Antibiotics
Whether antibiotic resistance is partially a result of not enough research dollars going into developing new antibiotics
Biology
Lowering you biological age
Cancer
Many cancer clinics publish results but critics often claim that many if not all of there supposed success have not been documented to have had cancer This is valid point, but one needs to be wary that his becomes a generalization that will dismissed without even checking whether they can be verified
Some seem to imply some substances, including George Altgelt, state that selenium, and iodine can help prevent apoptosis of cancer, but after apoptosis occurs they cannot effect the cancer for spreading
Holistic treatments can augment efficacy and relieve conventional treatment symptoms
Censored, grossly inaccurate or attacked sites
https://www.thenhf.com/
The idea that certain cancer remedies used to work in the past, but are not as effective now due to increased toxic load as time has gone by
Quality of life not always considered in cancer drug studies
Trade-off between short term remission from radiation and chemo but not in long term?
Causation and correlation In a sense there are two different ways to look at this. One is in the abstract where causation is of course causative and correlation is a relationship without causation being associated with said relationship in a demonstrable mechanistic manner However when a high statistical correlation is made, two factors remain, identifying a mechanistic relationship or a plausible explanation of a second correlation For instance, vegans may have statistically linked with better health outcomes which suggests a correlation with vegan diets and better general health, but vegans may also have other lifestyle factors that improve health outcomes
Conventional Health Care System Memes
The waiting list phenomenon Near terminal conditions and their scheduling
Chronic Disease
Young people and chronic disease http://www.fightchronicdisease.org/sites/default/files/docs/GrowingCrisisofChronicDiseaseintheUSfactsheet_81009.pdf
Community Health issues memes- We have suggested a bit of a division between the category of the issues involved with the conventional public policy approach to community health issues as separate from the more fundamental issue of physiology and health. There is indeed significant overlap since both try to teach about healthy diet and lifestyle choices, etc Yet public policy programs rarely explore the fundamental questions or assumptions of the conventional health wisdom in open ended manner with the public at large. Public policy is generally by institutional mechanisms which dictate policy in a sense, and in a way relieve the average citizen of any commitment to independent research of their own
Debunkers
Seemingly dominated by a select few individuals
This small contingent is often referenced by Wikipedia
Often debunkers will highlight violations with medical authorities which may or may not be serious. or biased, in nature
http://www.truthwiki.org/orac-david-h-gorski/
American Council on Science and Health
Committee For Skeptical Inquiry
Demographics
Are younger people suffering from chronic disease earlier? Acid reflux?
How confident that data is being collected for these questions?
Even for successful therapies they will not be effective for certain subsets
If therapies are working why do illness rates continue to climb
Diagnosis
Diagnosis by conventional doctors is often done by exclusion of other possibilities
Diet
Diet comparisons are difficult on a clinical trial basis
Population studies are also influenced by confounding factors
Questionnaires can be prone to inaccurate memory or other reporting errors
Very low carbohydrate diet dangers Paul Jaminet http://perfecthealthdiet.com/category/disease/hypothyroidism/
CICO Calories in calories out versus Hormone theory http://sciencedrivennutrition.com/the-ketogenic-diet/
Idea that we should get all nutrients from food and not supplements Sub arguments Well utilized supplementation can overcome diet shortfalls Eating a healthy diet still may need extra supplementation
Earlier we mentioned that even defining health can be problematic since feeling well can often be completely subjective. Yet complicating the issue even further is trying to compare diets in a meaningful way. There is no magic way to compare a vegan and paleo diet. Vegans can eat diets very high in sugars if they so choose and paleo folks can eat diets composed of high or low protein and varying amounts of fat. We should not conclude that all these complexities make comparisons impossible. Instead we should combine comparative studies and inferential understandings such as vegetables being high in phyto-nutrients as rough estimates that will need further elaboration
Different effects of different types of sugars
Has mineral deficiencies in soils effected quality of minerals in produce
Diet Related Memes
Legal standards, as they apply to health claims of food, are directed by legal frameworks that limit the manner in which food producers can make health claims including studies showing the positive effects of said foods are prohibited under Deshea
Diet
Disease as entity as opposed to confluence of factors, or as a continuum of factors with different presentations and causes in differing individuals
Doctor (conventional)Economics of eating organic foods means they will be less able to afford fruits and vegetables in general
DIY Diagnostics Individuals may have a variety of options for something like home testing which include things like elimination dieting, checking body temperature in response to certain activities, saliva testing, muscle testing, stomach challenges and other, sometimes controversial, DIY diagnoses
Digital
Health practitioners and interface with electronic information.
Doctor (conventional)
Doctors limited by defensive medicine
Lessening numbers of independent doctor practices Instead forced into large group practices
Many patients claim, that when they have success using alternative methods their conventional doctors express overt skepticism and list of excuses why whatever beneficial effects were for reasons other than the alternative
Two points arise
1 Trying to get a measure of how often this happens and some recording system of what is being said
2- How sound scientifically speaking is such a position justified?
Drugs
Argument that single components are targeting metabolic set points as counter argument that such strategies are reductionist
Do drugs generally interrupt bodily pathways, and therefore generally cause a side effect since the body must compensate for such interruptions.
Is the term side effect a euphemism since it is simply an effect
Off label use of drugs https://www.consumerreports.org/cro/2012/05/off-label-drug-prescribing-what-does-it-mean-for-you/index.htm
Lists of high profile drugs with significant side effects and risks
Epidemiology
Directly related to the issues of epidemiology is how and what statistics are being collected, and on what scale. For instance part of our interest is whether we need a greater ability to gather health information at the local level. An important disclaimer is that greater collection of health data at the local level does not necessarily equate to breech of private health information. . We might need to revisit those concerns as we move forward, but lets at least consider the potential of gathering local health information. For instance how much do we even know about individual eating habits? How many folks are eating fast food, etc? Trying to come up with meaningful statistics could come from both local questionnaires of some sort, or from gathering data from local restaurants and grocers. We must admit that we are a little unclear if any of this data is kept by anyone and whether it is accessible to the public. Our [point really however is whether such data could have meaning and whether we want o look further into how it could be collected
Evidence/Data Collection
It is likely that it is many days down the road before communities are able to collect a significant amount of data at the local level, but it is likely that the potential is there, Privacy concerns will likely to continue to play a role even when gathering data at the local level. Some types of information could be gathered especially in terms of what data people are open to sharing which could include dietary and lifestyle habits, and to the degree possible answering additional questionnaires on drug usage, disease,and maybe even genetic markers. It may be possible to track the data in a way that it remain in a veritable way but mask the identity of specific individuals when necessary The reasons for believing local data collection had advantages over other systems is that it could be both uniquely verifiable and it can offer insights into health factors at the local level How many are eating fast food, exercising, etc, and then using those statistics to perhaps tailor programs and policies to improve outcomes where possible
Experts
Generally experts are basing their claims on some given solid empirical science such as a study of some sort, yet always referring to the background studies is tedious as well as possibly taking away from, a certain kind of mystique of expertise
Expert organizations do not always reach conclusions that are considered 'representative of the organization as a whole' through a democratic process
Experts may actually take an anecdotal fact for a hard fact. For instance if they hear of something presented as fact, or close to it, from a trusted expert, they may pass it along as a hard fact. If this type of transmission were to become substantial it may become considered to be fact by its mere ubiquitous nature among experts
Expert knowledge cannot only be judged by background, but also by objective metrics of performance and understandings
Is the subject in question one that the expert has previously shown expertise in
Even then the expert would have to be able to explain and demonstrate a claim or theory
Information travels from expert to expert without each expert verifying what is being said by quoting source material This is understandable but it may allow for some situations where inaccuracies are multiplied
Observational Studies
Five G
Infrared heating as standard for conventional risk
Calcium channel increase of calcium
Disproportional effects onsegregated polaritties
FFQ.s Food Frequency t Questionnaires very unreliable?
Evidence
Even double blinded controlled studies suffer from an overly isolating effect. That purposely try to remove variables
Generalized statistics will not represent the results for certain subsets of individuals
When it is claimed there is no evidence for efficacy of a treatment, does that mean there is any evidence one way or another
Science based medicine
The actual modes of collecting evidence
What is media portrayal of controversies
Disproportionate response to small health risks (Almond scare)
Positive studies are often disregarded by always claiming more evidence is necessary
Animal studies may not serve as perfect translations for human health
Can short term studies make long term predictions
Clinical trial populations can be non random
Clinical studies rely on single substance being introduced to a static system to remove confounding factors
Closely related to the issue of how science connects with subjective experience Many forms of conventional health science asks questionnaires etc on assessing subjective symptoms, how you feel in essence
The usage of the term anecdotal may lead an individual to be overly suspicious of their own experiences, or perhaps further suggests that even a group of individuals cannot apply scientific principles outside of established institutional formats
Profit motives interfering with fact based science
Expert
Situations where a fundamental finding is accepted for even decades without being challenged Ansel Keys work perhaps being a good example
It is possible that some experts have little incentive to openly share the sources of their expertise since it would risk them losing their mystique of expertise
Food
Science of treating cravings and food addictions
Organic food makes people eat less fruits and vegetables overall because of cost
What is the most important shopping priorities? good meats, fats, vegetables, organic non GMO
Thus it may be the case that we at least consider that the individual try various diets and see what works for them. One again however the mufti factorial natural of existence gets in the way since an individual may have a changing environment, both physically and socially, during any given period which will serve as co-factors in the overall health picture. Diagnostic tests from laboratories could be utilized by individuals looking to make their own journey towards greater health through lifestyle and diet changes. Of course once again which tests and what they mean may be fairly complex, yet some tests such as blood sugar levels may have less controversy than others.
What is the most important food shopping priority, good meats, fats, vegetables, organic, non GMO
Fruit juice contains heavy metals
https://www.consumerreports.org/food-safety/arsenic-and-lead-are-in-your-fruit-juice-what-you-need-to-know/
This implies much of the tainted fruit comes from sources outside the US and implies more local and regional production would improve the situation
Food Substances
High fructose corn syrup
Bovine growth hormone
Trans Fats and Cholesterol
Holistic memes
Gathering conventional treatment statistics
How are official sources gathering their fundamental facts
Promoting health is a way to change their tune or vibration attitude etc. In other words to take in certain message even what we eat think and do could make us the right kind of receptacle for certain messages
When you try to formally present the balance point between two competing notions it seems more like a marketing effort than objective neutrality or well positioned for your readers
General
Holistic Approach takes time
Top narratives
What is preventive health and what is treating symptoms and not the cause of disease
Who sets professional standards
Is centralized control of setting standards problematic
Profit motives interfering with fact based science
Genetic Testing
Example of breast cancer gene where women chose to have breast removed prior to onset of disease
General memes
Claiming there is no evidence for a health claim is not the same as saying there is evidence that it is not effective
The standard paradigm. Thomas Kuhn
Holistic memes
Natural substances may effect the body in a holistic and non side effect creating manner as compared to pharmaceuticals
Media
What is media portrayal of controversies
Paradox
Simpson Paradox
Bulletproof 484
Dave: Let's talk about genetics for a little while. There's an interesting study of people who worked in a mercury mine. What they found is most of them had no problem at all, and so they're like, "Well, there you go. Mercury is not poisonous." But then they looked at the number of people who started and quit after a month, and that changed the data very substantially because it turns out the people who were genetically able to handle it could work in the mine and do well
Public
Disproportionate response to small health risks (Almond scare)
Reductionism versus holism
Disease as placeholders perhaps based on symptoms symptoms can mic different diseases. Misdiagnosis explains much of this but the lumping effect of disease has limitations and drawbacks
Disease seen as an entity in psychological perspective
Terrain or pathogen
Standard Treatment
Who sets professional standards
Is centralized control of setting standards problematic
Symptomatic treatment
Identifiable subsets such as those with genetic markers or a history of environmental exposure can represent a sub set population which will correlate to both specific disease risk and treatment efficacy ratios
Green Pharmaceuticals- Those natural supplements and herbs which are just targeted for symptom relief
Single constituents/whole compound
Supplements
The idea that vitamins are made fundamentally from pharmaceutical products and tainted products
Targeted single component supplements could be considered reductionist
Theory of homeostasis
Metaphor for homeostasis is a balance point for two ends pulling on a rope to make it just the right amount of tension
Theme of special relationships Gut mind connection
Hygiene hypothesis Include information on dishwasher study
Does arrival of the information provided by the Internet change the game
Regulators tend to want to sterilize substances to kill every bacteria or pathogen Also embedded in this narrative is a small number of outbreak deaths versus a perhaps large in terms of numbers versus a small negative health consequence This would be based on the idea that sterilized foods and whatever residues from the sterilization processes produce a less overall health food than untreated
High levels of good substances can be sign of a problem high HDl as an example
What is preventive health and what is treating symptoms and not the cause of disease
Herxing and detox reactions controversy
Joints If osteoarthritis is inflammatory why is the lack of cartilage its defining feature
Science is often based on several determining factors; genetic predisposition, condition of the body at a given time, nutritional and lifestyle factors, and the environment
Science might suggest that these factors exist in fixed ratios, or cumulative totals. At some point we have perhaps heard something like health is 50 percent genetic and 50 percent environmental
Science- Various forms of science apply including clinical trials, population studies, and controlling for individual variation
Others, who may still suggest they are following sound science, might instead suggest that health is a multi factorial dynamic relationship that defies certain forms of classic reductionist science that applies so well to the hard sciences. One example might be that true good health can only come from a series of lifestyle, dietary, and psychological changes which as a whole allow for a positive change by trying to measure them in an independent manner may be useless since they are contingent upon one another for measurable positive effects
Claims that new treatments are improving disease, yet rates continue to rise This might be explained by the possibility that environmental and lifestyle factors are continuing to worsen
Health Claims
Current law states that produce growers, such as the cherry producer's who actually went to trial on these issues, cannot quote any studies on the foods they produce. The idea roughly stated is that if a food producer makes a health claim regarding a food is equivalent to saying that food is a drug according the FDA. Therefore any food producer who wants to quote clinical studies regarding the food they produce must first go through the FDA drug application process to make their food become a drug. In other words a food must be seen first as a drug before health claims can be made about it
History
Max Gerson
Dangerous drugs and procedures
Health Practice
Defensive medicine Too many tests and procedures
Holistic
May also treat the symptom in some cases
Holistic versus conventional memes
Those claiming to strike a balance between these seemingly opposite approaches may be using such a claim more as a marketing ploy than a true attempt at objectivity
Argument that single components are targeting metabolic set points as counter argument that such strategies are not reductionist
Natural substances may effect the body in a holistic and non side effect creating manner as compared to pharmaceuticals
Theory of Homeostasis
Hygiene Hypothesis
Symptomatic treatment
Single Constituent/Whole Compound
Mind/body duality/ subjectivity
Individual memes/Mindsets
Individual health initiated
Responding to marketing
Responding to Convention/Social pressure
Industrial populations are healthier and happier than the developing world can be countered by the fact of the prevalence of chronic disease in the developed world
Subjective measures Describing how a patient feels by questionnaires for pain etc Trying to qualify this is difficult but necessary
There is a question of the range of knowledge appropriate patients versus researchers and scientists To put it another way what is the best approach for patients in terms of facts and strategies that apply to them
Outside of clinical and laboratory tests individuals themselves have opportunities to test themselves at home in many ways. There is some evidence to suggest that close evaluation of your temperature at various times throughout the day can give important clues towards your health status . Another suggestion is that while on an elimination diet, individuals can introduce new foods and then check their pulse a few minutes after ingestion to see if the food has caused an increase which may be indicative of a food allergy or sensitivity
Health Journal Taking your temperature, saliva and blood PH, elimination diets, checking blood pressure after ingesting particular foods
Insurance
Insurance companies often use outdated memes such as high cholesterol
Legislation and law
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html MACRA
Act (MACRA), replete with the Merit-Based Incentive Payment System (MIPS). MIPS is a rubric the federal government uses to grade physicians and assign each a score of 0 to 100. The Composite Performance Score (CPS) is used to financially incentivize or penalize physicians, and then the scores are posted on a public website for all to see.
Practitioner
If a condition is rare enough a geographical distribute then we might expect to have a particular practitioner who will have seen individuals with the rate condition
https://www.ssa.gov/OP_Home/ssact/title18/1802.htm
Lifestyle changes
Are not always about willpower, but can be hindered by emotioanl issues as well
Mindsets
We can observe that large percentages of people seem to reach conclusions through preconceived ideas rather than classic objective examination. An example might be those who do not believe the environment is in danger from man-made effects have much higher rates of concluding solar energy is not viable without examining objective facts rationally. Examples of such biases of course run both ways
Has profit motive actually skewered the effectiveness of natural inexpensive treatments such as castor oil for the skin or other examples where people tend to believe that those products cannot be as effective as consumer products otherwise we would see then in the marketplace
Organizations
Which organizations have responsive and non automated response systems Message link of Facebook
Physiology Memes
Different reactions to different types of sugar
PH
The P.H debate and various measuring techniques
Privacy
Genetic typing
Health practitioners and interface with electronic information.
Rhetorical memes
The statement that there is no existing evidence of a certain claim is often understood that the claim in question has been shown to be ineffective
Sexual
Precocious puberty caused by soy/ Kayla Danels
Share narratives
For famous practitioners with extensive therapeutic information, especially those with on line courses, should those students/patients pay to take such courses compare notes publicly?
Science
Molecular biologists and other medical specialties may require extensive background but the proof of efficacy does not require the lay person to have such a background to comprehend the demonstrable proof of efficacy for health considerations of substances and behaviors
Science sometimes is expressed in fixed ratios such as health is 50 percent lifestyle and 50 percent genetic. Such generalizations seem highly problematic
Standards
Who sets professional standards
Is centralized control of setting standards problematic
Profit motives interfering with fact based science
Legal standards, as they apply to health claims of food, come both in the form of legal frameworks that either limit the manner in which food producers can make health claims, and in the way institutions such as the FDA and AMA can control the conversation under the pretense of expertise. Whether such experts and their placement within public discourse is well advised is not our point. the point is looking at the structure
Standard of care
Who sets professional standards?
Who sets dietary standards such as My Plate
Doctors do not research issues since that is contrary to the licensing boards standard of care
Jerry Tennant Timpone 6/07/18 Talks about Texas medical boards move to make any symptom be only addressed by licensed MD's Ophthalmologist's ,and massage therapists would be out of luck
Statistical and Methodological debates
Iatrogenic, conventional medicine induced, deaths
Alternative cancer treatments that are considered unverifiable since it is claimed that thoser patients cannot be proven as having had cancer
Sugar
Different effects of different types of sugars
Supplement memes
Deshea Act
A few bad actors, especially either low quality body building products and very cheap generic brands, may be responsible for most of the problems invoked with purity and/or unwanted impurities beyond what is listed or required by law
The technique used by NY Attorney General Schneidermen included DNA bar coding which is a technique that identifies the animal or plant species said to be contained in the supplement. But there is reason to believe some supplements might not, or should not, contain the DNA of the original plant DNA but rather the intended final product is constituent derived from a deliberate process to refine the original product. an example would fish oil, the finished product EPA and DHA does not contain fish DNA,
False meme that FDA has no power to regulate supplements.
Supplement manufacturers and those who directly profit from them cannot make health claims
The idea that only deficiency of vitamins and minerals, and perhaps other nutrients makes supplementation valuable Or, to put it another way, a healthy person will not become healthier with supplements A related idea here is of body wisdom where it will only take the amount of vitamins and minerals it needs from the food it digests
In terms of absorption of supplements in the gut, do we assume the body tends to just unwittingly absorbs and then excrete that which is not necessary? Or is gut absorption already tied to a feedback system which is establish how much of a given substance needs to be absorbed at that time
Supplements
Food derived supplements
Green Pharmaceuticals- Those natural supplements and herbs which are just targeted for symptom relief
The idea that vitamins are often made from pharmaceutical products and tainted products
Targeted single component supplements could be considered reductionist
Natural substances may effect the body in a holistic and non side effect creating manner as compared to pharmaceuticals
Argument that single components are targeting metabolic set points as counter argument that such strategies are not reductionist
Cheap products like castor oil, apple cider vinegar, and other cheaper products discounted by some as too good to be true that cheap products could be as effective or more than expensive
A few bad actors, such as low quality body building supplements or low quality generic brands are used by generalizations to discredit supplements in general
In terms of absorption of supplements in the gut, there is an assumption that the body only absorbs what it needs and excretes that which is not necessary
This is tie to the famous meme that those who use supplements
However this does not prove that at times all of the supplement might be absorbed, or that even partial absorption provides health benefits worthy of the the expense of the product
There is also a complicating factor that some peoples guts might not be functioning well enough to absorb the supplement
If a person is not absorbing nutrients from foods, but that may also mean they will absorb supplements and are now spending even more money on something that is not effective
Jennifer Daniels makes the point that some nutrients such as Ashwaganda are second level nutrients that need a certain amount of fundamental nutrients in order to work.
The formulation of the supplement, or whether the supplement need to be taken with food, will also effect absorption. Enteric coatings may help with absorption
Technical
NNT, or number nedded to treat is a metaphor for a narrative since here we can weigh the ideas of a positive result in an amount of patients but can also weight the entirety of the side effects against them
The technique used by NY Attorney General Schneidemen included DNA bar coding, which is a technique, which is a technique that identifies the animal or plant species said to be in the supplement. But there are reasons to believe that some supplements might not, or should not contain the DNA of the original plant DNA. Rather the intended final product is a constituent derived from a deliberate process to refine the original product. . An example would be fish oil were the final refined products are DHA and EPA, but do not contain fish DNA.
The claim that individualized health care, especially in terms of genetic testing, will be a boon to the health industry and health care in general. One offset is of course it will take more technology to accomplish and calls into question whether at least some of the lower tech basics of healthcare would be just as effective in terms of resource dollars or work hours in comparison to genetic individualized treatment on a large scale
Hoffman we may not always need to cone up with new molecules but re purpose older known with new purposes
Technology memes
The claim that individualized health care, especially in terms of genetic testing will be a boon to the health care industry, and health care in general. One offset is that it will take more technology, and thus cost, to accomplish. This begs the question of whether some of the lower tech basics would be just as effective in terms of resource dollars
Technology
Genetics and epigenetics
Eliminating disease and pain, the road towards perfect humans
Companies owning human genes
Omega 3 fast converters slow converters
Treatment
Try a wide variety of treatments
Stick with one treatment for a long time
Try to determine where you at both by diagnostics including genetics,and even descriptions of how you feel at a given time
If you are looking for one treatment to relieve some particular target systems then it is important to keep other lifestyle factors consistent
Off label prescribing of drugs https://www.consumerreports.org/cro/2012/05/off-label-drug-prescribing-what-does-it-mean-for-you/index.html
Iatrogenic deaths
Herxing and detox reactions controversy. Certain therapies may make you feel worse initially though you are 'getting better.'This is generally associated with holistic treatments
Holistic methods may augment conventional treatments such as curcumin and cancer
Trends
A common trends narrative is that an increase in some disease rates can be attributed to increased screening or the official diagnostic criteria have changed
Epidemiology in determining overall trends is of course more of an evaluation of where we as a society in comparison to other times and other populations. In general this area rarely if ever gives direct answers about individual health problems, but is may instead be critical in establishing our attitudes and expectations in what health questions are significant. For instance the increases in rates of Alzheimer's, autism, diabetes and many other disorders seem to imply they have a cause of some sort. Diabetes may be recognized by many as being caused by greater intakes of sugar, yet many of these connections are filled with controversy. So in some sense it may be wise to see the issues of epidemiology and the cause of conditions as somewhat separate. In this manner epidemiology serves as pointer that something is happening and then a more specific examination of sub-populations may give us clues about why such conditions are occurring
Treatment strategies
Try a wide variety of treatments
Stick with one treatment for a longer time
Try to determine where you are at both by diagnostics including genetics,and even descriptions of how you feel at a given time
If you are looking for one treatment to relieve some particular target systems then it is important to keep other lifestyle factors consistent if your aim is to provide objective evidence
Standards for regulatory requirements for a given class of products New drugs for instance are a clear category while GMO was less clear
Evidence is of course the process and interpretation, of studies, understandings, and research of the subject at hand
The Standard is the conclusion drawn from that evidence
The scope of the question being asked is also a requirement of any evidence
The question of what is health and under what circumstances it is attained is the general scope of evidence in this section,
This idea of health is therefore intertwined with general rules of logic and empirical examination,so in a nutshell that is our purpose here