
Don’t Take Medical Advice From the New York Times Magazine - tokenadult
http://www.slate.com/articles/health_and_science/medical_examiner/2013/02/curing_chemophobia_don_t_buy_the_alternative_medicine_in_the_boy_with_a.html
======
tokenadult
From the article: "We are a chemophobic culture. Chemical has become a synonym
for something artificial, adulterated, hazardous, or toxic. Chemicals are
bad—for you, for your children, for the environment. But whatever chemophobics
would like to think, there is no avoiding chemicals, no way to create
chemical-free zones. Absolutely everything is made of atoms and molecules;
it’s all chemistry." This was striking to me, as I had seen an example just
recently elsewhere in cyberspace of reasoning that "chemicals" are bad
ingredients to have in a food, even though all foods are materials made up of,
um, chemicals. I have seen similar comments earlier here on Hacker News.

Matter is made up of atoms, and those atoms form various chemical elements or
compounds or mixtures. We breath chemicals, we eat chemicals, we touch
chemicals every day. Just because some foodstuffs have listed ingredients,
with names that are sometimes difficult to read out loud (I have no trouble
with the names, but then again I grew up with a parent who majored in
chemistry) doesn't mean that those foods are dangerous. Whatever kind of food
you think is perfectly safe surely contains some compounds with chemical names
that are hard to spell or pronounce, but are nevertheless perfectly "natural,"
and usually not listed on an ingredients label. Don't worry about it.

~~~
firefoxman1
Never heard the term "chemophobic" before, but now that I think about it I
have some chemophobic friends. Their argument is always something like this:

"Humans evolved consuming only organic material from their very beginnings up
until about 100 years ago. Humans just haven't evolved to tolerate synthesised
chemicals in a mere 100 years."

(that's obviously paraphrased but you get the point) But when it's said like
that, I tend to agree with them. When they're called "chemophobic" in articles
like this, I tend _not_ to agree with them. I've no clue which to agree with.

~~~
sliverstorm
Considering you can synthesize organic material, life can produce inorganic
compounds, and plenty of organic material is toxic as shit, I'm not sure I
agree with that line of thinking.

I can't speak for everyone, but I am of the opinion that glucose synthesized
in a lab requires no special evolution on the part of humans to process.

~~~
megablast
What you are saying is disingenuous. Clearly the pills made for pharmaceutical
are incredibly dangerous, even when taken as per the instructions. That is why
they are prescribed.

Avoiding taking prescription drugs unless you really have to (ie are going to
die), as I do, is not a bad way to live. Just because natural things will kill
you, does not mean we should not avoid man made things. So I do not take pills
for headaches, for sleeping, etc...

You thinking is because you can die by a bear, you should not look before
crossing the road.

~~~
DanBC
Paracetamol (acetaminophen) is a very safe drug if you do not take too much.

Being in pain when there is a simple, cheap, safe, effective medication is a
bad way to live.

~~~
megablast
The problem I have with it is that it lowers the bodies natural ways of
dealing with pain. You become more reliant on it, rather than just handling
the pain yourself.

This works for non extreme pain, of course.

~~~
DanBC
People in pain tense their muscles, they walk in a different way, they stop
exercising, they stop moving around so much.

All of these things help keep pain going on longer.

For long term pain with no worrying cause you should carefully take pain
killers and keep moving. Things like lower back pain (which can have serious
causes, so get it checked) get much worse if you stop exercising, but get
better if you get appropriate exercise.

------
ck2
In the same breath you should also not assume any doctor is an impartial
scientist.

Doctors are humans and are therefore also subject to being lazy, greedy,
ignorant, etc.

Just because they seem to have more knowledge and use something of a
scientific method doesn't mean they aren't locked into their ways, always
giving the same kind of diagnosis for certain symptoms without questioning
their limited knowledge.

They also face pressure from insurance and government agencies to behave in
certain manners.

As many of us are coders, let me put it this way - have you ever looked up to
another coder because they seemed to know so much more than you? Then after
some years you surpassed them in your knowledge and looked back on their code
and realized it was a "bit cr*p" in parts?

Yeah well your doctor is like that too. If they aren't constantly learning and
researching, they are set in their ways and being moved by forces that may not
make the best decisions for your health.

~~~
Zakharov
At the same time, consider that anyone peddling herbal remedies and the like
is almost guaranteed not to be an impartial scientist.

------
lizzard
So many people earnestly want to tell me how if I just drink the right cherry
juice, or do acupuncture, I will magically be fixed. It is very annoying.
Rather than take someone's anecdotes and try them one after another it seems
more sensible to look over the last 20 years or so of research papers and
decide on treatment based on that.

Also, 6 weeks on methotrexate is not a very long trial.

~~~
rdtsc
You could do worse than just not get "fixed". You could be harmed. Natural and
safe are fairly independent concepts.

------
Alex3917
"Another common chemical name for methotrexate is amethopterin, which comes
from the roots meth, Greek for wine, which I might stretch to spirits, and
pterin, Greek for feathers."

Except for it's ameth, which would mean lack of intoxication, a la 'amethyst'.

In fact the whole article is complete BS as it doesn't even remotely align
with the views the author presents in the original article -- nowhere does the
author say that she is 'chemophobic', nor is this even hinted at beyond her
saying that her husband has always been "more comfortable with
pharmaceuticals, more trusting in general." And of course naturopathic
medicine is going to seem like pure evil if you're willfully blinding yourself
to the arguments in its favor and only seeing the (legitimate) weaknesses, as
will anything else for that matter.

~~~
InclinedPlane
Except the NYT magazine article author makes it quite clear that she is
chemophobic, with repeated statements about her fear. Here's a direct quote:
_"It reinforced an image of Shepherd as sick, forever dependent on a drug I
felt afraid of, however unreasonable a doctor might tell me that fear was."_
Similarly, when a doctor suggests increasing the dose of methotrexate she
panics.

~~~
Alex3917
I guess I still don't see anything there that could be construed as
'chemophobia'. She doesn't want her kid to self-identify as sick or to die of
liver failure. I don't see how either of these concerns are crazy or anti-
technology or whatever. Especially since in the beginning she says she was
excited about the diagnosis because it meant they could try different drugs.

------
rgo
My sister is a recently turned vegetarian. As her meat-eater engineer older
brother, it's my insolent duty to explain to her that carbon chains like
protein are all the same, come it from a bean or a cow. Chickens are no more
than organic machines that turn molecules around so they taste rich,
especially when deep fried and extra crusty.

Needless to say, that won't do anything to change her mind -- not that she has
to, it's just me being a pain in the butt gaucho. She is a vegetarian for a
myriad of subjective reasons that I could never even start to debase or crack.
I've never heard of chemophobia (and the Chrome spell-checker hasn't either),
but I think that turning a desperate quest by a mother into a bunch of
molecules and atoms is an oversimplification of a complex, subjective choice
made by complex, subjective minds.

------
nicholassmith
Here's the thing, if you're taking medical advice from someone who isn't a
practising doctor, you're probably an idiot. All those natural herbs and old
wives tale remedies? Scientists actually have checked those and turned them
into _actual medicines_ where they worked. Everything else is a load of crap.

~~~
TazeTSchnitzel
Like aspirin, for example.

------
dools
_When Meadows’ husband has serious reservations about her desire to ditch the
advice of not one, but two, pediatric rheumatologists, Meadows implies he was
the poorly informed one: “I was nervous about keeping Shepherd on
methotrexate, but Darin didn’t share my squeamishness. He has always been more
comfortable with pharmaceuticals, more trusting in general.”_

If you read the original article, you'll see that she didn't "ditch" the
advice. She kept giving her son the prescribed medication. She discussed
"Walker's Regimen" with Dr. Kahn who approved it in conjunction with
methotrexate. Dr. Immundo gave her the number of a complementary practitioner.

The parents agreed that they would wait 6 weeks without increasing the dosage.
They did that, their kid got better.

Seems like a perfectly sensible course of action to me. I think even though
Michelle M. Francl (author of the OP) touts her self as a "scientist" her
article is just as influenced by emotion as the original article she's
referencing.

The only valid point she makes is that Susannah Meadows refers to the use of
"four-miracles powder" as a "drug free" solution. Cool, that's inaccurate and
pointing out that chemicals in "magically named" complementary medicines are
just chemicals the same as any other is a valuable discussion to have.

But she allows a really derisive and dismissive attitude to creep into her
writing which has no place in scientific discourse.

I realise that Meadows' article is just as emotive, but at no point does she
try and take the intellectual high ground.

TL;DR: we sought advice from everyone, tried everything, and our son got
better as a result. Win.

------
aheilbut
This is true, but totally misses the point of the NYT Magazine article. The
'four marvels' powder was mentioned only in passing. [edited to remove my dig
at homeopathy, which wasn't at issue here - it was naturopathy]

The more interesting thesis of the original article is that some inflammatory
disease is related to a 'leaky gut' syndrome and that it could be modulated by
diet and changing gut flora. Unfortunately this argument was not made very
rigorously in the article, and while it remains controversial there is a lot
of ongoing research into the idea.

~~~
nikatwork
> if it was homeopathic, we can be quite certain that it was doing nothing at
> all.

From TFA:

>several recent peer-reviewed studies have shown that at least one of the
active drugs in four-marvels powder, quercetin, exhibits anti-inflammatory
activity.

Dismissing _all_ traditional treatments without using research is just as woo-
ey as blindly accepting them.

~~~
aheilbut
Whoops. I misread 'naturopath' as 'homeopath'. When you dilute something
10e60-fold, I'm comfortable dismissing it, and it's not woo-ey at all. But
that wasn't the case here.

I didn't mean to imply that traditional treatments can't contain active
ingredients that can be useful -- they surely can, and are the source of many
drugs.

~~~
derleth
You can’t have naturopathy without homeopathy:

[http://scienceblogs.com/insolence/2011/01/28/you-cant-
have-n...](http://scienceblogs.com/insolence/2011/01/28/you-cant-have-
naturopathy-without-homeop/)

> the NPLEX (Naturopathic Physicians Licensing Examinations), which is
> required for naturopaths to be licensed in the 16 states in the U.S. and 5
> provinces in Canada that license naturopathic physicians tests naturopaths
> on homeopathy

> Then there’s the American Association of Naturopathic Physicians (AANP). If
> you take a look at its blog and search it for the word “homeopathy, you’ll
> rapidly see that the largest “professional” organization of naturopaths not
> only embraces homeopathy but defends it against attacks.

------
ars
addlepate: Your account has been banned, and almost no one can see your posts.

To reply to you: I challenge you to define "chemical" in the way you are
attempting to redefine it. People want to use it to describe unsafe or non-
natural compounds, but a little bit of thinking will quickly show that that
definition is impossible.

Use chemical as an adjective instead of a noun and you will do much better.

Used as a noun chemical has no meaning: _Everything_ is a chemical, so saying
the word says nothing at all.

~~~
robotresearcher
Some non-chemical things: Justice, beauty, truth, prime numbers, O(log n)
insertion time of a binary tree, Beethoven's 5th.

Just for the record.

~~~
ars
Those aren't things, they are concepts.

~~~
robotresearcher
And a concept isn't a thing? This is an old philosophical debate that pretty
much melts away in practice. For all practical purposes things like songs and
ideas are things. See how you weren't confused when I referred to them as
things in the previous sentence?

------
leoh
"We are a chemophobic culture." I take great issue with this statement. We are
most decidedly not a chemophobic culture. People are more than willing to take
medicines that are artificially synthesized and, as the author mentions, with
good reason.

I, for one, am not chemophobic. I personally know an individual who developed
one of the first total-syntheses (i.e. "artificial" chemical synthesis) of a
very important anti-cancer agent, Taxol. The TS of Taxol was exceedingly
important, since a single dose required the sacrifice of an mature Yew tree --
something that would have been entirely unfeasible for the millions of people
that stood to benefit from the drug.

But there are miraculous, mysterious things that we do not understand about
natural products and the human body. Take Yerba Maté, for example, a popular
beverage in Argentina and coffee. Or wine and whiskey. What all these
beverages have in common is that they rely on a principal chemical agent for
their effect (methylxanthine or caffeine in the case of Yerba Maté and Coffee;
ethanol in the case of wine or your favorite alcohol). Yet as the more
sensitive among us have realized, each different concoction effects us
differently -- even though the principal ingredient is the same (people report
calming, yet stimulating effects from Yerba Maté as opposed to caffeine,
etc.)!

It turns out there is a very simple explanation for this. There are other
constellations of chemicals in these concoctions which, in concert create an
altogether particular and unique effect. This, I believe, is where
"chemophobia" lies for some individuals (though again, I argue it is not
widespread among the greater population). It lies in the fact that we are
applying something very strong in a way that is not balanced or integrated.
One very real mainstream example of this is how calcium is accompanied by
vitamin D, as the latter enhances absorption of the the former. Since vitamin
D helps strengthen the effect of calcium, patients can take safer doses of
calcium which have great physiological effect. Another example is the fact
that African American heart patients who take ACE inhibitors (drugs that lower
blood pressure) along with diuretics have much, much better clinical outcomes
than taking ACE inhibitors alone, which is the standard of treatment for most
individuals.

The hope, then, is that when taking something more "natural" as opposed to
man-made is that that natural product will inherently contain a wider variety
of compounds that taken together create a more potent, but gentle effect on
the patient. Now of course, these effects could be created by taking
combinations of man-made products. But first these combinations need to be
discovered, and we are certainly a long ways off from that. And it is not easy
--different people are affected by different combinations and deciphering the
key players out of a set of natural products is not easy. This will take many
more years of careful, non-biased research. And there is indeed incredible
bias against natural products among mainstream medical establishment, which is
rather absurd given that so many of the drugs we take today come from natural
sources! To me this is the real travesty, not "chemophobia."

Moreover, we need to embrace treatments that work, even if we can't explain
them (provided that they are safe--more on this and LD50's in a moment). Good
scientists work with existing knowledge. Great scientists love the perplexing,
paradoxical, seemingly impossible phenomena that are not well characterized,
which the FDA (about the most mainstream medical organization on the planet)
does not necessarily approve of, for which there are no established doses or
LD50's. Why is the author so insistent on the notion of LD50's when so many
people have taken natural products for hundreds of years without ill-effect
(that's a pretty amazing safety standard, in a way -- the fact that people
without any scientific background have safely taken and studied natural
products without modern science; namely by studying themselves; in India and
China there were masters at this sort of art).

Sorry for such a long response. I hope someone appreciates these comments.

EDIT: I just want to add one other thing. Rofecoxib (better known as Vioxx)
has an established LD50. For mice it is 300mg/kg, for rabbits it is 3.2g/kg,
and for rats it is 980mg/kg [2]. But you know what? Vioxx exacerbated heart
disease for at least thousands of people and should have been recalled years
earlier than 2004[1]. An established LD50 does not mean a drug is safe.

[1]
[http://www.thelancet.com/journals/lancet/article/PIIS0140-67...](http://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(04\)17514-4/fulltext)

[2] <http://www.clearsynth.com/docs/MSD-CS-T-17609.pdf>

~~~
Camillo
_The hope, then, is that when taking something more "natural" as opposed to
man-made is that that natural product will inherently contain a wider variety
of compounds that taken together create a more potent, but gentle effect on
the patient._

And why would they? You are pretty much literally assuming an intelligent
design behind the mate plant or Meadows's Montmorency cherry juice. But from
an evolutionist perspective, what reason is there for a random plant to
contain just the right mix of chemicals to produce the most beneficial effects
in humans?

There is none, of course - except where the plant has been cultivated, that
is, subjected to _artificial_ selection. But while farmers can and did select
for taste, yield, size, color, how could they select for an ideal balance of
chemicals they don't even know about? How could they optimize for medical
benefits without double-blind trials, and when most of their harvest is used
for other purposes anyway? Why trust an imprecise, blind form of artificiality
over a scientific, informed one?

By the way, some of the plants more painstakingly selected for human benefit -
cereals - are the source of one of the (real or supposed) villains in
Meadows's story: gluten. And even more exotic (and therefore appealing) South
American plants like the Solanaceae (potato, tomato, eggplant...) contain
significant amounts of toxic alkaloids. So much for the harmonious, "gentle"
blend of compounds in natural products!

~~~
andreasvc
Aside from the fact that literally is not a gradable adjective, I don't see
the grandparent suggesting any kind of intelligent design. Evolution implies
getting adapted to your environment, this includes an oxygen level of roughly
20%, availability of nutrients, etc. But this also goes the other way: plants
to some extend need animals to spread their seeds (you could go as far as to
say it's the reason for our existence...), so it's to their benefit when they
evolve beneficial effects on animal through combinations of
nutrients/chemicals]; cf. <http://en.wikipedia.org/wiki/Co-evolution>

So while there may be a _reason_ the mate plant evolved to have pleasant
effects on us, this is not necessarily because there is a design or teleology.

~~~
Camillo
Nobody is arguing against the existance of beneficial compounds in plants.
Remember that the claim was that natural products somehow contain the perfect
blend of compounds, which is a very high bar to clean. Co-evolution does not
imply maximum benefits for all the organisms involved: for example, a plant
that wants you to eat its fruit to disperse its seeds may make itself
delicious, but it does not really care if it poisons you a little along the
way (see the example of the Solanaceae, which I already cited).

You should also consider that humans and the mate plant have coexisted for
maybe 15 thousand years, which is not really a lot of time to come to a
perfectly harmonized balance with the entire ecosystem; and that the average
(US) American's ancestors have been around the mate plant for approximately
_zero_ generations, so, if they are to benefit from the short period of co-
evolution of the plant with humans, it needs to be through changes _in the
plant_ (and it seems to me that an animal would evolve to maximize benefit
from its food source faster than the food source would evolve to maximize
benefit to it).

You may then say that the plant co-evolved with animals similar to us, but
then, see the comment someone else made about lethal doses being quite
different between species. I am not disputing the presence of beneficial
compounds in some plants, but the claim that they would somehow contain the
perfect blend that maximizes benefit to our particular species.

Also, "pretty much" is not a grading adverbial phrase.

------
Nursie
I'm just going to leave this here ...

<http://www.youtube.com/watch?v=HhGuXCuDb1U>

(Tim Minchin's "Storm")

~~~
TazeTSchnitzel
Ah, old but good:

"Alternative Medicine has, by definition, not been proved to work, or been
proved not to work. You know what we call alternative medicine that works?
Medicine."

------
praptak
Fear of chemicals in general? Silly, but that is a bit of a strawman.

Fear of ingesting synthesized chemicals in quantities to which our species has
not been exposed during its evolution? Count me in, with the obvious rational
disclaimers.

~~~
InclinedPlane
Does this not apply equally to ingesting any chemicals that humans have not
been exposed to during our evolution?

What about tea and coffee? Or beer and wine? Or tomatoes? Or capsaicin?

~~~
praptak
It's the _"with the obvious rational disclaimers"_ part. The above chemicals
have been extensively field tested. Huge numbers of people have eaten them for
a long long time, it's safe to assume any ill effects of these are known
(although obviously the natural selection had little time to adapt us humans
to these substances.)

~~~
InclinedPlane
How do you feel about vaccines? Anti-biotics?

Why is fear justified? Isn't the appropriate response reason and critical
thinking? FDA approved drugs have been extensively field tested as well. And
many "dangerous" chemicals are actually safer than, say, wine.

You're just trying to justify your fear of the unfamiliar. It's parochial and
small-minded. Do you think that the people who discovered tea, beer, tomatoes,
and cheese thought that way? Imagine how much smaller and less interesting our
lives would be today if these sorts of fears had gripped our ancestors, and
how much smaller our future will be if we allow them free reign today.

~~~
praptak
> How do you feel about vaccines? Anti-biotics?

Both extensively tested, although antibiotics are interesting because they
created drug-resistant strains. Which shows that it is rational to be on the
lookout for unexpected bad effects of new things in general.

> Why is fear justified? Isn't the appropriate response reason and critical
> thinking?

Never stated it's one or the other. Fear of ill effects is what makes us do
the whole critical evaluation, which is good.

> You're just trying to justify your fear of the unfamiliar.

I'm afraid you have read from my comments something that wasn't there at all.
"Fear until reasonably tested" = rational. "Fear that makes one ignore all
evidence" = obviously irrational.

> Do you think that the people who discovered tea, beer, tomatoes, and cheese
> thought that way?

They took the risk and won - good for us. I'm just against calling their
fellow tribesmen (or countrymen) irrational, especially those who already knew
about death caps & similar.

------
Apreche
I upvoted this because the article is GOOD, whoever wrote the title of this
submission needs some good old fashioned
<http://www.sciencebasedmedicine.org/>

------
Zakharov
Startup idea: take out-of-patent medicines, rebrand them as herbal remedies,
triple the markup, get a reputation as selling "safe" herbal remedies that
work particularly well.

------
jchrisa
The gist of the nytimes article was "don't eat poison" -- eg subtract stuff.
Arguments against superstitious and irrelevant additives are missing the
point.

------
passionfruit
This article makes some bad analogies. Showing the structure of two different
molecules and acting aghast that someone would choose one over the other is
like saying all digital information is 1's and 0's so it's all the same. Or
it's like saying all words are just a bunch of the same letters therefore they
have no meaning.

~~~
InclinedPlane
The point being that people react to the name and the classification
("natural" vs "chemical"), and they should be reacting to the scientifically
verified effects and side-effects.

------
Meatball_py
I'm just wondering if there's any relationship between the picture and the
article.

------
electic
How about, "Don't take any medical advice from any magazine?" Now why is that?
Well because it is a run of the mill magazine. I am not sure why people read
and follow this stuff.

~~~
InclinedPlane
The slate article isn't providing any medical advice, it's merely telling
people that they shouldn't fear synthetically manufactured medicines while
being completely trusting of naturopathic ones. If anything it's telling
people to be more informed, skeptical, and to use reason rather than emotion
when making informed choices about medicine.

~~~
electic
Yes, I got that. However, it is still medical advice...coming from a magazine.
What to "fear", "use", or any other word you can swap in there is still the
same thing....advice.

------
capkutay
If I believed journalistic health advice I'd think Ice cream is good for me
because it speeds up my metabolism but exercising is bad because it makes me
eat too much.

------
hecuba12
Don't take any advice from Slate.

------
OGinparadise
_Don’t Take Medical Advice From the New York Times Magazine_

Don’t Take Medical Advice From the Slate Magazine either. Research all you
want but call a doctor in the end.

~~~
snowwrestler
> call a doctor in the end

Which is the point of this article.

------
largesse
It's a good article. Human beings are wired to believe that things that are
"natural" or "pure" are better than things that are "artificial." It's a
quality of human nature that seems to show up in all cultures. Steven Pinker
lists many of them in _The Blank Slate_. It pretty much explains the huge
market in "organic" food.

Since people have a bias for the "natural" it is hard to have any sort of a
conversation about what chemicals might be good for you that don't occur
naturally. And, people are unduly scared of "artificial" chemicals while
turning a blind eye toward the dangers than many "natural" chemicals have.

Inclination toward "natural" makes a lot of sense as an evolved bias.
Doubtless, it kept our ancestors alive. But our bodies don't have any sort of
magical scanner to detect whether something is natural or not, they simply
reacts in mixed ways. To us, some of those reactions are positive or negative,
even for the same chemical.

