natural regardless of the fact that any any herb concoction I have ever taken has done nothing more than give me a headache. Although I can attest that a good message does wonders for anxiety and insomnia.

    It is still mind boggling that there is such a divide in the medical community. I wonder if this is truly a medical metamorphosis we are witnessing or the just result of a marketing crazed culture. My doctor who is young and progressive (I thought) just tried to put me on Crestor yesterday because my cholesterol was a little high. I brought up the ‘lack of evidence in women’ argument and he replied that it is because good studies have not been done for some time and when they were done, testing was just done on just men, (no equal opportunity diseases back then I guess) that’s why there is no evidence on the drug helping women. He said that in general, no more than 30% of people are helped with statin use. Are those 30% the men under 65 with heart disease?

    Re the placebo effect: Our brains are tricky monsters. When we want to see something happen, the wheels get put in motion to get us the desired results. Our motivation actually triggers a brain restructure to facilitate the process. In other words, whenever you act on what you expect to happen, your brain responds by actually creating just the right neuron pathways to bring about that new reality. Far fetched maybe, but I believe it to be true.

    Yep, those are the 30 percent, but I think the 30 percent figure is way, way too high.

  36. I agree with most of your points on statins, Llet’s forget about their effect on cholesterol because there isn’t a corresponding reduction of overall mortality.

    But I do have some questions. Most statins reduce inflammatory markers, yes? If one takes a low dose of what seems to be the least harmful of the group (pravastatin), is that person not being helped? Are the reduced inflammatory markers not an indication of an actual reduction in inflammation?

    I ask because a close friend has familial hypercholesterolemia and a family history of CVD. He cant get his HDL above 33. He is age 44, not overweight, but has a small spare tire above the beltline. He reduced his carb intake after observing my weight loss and stellar lab results, but it’s not enough to get rid of the tire.

    More importantly, is FH different when it comes to statins? Is there a need for them in his situation?

    If what you are looking for is a reduction in inflammation, I suppose you could achieve it with a statin. But if what you are looking for is a decreased risk of dying, you won’t find it with the statin. So, if you want to spend the money and risk the side effects (some of which are fatal) to decrease inflammation but not reduce your risk of death, then statins are for you. Or you could take some arginine and go on a low-carb diet and reduce inflammation with all the attendant expense and risk you incur by taking statins.

    I’m not up with the literature on statins and FH, so I can’t comment intelligently. But my bet is that they don’t work any better there in terms of decreasing all-cause mortality than they do in the general population of people with minimally elevated cholesterol.

  37. Having dieted for 71 years (since the school nurse put me on a diet at 5), I’ve tried everything to change my silhouette. My experience with HCG was in the early sixties. I loved how quickly I was losing weight, but in my case, I did the daily injections myself. Everything went swimmingly until I hit an artery in my thigh and turned my white-tile bathroom into a blood bath. End of my HCG experience.

    As a non-believer in acupuncture, I was amazed that two sessions with an obnoxious doctor relieved the pain of a leg injury I’d received during the 1994 earthquake. It was expensive and not covered by insurance but it’s worked to this day.

    I’ve also tried, among many other things, hypnotism. Zilch.

  38. I’ve been taking a good quality ginkgo biloba powder for a few months. I can’t say that i notice much, if any, improvement in mental clarity or blood flow in general. However, i can say that it does not taste great, and gives headaches when taken at large doses. Perhaps, the headaches are indicative of some effect on the brain.

  39. I am quite convinced the hcg protocol does what it is supposed to do, especially after reading Dr Simeon’s manuscript “pounds & inches”. I am one of those people who had become very much overweight by not eating enough. I had put myself into starvation reflex mode and I was stuck there, no matter how much healthy foods I ate or how much I exercised or how much I starved myself. My doc told me about the hcg and I figured it was worth trying seeing as nothing else worked. It worked very well and I”ve lost 50 lbs so far. I know my body is not starving because the hcg pulls the needed 2000 calories from abnormal fat, just like it would do during pregnancy. Energy is increased and things just seem to work! My husband started protocol and he is a VERY large skeptic of alternative therapies that are so unique.

    I suggest people read the original manuscript that has the original studies and observations described in it. I personally distrust ‘double blind studies’ because they are usually financed by big pharma and are skewed to prove that it doesn’t work or for whatever purposes suits their needs. I’ve seen too many cases of supposedly ‘safe’ medications that were ‘successful in double blind trials’ actually are lies so I am a BIG skeptic. Think of how much money would be lost if this and other natural remedies/therapies really DO work?!

    Another thing to consider is the protocol helps re-teach people how to eat properly again. It forces everyone to realize the reasons they eat certain foods or overeat. It helps them get off the sugar/simple carb addictions and learn about normal portions, to eat to live, not live to eat. It helps a person re-learn what REAL hunger is vs boredom hunger or stress hunger. Those that don’t learn these important lessons will usually re-gain all they have lost because they have not changed their habits.

    As a society, we are too addicted to sugars, simple carbs, chemicals and medications which all help damage our sensitive glandular system. The hypothalamus is the master gland and controls so many areas our bodies. Maybe, just MAYBE there really is something to this whole hcg fad? Hcg protocol is a paradigm shift for sure!

  40. No one therapy works for everybody. I do very well with homeopathy,
    my boyfriend prefers allopathic medicine, my mother does nicely with
    a couple of herbs and acupuncture, and my grandparents knew a guy that
    lived to be 99 on meat, two shots of whiskey and a cigar a day (according
    to his own opinion – who’s to say he was wrong?).

    It makes good sense to try different healing methods to find the combination
    that works best for you.

  41. Ah! I will borrow from another poster.

    “If preventative medicine worked, it would just be called medicine.”

    I think that’s what you were trying to convey about statins, Dr Eades?

    I think the statement is that if alternative medicine worked, it would just be called medicine. I don’t know if this is true, however, because most mainstream docs like to use either drugs or procedures or both. They didn’t have to go to medical school to be able to give patients herbs or other nutraceuticals – they went so they could prescribe drugs and/or do procedures. Those are what they view as healing. So even if an herbal remedy were shown to be vastly superior to a given drug, most mainstream docs would still give the drug. Sad but true. And the more efficacious herbal remedy would still be called ‘alternative medicine.’ Statins don’t work for the majority of people who take them, but they are still considered real medicine. Strange.

  42. Dr Eades.
    The study you reference could not be more wrong about the Simeons protocol being placebo effect.
    First – as far as placebo – I had completed a successful 1st round (30 lbs in 32 days) and was posting periodic videos of my progression on YouTube. I started a 2nd round, again posting with full knowledge it works and with full intent of reaching the 190’s in the 2nd round. About 10 days into the doses – I hit immunity, big time… was like a ton of bricks and all I could think about was food. Had to immediately increase caloric intake to around 1000 a day until the 23rd dose was done and I could complete the round.
    Second – a group of friends wanted to try it after they saw my rapid weight loss and asked me to reconstitute their hCG for them – I said I would if they were open to participating in an experiment (didn’t go into the details) After the typical rough 2 days of the low calorie diet everyone was getting along fine. The 2nd week I gave them 3 doses of NaCl in place of the hCG – and amazingly – they all started to complain of hunger issues when they’d done just fine the week before. I told them the mix must have lost potency and I’d mix up a fresh batch. 2 days later, after resuming the hCG – another miracle – the hunger was gone, and 4 of 5 went on to successfully complete their course. (the 5th dropped out due to gall bladder issues)
    Third – Since most hCG clinincs don’t take a patient’s cash flow into consideration as far as quality of life issues – due to their unethical profit margins of 1000% or more in some cases – most people I’m in contact with do the protocol on their own – for around $100 vs. spending $800, $1000, $2000 through a clinic. And I hear a good amount of time from ones who DID pay through the nose that the online chat groups provide more support and better instruction than the clinic who took their money. Many clinics ALTER the protocol to lengthen a “patients” need for treatment. Point being – over 600 people I’ve spoken with personally have been successful on the protocol for $100 – and $100 isn’t really hard enough on the wallet to produce money motivated placebo effect. (I’ve known several people who spent 4 times as much on a gym membership and never set foot in the gym)
    1-3 would cast huge doubt on your opinion that it’s simply placebo effect.
    Additionally – and this is my impression based on personal experience – hCG hastens lipolysis. I’ve fasted before, tried Atkins before – usually day four or five before I’d show trace of ketones. Yet on the protocol – was half way up the stick on the 2nd day of VLCD. Again – placebo effect wouldn’t throw me into a state of ketosis that quickly. Or – as another who did the protocol observed – ketone levels dropped significantly when he stopped dosing but continued with the 500 cal diet for 3 days when ending the course.
    Personally – and this is amazing to me – I believe the protocol breaks down leptin resistance… which would make Dr Simeons so far ahead of his time – as leptin was discovered about 40 years after he wrote Pounds and Inches.
    A curiosity – Simeons Management was sued in the 70’s over the protocol – Trudeau rather recently – yet, in neither court case did the government claim the protocol unsafe or ineffective. More curious – that it was the FTC that sued Simeons Management for “deceptive advertisement” in their clinic print ads in the San Fran bay area (didn’t mention injections of a prescription medication) and somehow the FDA got involved when they weren’t the defendant.
    I’ve spoken with several physicians, have had many who actually TRIED the protocol and were shocked with their losses, many wished they’d been able to offer it as a treatment years ago. There’s one that posts frequenty on MedHelp – and told the story of a patient who pestered him to put her on it. After months of being annoyed, and after reading up on it and deciding it wouldn’t harm her – he did just that – assuming her metabolism would plummet and she’d go on one of the weight loss plans he DID offer after find out it was one big sham. To his shock – the opposite occurred, she was very successful, her metabolim increased – and for the past few years he’s added it to his clinics services.
    The meta study you referenced used several of the studies that in fact DID NOT FOLLOW the protocol as written by Dr Simeons. Pounds and Inches stated clearly enough that a layperson could understand – the approved foods only and no more than 500 calories a day – a calorie isn’t a calorie and it DOES matter which foods are consumed.
    Directly from P&I concerning dietary guidelines:
    “Every item in the list is gone over carefully, continually stressing the point that no variations other than those listed may be introduced. All things not listed are forbidden, and the patient is assured that nothing permissible has been left out”
    The Frank study for instance, dosed 200 IU 3 times a week instead of 125 IU daily, and allowed caloric intake over TWICE what is allowed, less than HALF the required PROTEIN.
    Frank totally disregarded the dietary restrictions for the sake of convenience, using an exchange type diet and as such his study is completely worthless. The fact that they didn’t throw out any studies that didn’t follow the protocol restrictions verbatim skews the results. Yet – they somehow gave it a score of 52 and was included in their conclusion… to wit – the meta is as worthless as the Frank study.
    As mentioned in the meta – “… the need for a well-designed, well executed,
    double-blind investigation into the effect of HCG in the Simeons therapy” – IT’S STILL NEEDED TODAY . Who’s going to do it ? The FDA is in bed with big pharma, pharma has 3 or 4 weight loss pills in the testing phase right now, with revenue for obesity meds expected to quadruple over the next few years. They certainly won’t be keen on a drug that cost under $30 wholesale for a months supply – and is so effective the course of treatment is self limiting. I don’t think any university would do one independently for fear of losing federal funds. Then there’s the appetite suppressants, the type 2 diabetes medications, the high blood pressure manufacturers.
    Not only that – NOW there’s Nutri, Jenny, WW, etc – with their “results NOT typical” celeb endorsers – sure they’re licking their chops with the projections that 90% of Americans will be overweight or obese by 2030. Not to cast a dim light on the medical profession – but with so many diseases directly or indirectly related to being overweight, can’t rule them out either. Bariatric & plastic surgeons would be none too happy I suspect.
    You know all too well the government corruption, 4-4-3-2 … I remember seeing a physician reporting back in the 70s that the pyramid was unhealthy. Is it outside the realm of possibility that big pharma had some financial influence on the outcome of the studies or the FDA ? By the way – can you think of ANY other drug that requires an FDA warning concerning off label use ?
    So – if I read you correctly Dr Eads – you don’t really see any harm in using hCG – simply that in your opinion it’s merely placebo effect. I respect your position on the food pyramid, believe in Protein Power, believe the statins are one of the biggest medical scams of all time (and by the by – might want to ad a few comments to your Lipitor commercial posted on YouTube – just so people who don’t know you understand your position, it looks like you’re promoting it to someone unfamiliar with your work ) and as far as Cafe Americano – forget about it ! SO good.
    Listen to Dr Robert Jones – the first 30 seconds he does not mince words …
    http://www.youtube.com/watch?v=diFSL0y144w
    Sounds quite a bit like the same reason we were still being fed a dietary guideline by the government more than 20 years after they were told it was unhealthy. What if all along – Simeons protocol is another pyramid ? Marinate on that for a moment if you would.
    What I’d like you to consider if you have the time, the resources and facilities – and wouldn’t mind another NY Times best seller – set up a well-designed, well executed, double-blind study following the exact guidelines in Pounds and Inches and if possible in a controlled environment where the meals can be identical in substance and portion size.
    Perhaps make a documentary as well.
    You obviously have your doubts that hCG has any direct effect on fat loss – the funny thing is Asher & Harper – who had the only really positive study, documenting nearly twice as much weight loss and the feeling of well being – started out assuming they’d prove Simeons protocol didn’t work.
    I’ll make suggestions as far as design – and you’d REALLY need to do them as they address every claim that has been disputed for over 50 years. The nay sayers typical claims – “it’s placebo effect” – “it doesn’t promote fat loss” – “it’s all water weight” – “you’d have to expend X energy to lose that much weight – there’s no way you could lose that much in a day, you’d have to jog more hours than there are in a day” – “anyone could lose that much on 500 cals, you don’t need the hcg.” (just try a week of 500 cals WITHOUT it, if you can go that long)
    BASELINE and POST protocol :
    Take several body measurements (as evidence to losing in “problem areas” and only losing “abnormal fat”)
    Take accurate body compositions to ascertain where the weight loss has come from. (fat, water, muscle – to verify or disprove hCG has muscle sparing effects vs. placebo group) hCG has been used in the treatment of AIDS patients to prevent muscle wasting.
    Take thyroid panels, liver panels, cholesterol panels, and leptin levels.
    Test metabolic rate.
    DAILY:
    Report level of hunger on a scale of 1-5.
    Weight at the same time daily.
    First morning void ketone levels.
    End of study: Compare amount of lean muscle mass lost from each group.
    *****************
    Worst case (at least in my opinion) your findings show it’s purely placebo effect, you get some quality air time to discuss your results, get the results published and promote Protein Power.
    Best case – Hello Oprah – bringing the protocol into the 21st century your findings confirm many of the claims Dr Simeons made so long ago. Instead of Trudeau with a jaded past, no medical background or credibility – with scientific proof from a well run double-blind study… personally, near single handedly – you add legitimacy to Simeons protocol, perhaps add a little insight to how and why it works, promote your book detailing the findings of the study and your personal observations and the synergy of following Protein Power once you’ve ended the protocol.
    *****************************
    For full disclosure I do run a site that sells kits for the protocol – but I’d rather not. As many times as I tell people to run it by their physician before starting I fear the majority don’t. This is SO much bigger than people making a few bucks. It should be mandatory continuing education for all physicians instead of being shunned by the FDA and the profession as a whole. It NEEDS to be approved by the FDA for weight loss, and covered by insurance.
    I’m just a regular Joe, nothing special – and yet can’t count on all my digits the number of people who have told me how I changed their lives for the better. (Dr Simeons protocol did, I just gave a few encouraging words here and there) One gent had gastric bypass and lost a total of 10 lbs 2 years post-op. Less than a week on the protocol and he’d lost twice that, over 40 lbs in a month.
    And for the record – I don’t recommend it for everyone, it DOES have possible side effects, it ISN’T a cure and you CAN’T eat anything you want after and not worry about gaining anything back. Personally the “harder to rebound” claim seems to be true but I don’t have enough data yet to take a firm position.
    From the data I have received I can tell you that the majority of people who provide results are losing 10-14% of their total body weight in 30 days. For someone bedridden, morbidly obese – the protocol could literally give them hope of something better, and actually deliver. I haven’t worked with anyone over 500 lbs – but believe a 70 lb loss in 30 days would be possible. (though Dr Simeons suggested limiting loss to a maximum of 40 lbs per dosing period.) I’ve already had someone report a 51 lb loss in 32 days.
    One thing I hear time and time again – people looking for direction, some dietary guidelines to use once the protocol stabilization is complete. Protein Power.
    I’m having a hard time trying to figure out how the country is going to pay down the national debt as it is – can’t image it ever happening, especially when they’re projecting medical costs to treat obesity related illnesses alone at close to one trillion dollars per annum by 2030. People just glance through the headlines with no thought as to the future ramifications. They’re already turning away about 20% of armed forces applicants for being overweight – knowing the way the government works – will they subcontract the work out to another country or just do like they already do with schools, keep lowering the standards to match the declines ?
    Truth be told, I blew $100 on that first round – considering the source (the Trudeau infomercial) had planned on posting on YouTube what a fraud it was. (yet another case for not being placebo, I fully expected to fail when I started) Instead the genious of a British Endocrinologist took me a different direction and a dumb little vlog turned into a hobby, then a side business, then a passion bordering obsession… and somehow far and away has become my greatest contribution to society.
    If not you, who ? If not now, when ? Take the chance. Either you give a fresh, more scientifically based “no” – or as I suspect you surprisingly find Asher and Harper were correct, give some added insight as to methodology, new credible scientific data that disproves the naysayers – and you bust this thing wide open… help to stop this obesity epidemic, bring it out of the shadows, make it known to primary care physicians and available for the price of a co-pay.
    If in under a year a schmuck like me can help 600 people lose over 15,000 lbs – how many millions more could you help ?
    Thanks for your consideration.
    It would be extremely difficult to get funding for the study you suggest since all the preliminary work has shown there to be no benefit. The road to getting studies funded is by doing small pilot studies first that show promise, then the various funding agencies may open their purses. When there are at least 20 studies out there published in reputable journals most of which show no effect as compared to placebo, then no one is going to fund another.
    And, BTW, I pulled the Asher study and it has serious problems. First, as I recall, Bill Asher had a clinic in Denver that treated patients with HCG, so he couldn’t be considered an unbiased observer of the data, but after this study he became skeptical. Second, the data analysis was totally flawed. Significantly more people dropped from the placebo group than from the HCG group, but all results were based on all people starting the study. So if you’ve got more people in one arm of the study (the HCG) are who are following 500 kcal/diets and finish the study than you do subjects on the placebo arm following 500 kcal/day diets, yet the same number started the study, you are going to get a larger average weight loss from the group who had more 500 kcal/day completers. Therefore the data is totally screwed up. Moreover, as the authors mention another study they are doing involving four other HCG practices. They state:

    It is interesting to note the HH’s [one of the authors of this paper along with Asher] patients who were given a placebo lost more on the average then either the HCG or placebo patients of the other four practitioners. … Certainly, the psychological impact of receiving a daily injection which the patient believes in is important.

    You can get free full text of the entire study here. Read it for yourself. If I were you, I wouldn’t really use it to bolster my argument that HCG is effective.

  43. dr Eades
    This is one of my favorite posts, and I will tell you why. It is so well thought out and analysed. You presented the information and then calmly, logically and in an even handed manner considered several inferences. I particularly like how you noticed the snickering of the mainstream. It is so similar to their depreciation of lo carb. They were happy that a study protected their inflated incomes derived from presenting themselves as the high priests of all knowledge.
    The fact is that alternative medicines do not work consistantly. There are some people who swear by them, but for most people they do not work. Does this not seem like there is something there, but the mechanism is still unknown? Logic will suggest that what is needed is research to determine what might be there. But just as for lo carb, this would be a long time coming, simply because if it were discovered that there was some real mechanism there that can make the therepy work, that would disturb the lucretive status quo. Now we cant have facts that would affect our income, can we? Talk about an inconvenient truth! I mean it is bad enough that the damn lo carbers are close to screwing up the whole market for almost all the lucretive drugs, and giving it to bloody cattle and pig farmers!
    Now for my own little anecdote. Some years ago I hurt my knee. Of course since I did not walk properly my ankle began to hurt. And since I am male I procrastinated until it was so bad that I was in such pain that I was willing to try anything. It was at this strategic moment that my then wife suggested that I visit her homeopathic doctor. This guy was a licenced conventional doctor who studied and practiced homeopathy. The guy sat me down and waved a wand ( yes, that is a WAND ) over a contraption that was full of buttons and stuff. He put some tiny balls of sugar into another part of the contraption and told me he impregnated them with a substance that would cure me. He said I was allergic to cow’s milk so all I had to do was to take the tiny balls and stay away from milk. To make an already long story a little shorter, the thing worked quickly and spectaularly.
    Now you might remember that I mentioned that I am male. Like so much of that ilk, once the pain went I totally disregarded the advice I was given, after all, a wand for heavens sake! So I began to have milk again and pretty soon the pain came back in spades. Suitably humbled, I went back to the doc and was given the same remedy and the same advice with the same results.
    The similarity continued, since of course I disregarded the advice, the pain came back and I again went off to the doc. This time, in the course of our conversation, he mentioned that he even cured a horse.
    Now it so happened that at this time I had a prize boar pig that had developed some bad ulcers on his face below his eyes. It was so bad that he could not see and I had reluctantly and painfully decided to call the butcher. So I asked about my pig. He told me to bring a photo of the pig, which I did. He did his wand thing with his contraption and gave me some tiny balls to give the pig. I felt pretty stupid to treat the pig, in secret of course, but I was desperate. Within about a week his face was as clear as a little piglet. Placebo effect with a pig?
    Thanks for a great post doc.
    Glad you enjoyed it.

  44. I think you may be missing the big picture behind the article you commented on.
    In recent months I have observed an escalating series of media reports and articles citing studies which found little or no benefit and even danger from the use of common vitamin supplements and alternative therapies. Concurrent with such articles is the reporting of the latest scientific discoveries that could lead to miraculous new drugs that will cure every illness known to man. Coincidence? I think not. To me this is the artillery bombardment intended quash resistance and garner public support for the introduction of legislation such as CODEX that will severely limit access to nutritional supplements or only make them available by prescription at anything above food guide levels.
    Insofar as the resistance to the acceptance of low carb the exact same carbohydrate promoting strategies are being used to support commercial dog and cat foods which are around 60% carbohydrate – the same as humans. While there may be a place for limited carbohydrate in dog food formulas cats are obligate carnivores. Put another way, carbs are poison to cats.

  45. An early natural hygienist MD named J.H. Tilden once wrote:
    “If many kinds of diseases get well at nature’s hands, and others get well under the treatment of all sorts of mountebanks, quacks, cults, and deluded scientists, what does that mean? It means that headaches and many other minor discomforts–such as colds, sore throats, indigestion, constipation, diarrhea et alii–come and go, receiving no attention, or at most home remedies whose principal virtue is in not doing any harm. This tendency to stay normal, or to get back to the normal, or to throw off disease, is so constant that all sorts of delusions, theories, and systems of cures have been given life and perpetuity. Every sort of scientific medical man, mountebank, adventurer, knave, and fool has found success and a following–-for a time at least-–in this No Man’s Land, with its serious, grotesque, scientific, pseudoscientific, and superstitious therapeutic cure-alls. The advocates of all sorts of overnight cures, physical and mental, extend their pipelines into this Fool’s Medical Paradise, and never fail to suck sustenance–-a thing made possible by the fact that nature so often cures ills without extraneous aid from any source.”

  46. I was surprised to see glucosamine/chondroitin on the list. When my father was having severe hip pain that that was the first line of attack. his orthopedic surgeon put him on a specific brand of glucosamine/chondroitin and told him to try it for six months. My dad couldn’t make it past 3 months and demanded a hip replacement which he had at the ripe age of 87. Yet I started taking a proprietary blend of 8 pills a day that includes glucosamine, chondroitin, msm, flaxseed oil, turmeric, quercitin and a bunch of other ingredients i never heard of. within 3 weeks my pain was cut in half. by 6 weeks and after my pain could disappear for days at a time. My point is that an MD prescribed supplement might not always be as effective as an herbalist prescribed supplement. on the other hand echinacea never did a thing for me when i had a cold. I guess ymmv is at play.

  47. Okay, I’m not bashing just alternative medicine. Mainstream medicine has huge faults as well. Cholesterol, statins, etc. Follow the money. Money polutes everything. I mean, it’s literally “big herbal” and “big phrama” now. These companies are massive, and produce the products for smaller “home grown” companies which give people a cosy feeling about what they are taking, when efficacy isn’t proven (or is shown to have no effect), quality control isn’t regulated, etc.
    But yes, the quote above was about alternative medicine. I’m all for preventing rather then curing (hence my adoption of a Paleo diet instead of waiting for my insulin shots and heart by-pass surgury). But if you have cancer and you want to treat yourself by drinking water that “remembers” (whatever that means for two hydrogen atoms covalently bonded to a single oxygen atom) another substance that was diluted in it so much so that no molecules of it now exist, rather than get proper medical treatment, I’ll have no pity for your funeral.
    My other basic point was, if you can’t AT LEAST do a double-blind study on your purported cure (reiki, prayer, ground up tree bark, rhino horn, fairy dust, handstands, whatever), then I have no reason to believe it’s effectiveness. You can make crap up until the cows come home, and that’s exactly what many of these alternative “therapies” are… literally still “hypotheses” that were never actually shown to be effective. And indeed you might end up worse off. For example, many probiotics tested contain different bacteria than they actually say they do.
    That said, I’m not really much for studies anyways. As they say, you can produce a study to show almost any viewpoint, the big question is which ones contain the least amount of flaws. The human element (bias, greed, etc) can play an effect in all those hard numbers, on any study.
    I think my response was generated because I was haven’t trouble figuring out exactly what the focus of Dr. Eades article was about. Is it about how statins aren’t effective and yet a multi-billion dollar industry? Or was it about standing up for the products in the study that weren’t shown to be effective? It just sounded too much like pure faith to me, “No study will ever prove that they don’t work”. An analogy, I can’t prove that god doesn’t exist, but I’m not the one making the claim that he does. I was speaking of burden of proof, and this applies to all claims.
    Sorry for the length.
    Here are the points I was making in the post.
    1) $2.5 B has been spent to study alternative medicines and, with a few exceptions, they have been found lacking; 2) That does’t mean, however, that every alternative therapy known to man has been tested; 3) nor does it mean that those tested were tested in all possible forms. (For example, many extracts were used instead of the entire plant that most practitioners use); and therefore 4) one can’t make the blanket statement that all alternative remedies are rubbish because the ones they’ve tested so far and in the forms tested have been shown to be ineffectual; 5) probably, however, many are ineffectual but we simply can’t make the blanket statement that all are; 6) mainstreamers are gloating over this as if it is the ultimate proof of the ineffectiveness of alternative therapies while they themselves cling to a belief in the effectiveness of statins, which have been shown in multiple studies costing much more to be ineffective.
    Clear enough?

  48. Wait wait wait. I just did some more looking up on hcg. I’d really like the people who swear by homeopathic HCG to explain exactly how injecting water is helping them lose weight, and not the caloric restriction?

  49. You wrote: “I did with this just as I do with the low-carb diet. I depend upon what well-conducted scientific studies demonstrate. I started with low-carb dieting because it was effective for both me and then a boatload of patients. I told anyone who would listen about the virtues of low-carb dieting, but was constantly asked ‘Where are the studies?’ When the studies finally started rolling in, they confirmed what I had found in myself and in a large clinical practice. In the case of HCG, when the studies came in, they didn’t confirm what many people had found in clinical practice, which leads me to believe that there is a placebo effect taking place. Or that it works for some, but not for others, averaging out to no effect over a large number of patients. If it were a single study showing HCG to be ineffective, I wouldn’t think much about it, but there are at least 20 studies out there all showing the same thing. Knowing that, I wouldn’t recommend it to my patients who were contemplating its use despite the fact that you and a number of others had achieved great success with it.”
    Really? Again, this strikes me oddly? If I were aware of something that is helping others who claim that they were the types that were ‘hard to lose’ and now are finding success I think I’d have to break out and do some of my own experimentation. Just as you found with your experience with low carb and how it worked on yourself and others under your care. Why NOT give this a try? Why NOT try to adapt it with an updated protein powered plan? Why NOT.
    If you say you are aware of most ‘diet’ plans out there…I can’t imagine that your not seeing for yourself the SCORES and SCORES of success on hcg forums? I’m personally astonished by the sucess rate I see from person after person on them. No, they are no scientific studies, and there is NOTHING offical about them…but what they are are REAL people experiencing REAL progress. I know those personalities that use support forums because I’ve BEEN there. The difference isn’t my mind over matter, the difference is the hcg.
    I once fired a Dr. who only was willing to prescribe me thyroid medicine (synthroid only) on a dose based on ‘what works for most”…when I learned that adding armour was really a wise choice. I was correct. I was extremely upset with a Dr. that could only think in terms of that broad brush stroke. Nothing about me is ‘most’. The truth was it was just the limit on her experience.
    Dr. Eades, consider this. You have by your own admission said that there is a segment of folks that have a difficult time losing. Middle aged, hormonally challenged woman. This is a BIG group, no doubt….and what if there is indeed something out there that is tipping us over that edge? What “if” is becoming a reality for those of us….. hard to lose… You wouldn’t personally look into this for OUR sake??
    I have looked into it by reading the medical literature. You can’t do diet studies using a placebo. You can’t put one group of subjects on a low-carb diet and another on a placebo to see what happens. You can with lab animals because they have no choice. You can make all kinds of chow and control the calories specifically – you can’t do that with humans. So dietary studies aren’t the same as studies in which placebos can be used, therefor you can’t get absolutely accurate info in the same way you can with double-blind, placebo-controlled studes.
    But placebos can be used in HCG studies and have been. When people are randomized into two groups following the same diet, one group given HCG and the other given placebo, both groups get the same results. Which means that the HCG is no better than placebo. These studies have been done numerous times in numerous labs, all with the same results. So I’m left in the position of either believing that all these studies from many different facilities are frauds and there is a giant conspiracy to suppress the use of HCG or believing that HCG is really no better than placebo.
    The placebo effect is much stronger and deeper than just the placebo. There is an adherer effect as well. Those who adhere to any difficult regimen are the type of people who end up getting major benefit even with placebo. People who hang in there for repeated administration of HCG fall into this category.

  50. Wanda, for my first couple of courses of HCG, I stuck with Simeons recommendations pretty strictly – 2 apples a day, water and black coffee (or with Stevia), and lunch and dinner of 100g chicken breast or bison steak with some vegetables. Perhaps not coincidentally, those were the rounds on which I lost the most weight per day, typically 1.5 lb/day. After that I got a lot less strict, and on recent rounds I’d guess I’m probably eating 1000-1200 calories a day; I’m still losing about a pound per day. I found that I was comfortable during “Phase 3” (i.e. Simeons’ 3 week transition period) with Simeons’ no starch, no sugar recommendation, and that led to more reading on paleo/low carb. I’ve tried it in the past and never really lost much weight eating low carb, but I find that I can maintain on it pretty well between rounds of HCG, and I experience all the other health benefits.
    It’s interesting that this topic’s come up here. After 164 lbs. (targeting 200-210 ultimately), I’m pretty convinced of HCG’s efficacy, for a lot of reasons that others here who’ve done it would understand (as an aside, I’ve also had virtually no stretching or loose skin, my Dr.’s been pretty shocked at that). Personally, I don’t handle hunger well. I’m trying to get into the idea of intermittent fasting as recommended by some in the low carb/paleo community, but the hunger gets to me – I like to eat fairly regularly. In that context, I just have a hard time accepting that I could go for 35 days on my first round at 500 calories per without going nuts from hunger, i.e. I believe there’s something besides the placebo effect going on. Anyway, this isn’t the place to argue the point.

  51. I’m gonna tell you the same thing I would tell someone who questioned low-carb eating because of various and sundry “studies” that “prove” that way of eating is bad for you: Show me the studies. Show me the criteria used. Show me the lab results. Otherwise it’s all B.S. as far as I’m concerned.
    Echinacea, for instance–if they tested it with capsules, that’s gonna have a different result than if they tested with liquid extracts or teas, and if they test whole herb vs. “active constituent” and 300mg vs. 1000 mg and so on. If you think herbs don’t work, don’t ever take an aspirin or suck on a eucalyptus/menthol cough drop or use digitalis. Whoa nelly. I cured an earache once with mullein drops because I couldn’t afford a doctor. Maybe it was the placebo effect but man, as much water as I get in my ears when I shower, obviously water doesn’t work for earaches.
    The glucosamine and chondroitin thing was what really got me. What do you think is in high concentrations in animal cartilage? Cartilage is living tissue. In fact, it continues growing throughout your life, which is why old people tend to have bigger ears and noses than when they were younger. What do you think it grows with, good wishes and fairy farts? Now, maybe the supplements of the stuff they make out of various weird substances might not do as much good as, say, eating gristle or drinking homemade bone broth (which by definition involves boiling down cartilage too, from the bone ends). That’s not difficult to imagine–there’s some evidence to indicate that nutrients from whole foods work better than isolated molecules in a pill, and by “whole foods” I do not mean “freeze-dried pond scum.” But to say the stuff doesn’t work *at all* just makes no sense.
    Anyway, I’m sorry, but be consistent. Suspect everything til it’s been proven over and over again in a variety of different studies. And for someone who distrusts the government so much, especially when Democrats are in charge of it–what–you’re going to trust it now when it “proves” your biases? Shame on you.
    I appreciate your weight-loss work, but man… I guess we all have our blind spots.
    Something tells me you either misread, misinterpreted or didn’t understand the post I wrote. Scroll up to Arlo’s comment and read my simple summary there.

  52. Here’s another one for ya, and a tad less grouchy to boot: If herbs don’t ever work, explain catnip and cats. It makes for amusing YouTube video, anyway.

  53. Dude. I got halfway through your post and thought, “Oh, my God, he’s slamming altmed. Wait. He treats people with diet. WTF?” Never mind. Take every instance where I said “you” and presume I’m aiming it at the folks you’re talking about who are gleeful that altmed has been “disproven.”
    I mean, the same mainstream media will occasionally print warnings to young women to not use pennyroyal to bring on a late period because it’s “dangerous.” Well, yes, the essential oil and tincture are dangerous to take internally, but the tea has killed no one as far as I know. But wait! I thought herbs didn’t work!
    They’re all full of crap, as far as I’m concerned. When most of the herbs you can get from health food shops are at least six months old and have been stored in less-than-optimal conditions, you’re not going to get the best possible response from them. When I can go into my local co-op which has gone out of its way to source organic herbs where possible and lo and behold they store them in CLEAR PLASTIC CONTAINERS, it seems pretty hopeless.
    It took me purchasing my own bay tree in the mid-90s and pruning it a couple of times to understand just how bad this problem is. It’s worse with culinary herbs. Hint: If you ever get a chance to try freshly dried bay leaves? Take it and run. Trust me. You’ll never want the grocery store crap again. Or most health food shops’ crap, for that matter.

  54. THE REAL CAUSE OF DIABETES, CANCER, HEART RELATED DEACEASE IN AMERICA IS NOT CIGARETTE SMOKING !! IT IS THE AMERICAN DIET HIGH ON STARCHY-CARBOHYDRATES (BREADS, POTATOES, RICE, WHITE-FLOUR FOODS, ETC.)
    What USA really needs is an anti-carbohydrate, diet revolution. What the FDA and the whole US medical system needs in order to help the americans is really a low-carbohydrate revolution. I know cigarette smoking is not good for health. But the american diet high on carbohydrates kills a lot more americans than cigarette smoking.

  55. Off topic for this post but I was so excited to read this article I just had to pass it on to you. http://news.yahoo.com/s/ap/20090621/ap_on_re_us/us_burpless_cows
    I was excited not because of the reduction in greenhouse gas point of the article but because of the “secondary” points (more important points IMO) that the cows are healthier, vet bills lower and that obviously the milk will be higher in Omega 3. Low-carb IS better for cows too! 🙂
    I also loved the point you made in this post about “Absence of evidence is not necessarily evidence of absence. ” and I very much enjoy following your twitters. As ever, thanks so much!

  56. Alternative medicine is a term used to differentiate it from conventional medicine. Its a wrong term because it implies that it is alternative to medicine, so its not medicine.
    I like the term complementary medicine.

  57. What this sounds like to me is the government priming the pump for a ban on all supplements or at least governmental control (and taxing) of these supplements (See folks, they don’t work, only our pharmaceutical statins do, come on down for your handful of statins!)
    If I want to load up on snake oil, ginko, Vitamin C, or twinkies, that’s my business. BUT, as we’ve seen, this current administration and congress has a penchant for controlling our lives. Since the gov’t will be taking over health care and the Rx co’s by proxy, all remedies must come from the officially sanctioned Rx company as prescribed by an officially sanctioned government doctor. Oh and make sure you take those statin pills as prescribed OR, you won’t qualify for government health coverage in the future and make sure you come in for your regular physical and blood work (so we know if you’ve been taking the statins), if not, you’ll be black listed for any further health care treatments. Government health care will probably provide a HAL computer for each of us in our homes to ask us in a creepy voice every day: “hello Bill, did you take your little purple pill yet today?” Government health care = BE VERY AFRAID.

  58. Obama’s New Deal for Healthcare – statins for every senior, a sweet deal for big pharma
    Drug companies would pay for some Medicare prescriptions under $80 billion deal.
    “The pharmaceutical industry agreed Saturday to spend $80 billion over the next decade improving drug benefits for seniors on Medicare and defraying the cost of President Barack Obama’s health care legislation. Baucus’ announcement said drug companies would pay half of the cost of brand-name drugs for seniors in the so-called doughnut hole”
    (i.e. brand-name drugs like Crestor, Liptor etc.)
    abcnews.go.com/m/screen?id=7887358&pid=4380645

  59. Dr Mike,
    What are your thoughts on algae-derived DHA as a supplement? Seems like it may be better than flaxseed oil for those who don’t tolerate fish oil. Have you written about it?
    Haven’t written about algae-derived DHA yet. But, DHA is DHA irrespective of where it comes from. There are differences, however, in overall effectiveness of the total package. Fish oil and krill oil contain other substances besides DHA making them more potent than just DHA by itself.

  60. Rob~
    Your relief may have come from just a couple of the many ingredients in that “proprietary blend” and not from the glucosamine/chondroitin at all (I’m thinking turmeric/flaxseed oil).

  61. Very interesting post. I’m one who is struggling to lose weight on low carb (and I have a LOT of weight I need to lose, well over 100 pounds). If the placebo effect were all it took I’d be skinny by now because I utterly *believe* in low carb as the best eating plan. And yet the weight is not coming off. In fact I have *gained* 10 pounds in the month of June while sticking to strict 20-50g carbs daily and no grains, no sugars. I’ve tried all sorts of things designed to speed up weight loss including Pentabosol, and none did me the least bit of good. Yet I was utterly convinced they would be the “magic bullet” so clearly the placebo effect did not much help me. 🙂
    LOL, just from the anecdotal stories here I’m ready to try HCG myself. Except googling for it I can only find it for hundreds of dollars, and I’m not *that* committed to something that may be worthless. I sure can’t find this $21/month version a few have talked about. At that price it’s worth giving a try as even if it proves to be as worthless as everything else I’ve tried I won’t be out a fortune.
    I’ll continue to eat low carb as I feel the best on it ,and I feel it’s most optimal for good health. But I’m willing to try any reasonable product to help lose weight – reasonable meaning a reasonable price, and not detrimental to health in other ways.

  62. Dr. Eades,
    Any plans to blog about the Food, Inc. book or movie? I’d love to hear your take on it. I apologize if I’ve missed it in a prior post.
    Paul
    Haven’t seen it yet, but will when I get the chance.

  63. It is simply just not true that the natural (or alternative) therapies don’t work. I have cured myself of diabetes, hypertension (I had 240/140 !!!), back pain, depression etc. and went through menopause without even noticing. I had no shots whatsoever, and went to no practitioner. I did it myself.
    I continue taking the herbs, vitamins, enzymes etc. and I look and feel great. I have cancelled my health insurance. People think I’m at least 15 years younger. How’s that for a placebo effect?
    Furthermore, I have cured my three dogs of hip dysplasia, allergies, pannus (an autoimmune eye disease), epilepsy and GI problems with completely natural therapies. I don’t think the placebo effect works for dogs. Do you?
    Natural remedies work on the genes, mainstream drugs work on the symptoms. Big difference.

  64. Well, of course, I must not foget to mention that all along, I have also been eating low carb. It’s the basis for everything. No natural therapy will be successful (or quite as successful) if the besic nutrition is not right.

  65. I’m amazed at the inability of people to argue a principle without attacking the personality.
    I”m also amazed at the negative view people have of placebos. Instead of thinking, “No, this isn’t a placebo. This [herb, hormone, alternative therapy, drug] actually works,” try thinking, “Wow, you mean the mind can do the same things all those therapies are purported to do?”
    Regardless, most “therapies” aim at suppressing symptoms, and as such are useless for anything other than short-term pain relief.
    A poster above mentioned aspirin. I used to take aspirin, tylenol, fiorinal, all sorts of pain relievers for chronic headaches. Then after reading that they only contribute to the continuation of headaches, I stopped taking them altogether. I lived with headaches for a while, but they became spaced further and further apart. Now I hardly ever get them, usually when I violate rules of health, like consuming a bunch of sugar at night or getting really stressed. I haven’t taken a drug in over five years.

  66. As I previously pointed out – regardless on which “reputable journal” posted studies – kind of sullies the reputation of said publication to post studies that slap Dr Simeons name on them – but totally fail to follow his protocol.
    As you pointed out – “significantly more people on placebo dropped out” which skewed the Asher Harper study… BUT – if the placebo group THOUGHT they were receiving real hCG – shouldn’t the drop out rate have been similar between groups if it’s just placebo effect ?
    I mentioned in my first post it’s rare to find someone NOT on hCG to be able to stick with a 500 cal diet. I couldn’t make it 1 hour when I had my bout with immunity, and would assume anyone on placebo would feel like that for a month.
    But as to my specific tests for a study in the 21st century – body comps would be the breakthrough as far as analyzing effectiveness of the protocol – IF someone could make it 30 days on 500 cals without hCG they might lose 30 lbs as well as the hCG paitent, but they’d be losing significantly more weight from the loss of lean muscle mass, whereas the majority of the weight from those receiving hCG would be body fat. That’s the theory at least – and to date I know of no study that bothered to determine where the weight loss came from.
    As far as the Asher Harper study – they mention in the very first paragraph that the majority of negative studies significantly altered the original protocol. And they DO mention they did not expect to see significant differences in loss, just that the patient on hCG felt better.
    If it was a true double blind study – and the literature makes it clear it was – should make no difference if Dr Harper ran an hCG clinic – as he’d have no idea during the study which patients were receiving the placebo vs. the real thing.
    Would I question the results of a study you did on a high protein low carb diet ? Guess it depends on how much integrity you think someone has. As far as physicians go I hold you in pretty high regards, which is one of the only reasons I bothered to post in the first place, that and because I suggest your book to many to follow after the protocol.
    4-4-3-2 … yeah, that must be healthy ’cause the govt says it is. And cigarettes AREN’T addictive… and STATINS are a GOOD thing. Of all the physicians out there – wouldn’t think you’d be one to just accept studies not knowing who might have influenced them. Guess I’ll make an open invitation on YouTube for anyone to do a real double blind. But would be really good for you to try the protocol with a few patients and THEN post your personal observations.
    Thanks again.
    Tim
    You wrote:

    As you pointed out – “significantly more people on placebo dropped out” which skewed the Asher Harper study… BUT – if the placebo group THOUGHT they were receiving real hCG – shouldn’t the drop out rate have been similar between groups if it’s just placebo effect ?

    I think you missed the point. Let’s say I have a study in which there are 20 people starting in each group with one group on HCG and the other on placebo and both groups consuming 500 kcal per day. Let’s assume for argument’s sake that neither the HCG nor the placebo have any effect on weight loss and that all the weight lost by the subjects over the course of the study comes about because of the caloric restriction. Now let’s assume that six people drop out of one side of the study and two people drop out of the other, and lets say that each person staying in the study until the end loses 10 pounds. So in one arm of the study, the one where only two people dropped, the total weight loss of the group is 180 pounds (18 people finishing the study losing 10 pounds each). In the other group the total weight loss is 140 pounds (the 14 people remaining in the study times 10 pounds each). If you calculate the average weight loss of all the people completing the study, you come up with 10 pounds each. But if you instead do like the guys did in this study and calculate based on the number of people starting the study, then the one arm (the HCG arm) shows an average weight loss of 180 lbs/20 or 9 pounds per person. The other arm (the placebo arm) shows an average weight loss of 140 lbs/20 or 7 pounds per person, which makes it look like the HCG is causing greater weight loss while it really isn’t.

  67. You mentioned HH’s placebo group lost more than studies by 4 other practices – the point was the importance of sticking to the strict dietary guidelines… which the 4 others (as well as the many negative published studies) didn’t do. The Franks Study was a farce since he failed to follow the food restrictions. ( would equate to me doing a efficacy study on Protein Power – adding 5 baked potatoes & rice cakes to daily intake – then writing a paper as to why Dr Eades Protein Power did not contribute to weight loss ) The VLCD is paramount to effectiveness.
    Each point I made from real experience you’ve dismissed without addressing…
    immunity, hunger while on NaCl, rapid onset of a ketogenic state, that
    if placebo effect alone there should not have been a drop out rate
    more than twice as high in the placebo group.
    Some people suggest that any drop outs in a double blind study would negate all results. It’s true that the Asher Harper Study should have adjusted results based soley on those who completed the study. I don’t believe the study provides complete info on which subjects dropped out, so unable to adjust their conclusions with study data. But the final numbers are all there.
    Just to appease your negative view – I crunched some numbers – and recalculated the average loss for the hCG group – removing patients 1, 9, 14, 38 – 1 & 9 about midland at 14.5 lbs lost, 14 & 38 having the largest losses (41.5 lbs & 31.75 lbs respectively)
    The hCG group lost 3.5% more weight over the placebo group even using negative bias. (just so you know – removing all 4 of the biggest losers from those receiving hCG – and the hCG group still lost over 2.5% more than the placebo group.)
    To analyze more fairly – assuming those with the smallest % loss in each group were the drop outs – removing 5, 7, 9 & 38 from the hCG group and averaging by the number that actually completed the study – the average loss was 22.519 lbs… removing subjects 25, 33, 6, 26, 20, 10 & 39 from the placebo group and averaging by the number that actually completed the study – the average loss was 15.71 lbs. This more even handedly adjusted recalc shows the hCG subjects on average lost 42 % more weight.
    hCG is causing greater weight loss – 10-14% of total body weight gone in 30 days with no exercise, it’s not the psychological impact.
    * * * * *
    While I have the calculator out – if you need a 3500 calorie deficit to lose 1 lb – based on a BMR of 2250 my first round – at the end of 32 days by deficit the most I could have lost is 16 lbs… but I lost 30 lbs. According to some that defies any logic – and many would call me a liar if not for my periodic posts on YouTube and the scores that have followed since.
    “placebo effect” – the first 2 days of the protocol are “load days” when it’s suggested to eat foods high in carbs and bad fats while dosing with hCG – generally I’d estimate people eat about 4,000 cals on the load days – and based on 3500 cals per lb – no one should gain more than 3 lbs. Yet – is pretty common for people to gain 8-10 lbs in 2 days of loading. 8 lbs (using 3500 cal per pound) would be an astronomical 28,000 calories in 2 days – most people dread the load days as they know they’ll gain weight – does that sound like placebo effect to you ?
    You seemed to imply a certain doubt to Dr Harper’s integrity regardling the study since he ran an hCG clinic. To the best of my knowledge Dr Asher – a member of the American Society of Bariatric Physicians Research Council – would have no alterior motive for slanting a study one way or another.
    I’d be embarrassed to say how many hours I’ve spent going over studies & personally collected data from those I’m in contact with prior to posting to your blog. Now if you consider that I sell kits for the protocol because of the bad wrap the medical community has given it – and as an alternative to going to a high priced clinic – why in the world would I want a credible physician to come forward with positive results with the hope of getting primary care physicians onboard ? ( assuming it’d become widely used at reasonable price and there would be no need for high priced clinics, expensive medications or DIY – and there goes my little income stream )
    It’d be to my financial detriment for a respected physician such as yourself to hit the broadcast circuit touting the protocol’s effectiveness and calling into question the legitamacy of the FDA’s position as well as the negative studies. (though if you want to thank me in the foreward of your book on the effectiveness of the protocol for my tenacity I guess I won’t complain) Why am I doing it then ? The greater good. I’d like to think I was a small part of the solution.
    You can either stick with your opinion based on poorly run studies, or try the protocol with a handful of obese patients and see the truth. There are enough inconsistencies with the negative studies that I hoped you’d dig deeper, be willing to challenge conventional thought – I could be barking up the wrong tree. Until someone actually does a more thorough investigation (as previously mentioned who would fund one with billions on the line for far less effective pharma) no one will know for sure why it works as well as it does. Insulin, leptin, IGF-1…
    You said it yourself – “Changing closed minds is a tough – and usually thankless – proposition.” You refer to the negative reports as “well-conducted scientific studies” – not acknowledging the Franks study from the meta was not even in the same ballpark as the Simeons protocol with the exception of injecting hCG. But you DO want to challenge the Asher Harper study (which is warranted but I think fairly adjusted above)
    Discount all the studies, discount my data and observations – start with a clean slate and the truth will out.
    “…I had spared no pains nor expense to accomplish the great end of stopping and curing obesity.” – William Banting – Letter on Corpulence – 1864
    No, I fear the truth wouldn’t will out. At least not in your mind. If I were to conduct the most meticulous randomized, double-blind, placebo-controlled study in the history of medicine, and it showed HCG to be no better than placebo, I’m fairly certain that you would believe the study somehow flawed because it didn’t confirm your bias.
    Based on your experiences – which are all anecdotal simply because they haven’t been controlled with a placebo group – you are a firm believer in the notion that HCG brings about more weight loss, less hunger, etc. than following the same dietary regimen without HCG. It’s obvious that this us firmly hammered into your mind. Therefore any study that shows the opposite, you are going to believe is somehow tainted. So what’s the point?
    I’ll make you a deal. You arrange funding for such a study, and I’ll get it done. It will have to be funded by you or some outside source because funding will never come from any of the normal sources of scientific-inquiry funding because there are at least 20 studies out there showing HCG to be no better than placebo, and any of these funding agencies won’t be willing to throw good money after bad. If you do come up with the funds for the study, I’ll make you a guarantee. If the study shows HCG to be no better than placebo, you won’t believe the results. That’s my guarantee.

  68. As someone who has lost 26lbs (and counting) on the HCG protocol, I’d like to point out one thing in regards to the placebo effect.
    Three days ago (day 40 of VLCD) I was given by my doctor an increased HCG dosage – from 150mg to 170mg. I was hopefully anticipating even greater losses over the next week of increased dosage.
    To my surprise, the day that I took the increased dose I became ravenously hungry – starving, in fact. Why? Because too much HCG can have the same symptoms as too little HCG: great hunger. Not only that, but that day was the first day that my ketone levels dropped considerably, whereas before they unfailingly showed high levels. I hadn’t changed my diet, or done anything else differently. The next day I immediately lowered my dosage back to 150mg, have had continued losses, and my hunger almost immediately went away again. Placebo effect? I don’t think so.

  69. Here’s a question that’s been bugging me recently: are those of us who read the studies and know the truth about placebos too smart for our own good? Are there ever any cases when time or money could be saved by using something that works purely by the power of belief?
    I’m sure there are cases. But you’ve got to get the patient to believe, and you can’t do it unless he/she thinks some kind of treatment is being administered.

  70. Who cares, I bet there are more people on the HCG DIET and losing weight, then there are people by your book and losing the same amount of weight.

  71. S.P., if you don’t follow the scientific method, then you are being intellectually dishonest. Sometimes that means that you will need to change your mind, even if that’s hard.
    Many can’t do it. There is truth in that quote about science progressing by the death of scientists.

  72. Who is to say that any method except the scientific method is the end all and be all? Oh yes, ‘scientists’.
    I’m quite capable of changing my mind if I’m proven otherwise, but in this case, NOT!
    Bottom line is that HCG works for lots of people.
    People who doubt it’s ability to ‘work’ will hopefully not be a person who needs to lose weight. It’s a very effective program and becoming quite popular simply through word of mouth because people who are on it and losing are perfect walking advertisements in it’s effectiveness.
    I think that would beat any scientific data any day and either way, believer or non believer or whatever else, the bottom line is that people are losing weight and getting healthy and we can leave it to the ‘scientist’ to figure out ‘why’ or ‘how’ or whatever.
    So anyone who has had a hard time losing weight and want a fast and effective diet, just Google HCG and conduct your own experiment on yourself, that might not fit all the criteria’s dictated by EADES, but I think quite sufficient if it changes your life and gets those pounds off!
    I don’t gain anything from monetarily nor is someone’s belief or non belief in the effectiveness of HCG in conflict with my need to sell a book or product. Just give it a chance to work for you!

  73. Here’s my theory:
    when men take HCG, their bodies say “what?! WHAT!? A baby? WHAT!!! WHERE’S MY UTERUS? I can’t find it! Where is it where is it where is it…” and they’re so distracted looking for their missing uterus they forget about their hunger.
    Simple as that. 🙂
    Hmmm. A theory I had never considered.

  74. This blog has been dead for awhile, but I wanted to add my 2 cents…
    I battled my weight for over 12 years and was doing everything “right” to shed the extra pounds. I exercised my a** off and tried calorie restriction. Nothing worked, except that I got in great shape under a big layer of fat.
    Last fall (2009) I was introduced to the HCG protocol and after reading it, I knew for sure that this would work for me. I started at 164 pounds and approx 35% body fat. I lost 21 pounds of fat in 35 days. I did a second round of the protocol 6 weeks later and lost another 10 pounds. I went to my local university’s “Human Performance Lab” to be hydrostatically weighed and I came in at 20.4% body fat. My body fat tests confirmed that I lost all fat on the protocol and no lean body mass. I ended at 133 pounds and a size 2-4.
    I also had metabolic testing done before and after, using the FDA approved Korr REE. My pre-protocol REE was 1700 cal/day. Post 2nd protocol it had increased to 2025 cal/day. I would be really interested in having a doctor explain to me how my REE could increase after shedding 33 pounds of fat. To me, the only explanation is that losing fat has allowed my kidneys and liver to function more optimally. It is my understanding that kidney and liver function account for about 40% of the body’s metabolic needs.
    It has been a year since starting the protocol and I have maintained my weight within 5-7 pounds. I am a self-admitted “carb addict” and I am yet to truly overcome the addiction. It is a daily battle to accept reality that I need to abide by a low-carb diet to maintain my loss.
    I also found Gary Taubes book after losing weight and it has made a huge difference to how I view food. To me, his book really helped to explain why I had success on the HCG (the protocol diet is approx 72g of carbs in the form of veggie, fruit and melba toast plus 200g of lean meat, which is about 48g of protein). It seems to me, from my understanding of Taubes research, that when a person is meeting their basic protein needs, they ARE NOT starving, despite being on a very low calorie diet. The body is free then to look for the extra calories it needs from the fat storage. I have never succeeded at losing weight on any other diet (trust me, I tried them all) because I would get hungry. The mere fact that i could go 35 days on 500 calories without hunger is amazing.
    I actually am conflicted about the role of HCG in weight loss. I think that it is very possible that it is a placebo. But, even if it is, it worked and the weight loss came from fat (also, the fact that I was sticking a needle in my leg every day helped me stick to the plan and take it more seriously). I actually have a friend whose father followed the protocol diet, without the HCG and lost over 20 pounds in a month. He is a physician and is convinced that the HCG is a placebo. Either way, it proves that a very low calorie diet with adequate protein can result in rapid fat loss without hunger.
    This is a great website that I just found yesterday. I have ordered Protein Power and I am looking forward to reading it. I have read multiple books over the last year in an attempt to better understand human nutrition and the low carb, whole foods approach just makes the most sense to me.

  75. I’m trying the HCG. My sister recently lost 52 lbs while on the HCG. She had tried all kinds of other low calorie diets but was very hungry and dizzy and could not stick with them for these reasons. She told me that while following the HCG regimen she does not have any dizziness or hunger and has therefore been able to continue with the diet. I do not doubt her so I am trying it and will follow it exactly. If I can sustain without feeling sick/hungry/light headed then that’s all I need.

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