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Over the last decade I've been having increasingly bad hay fever. The doctor said "eat these pills". They worked but they made me fall asleep right at my desk.
by skrebbel 9y ago
Over the last decade I've been having increasingly bad hay fever. The doctor said "eat these pills". They worked but they made me fall asleep right at my desk.
This year my girlfriend put me on some decent snake oil indeed. Tens of euros worth of food supplements per month. I also went to see an acupuncturist. My problems aren't reduced, they're gone. I can be outside for an entire day and not notice a thing. My problem is, 0% of what I did is evidence-based medicine.
Now, this is the whole issue with snake oil. Anecotes like mine don't further science. But the Ars article puts all of Goop's stuff on a single big pile of "snake oil".
Isn't it possible that there are things that work, even though they have not been scientifically proven yet? Why can't there ever be a middle ground? I mean I also think homeopathy is a fraud. But I also know that either dried extract from Indian moringa trees or needles put into appropriate places in my body's "energy streams", or both combined, fixed all my problems. This is pretty major to me. I can live again.
In fact, I think there's an upside to non-evidence-based things selling more: maybe at some point the sellers will earn enough money to be able to finance decent clinical trials.
Many forms of irritable bowel syndrome (a disease defined by a list of symptoms, for which "there is no cure") can be fixed simply by changing your diet. I know someone who had stomach aches every day for 10 years and went to once a month simply by eating oatmeal every morning. Evidence based? No. I have no idea how you could ever design an affordable clinical trial for that, too many factors involed. The cost would be huge and the oatmeal industry doesn't have deep enough pockets.
I think that to dismiss everything that's not evidence based medicine as snake oil, like this article does, is just as bad as dismissing mainstream medicine like Goop appears to do.
- collyw 9y agoAlternative medicine with proof that it works becomes convetional medicine.
- kingkawn 9y agoVery little appreciation for the fact that alternative or conventional at some point someone has to make the leap and try something unknown and see if it has any impact.
- louhike 9y agoI'm not sure that selling that to tons of people at a high price without funding real trials is a good way to check if it has impact.
- mikeash 9y agoThat last part being the key. If you make the leap and see if it has an impact, you're doing good. If you make the leap and sell it for $60/bottle without ever checking to see if it works, you're selling snake oil.
- skrebbel 9y agoIndeed! The issue isn't snake oil, the issue is that clinical trials are slow and expensive.
- pjc50 9y agoFor a large category of stuff: no it doesn't, unless it's patentable. Simply because there's no drive and funding to get it through the trials. It's "not invented here" on a societal scale. And for a lot of alternative medicine, the hit rate is quite low; it seems there are elements of matching the treatment to the patient that the RCT has trouble with. This is especially bad for chronic low-level conditions that conventional medicine is bad at even bothering with. Minor aches and pains, fatigue, that kind of thing.
- coldtea 9y ago>For a large category of stuff: no it doesn't, unless it's patentable. Simply because there's no drive and funding to get it through the trials. We have no shortage of very cheap and totally free solutions that are nonetheless accepted by conventional medicine. >And for a lot of alternative medicine, the hit rate is quite low; it seems there are elements of matching the treatment to the patient that the RCT has trouble with Or it's just that the "alternative medicine" hit rate is just the statistical noise from random healing, placebo and self-recovery.
- addicted 9y agoIronically, vaccines, which are probably the greatest bang for the buck in human history (and ridiculously cheap even at an absolute level) are currently the most attacked medicine. And the attacks come from the same people peddling the $40 sugar pills.
- teslabox 9y agoI think trash collection, indoor plumbing and refrigerators/freezers have done much more to improve the public' health.
- mikeash 9y agoI agree that those have bigger bangs, but the "buck" part for vaccines is extremely small. Good plumbing and sewers have probably saved a lot more lives, but the cost per person is orders of magnitude higher. For example, the cost of eradicating smallpox was about $1-2 billion (in 2017 dollars), and saves around 2 million lives per year. (This is a rare example of a one-time investment that pays off forever with no additional action on our part, which is pretty nice.) This is about what New York City spends annually to maintain city water and sewer infrastructure.
- TheOtherHobbes 9y agoI had interesting experiences with snake oil. I saw four acupuncturists. Two were useless, two changed my life. I'm talking about lasting, unambiguous, not-up-for-debate physical changes that are still present more than fifteen years later. I have no explanation, but I'm not going to deny my experience because of that. ("Placebo" doesn't do it. Not for this level of change.) It's not as if mainstream medicine lacks snake oil. I recently researched anticoagulants after I was put on one and had an incredibly unpleasant, potentially fatal, reaction. I looked at the original papers and the statistics quantifying side effects didn't make sense. There was no way to estimate the risks accurately, and when I talked to my doctor he said that they'd had quite a few problems - certainly more than you'd expect from the official numbers. One manufacturer was caught flat-out lying about dosage and efficacy. The BMJ destroyed their claim that their product didn't need the same monitoring that warfarin does. But the medication is still recommended - which I find rather strange. And so on. The problem with these debates is they become very tribal. It's easy for not very interesting people to assume an air of instant scientific authority and credibility by calling out "obvious" nonsense. Unfortunately it's a very selective form of criticism, and IMO it's selective bullying directed exclusively at certain demographics. The reality is that everyone believes utter nonsense, and every area of human experience is prone to it. We're not nearly as rational as we think we are. Goop is an easy target, but there's plenty of snake oil in finance, econ, business, and politics. IMO it's far more dangerous and destructive there - and challenged far less often.
- skrebbel 9y ago> The problem with these debates is they become very tribal. Yes! This! This bothers me to no end. Somehow I can't let acupuncture fix me unless I'm also an antivaxxer. Thank you :)
- everyone 9y ago'"Placebo" doesn't do it. Not for this level of change.' Really, why do you say that? The placebo effect has been confirmed and measured many times, and can be very effective. Any clinical trials of new treatments must be designed account for it. Normally about one third of the control group being given sugar pills for instance will see improvements and some will be cured entirely. Theres even quite a bit of evidence suggesting the placebo effect can cause death. Read a bit about it, its very interesting. How is actually works is not understood afaik, but sugar pills, acupuncture, homeopathy, or just being told that something will happen by your local witch doctor can all cause the placebo effect. I think that salient fact here is that all the above fit into the same category.
- coldtea 9y ago>This year my girlfriend put me on some decent snake oil indeed. Tens of euros worth of food supplements per month. I also went to see an acupuncturist. My problems aren't reduced, they're gone. I can be outside for an entire day and not notice a thing. My problem is, 0% of what I did is evidence-based medicine. For one, your issues could have healed by themselves, even without it, just through time passing. Since there's a sample of 1 of you, and you did take those drugs, we don't have a control group, and can't know. Second, those food supplements make have actually had some good stuff -- like a vitamin you're deficient in -- that helped in this case. Lastly, there's always the placebo effect. None of the above are an argument against the Goop stuff being snake-oil (and neither is "but it worked for me" for some Goop product).
- skrebbel 9y agoI fully agree. But dismissing the option that something unproven could have helped me is the same fallacy as not trying it because it's unproven. I mean, there's also conclusive evidence that eg homeopathy does not work better than a placebo. I'm talking about the cases where there's no conclusive evidence for either outcome (1). Ars calls those snake oil and I think they're jumping to conclusions too fast. (1) admittedly I don't know whether such evidence exists for acupuncture but I know that no such evidence exists, either way, for the particular giant pile of pills I've been eating.
- coldtea 9y ago>But dismissing the option that something unproven could have helped me is the same fallacy as not trying it because it's unproven. It's not about dismissing it. It's that the burden on proof is on that side, not on those that are not convinced. It might very well have been a case of self-healing, the kind that happened many times (often thought as miraculous, etc), and whose exact mechanism is not known. >I mean, there's also conclusive evidence that eg homeopathy does not work better than a placebo. I'm talking about the cases where there's no conclusive evidence for either outcome (1). Ars calls those snake oil and I think they're jumping to conclusions too fast. Well, the burden on proof is not on Ars side though. They can legitimately call snake-oil anything that has not been proven but is nonetheless sold.
- Shivetya 9y agoWithout full accounting of other changes made in your life during this time it is very difficult to attribute the improvement to snake oil supplements. when you are trying to correct a problem with your health you need to honestly journal your activities to include everything you consume. changes to where you live and work can have great effect to something as simple as how often you are in public. with regards to supplements, many adults do not eat properly and there can be benefits with taking simple vitamin pills or fortified drinks to make up for it. the key is to change previous habits
- acranox 9y agoYou make some good points. But it is worth pointing out that if you sold a package of oatmeal at $20 each and labeled it a cure for IBS, we'd still call it snake oil. Eating healthy can solve a lot of health issues. Selling cheap healthy food as an expensive cure for a disease is taking advantage of someone else. That's my 2 cents.
- 5partan 9y agoDefine eating healthy, i’m sure you will stir much controversy here, what you consider eating healthy, others may interpret as falling for that snake oil seller.
- epmaybe 9y agoNot dismissing the rest of your comment, but there has been some research into FODMAP diets for IBS. I'm not sure that clinical trials are underway, but evidence based medicine is in full gear trying to determine if these kinds of diets work. Retrospective studies, case control studies, stuff like that.
- skrebbel 9y agoAwesome! I didn't know that. In fact, this is my point - should we wait with tuning our diets to fight IBS until those trials are done and conclusive? Of course not.
- epmaybe 9y agoI'm sure nobody is saying that it isn't worth trying if there's no risks. It's just that for a lot of therapies that aren't studied, we haven't really figured out what the adverse effects are. Like, look at homeopathy. At it's surface, the theory behind using natural "things" at different doses causing either therapeutic or toxic effects isn't really wrong. In fact, it's probably our foundation for pharmacology. But telling someone that it's probably safe to take x amount of something that hasn't undergone any clinical trials for toxic or side effects doesn't sit well with me. Of course, I'm also assuming that these clinical trials are rigorous and transparent.
- futurix 9y agoHay fever can disappear in older age (just like it can suddenly appear in mid-age). I first experienced mine at 33 - without any gradual changes in the years before that; just suddenly, out of nowhere, full blown hay fever. One of my relatives had hay fever all her life, until it suddenly disappeared at the age of 42. She had it at 41, she had none at all at 42.
- Sleeep 9y agoYeah I was never allergic to anything my entire life until I woke up one day at 24 allergic to everything.
- Chris2048 9y agoStrangely, I've noticed this two - friends/family and myself suddenly getting hayfever, despite never having it before. I wonder if it relates to changes in type of pollen?
- Jedd 9y agoAlmost definitely. I suffer hayfever-like symptoms only when visiting a certain area for a few days, and typically it takes a few days for the effect to kick in. (I live in Sydney, Australia, and the area is about 3 hours drive north of same.) Flora shouldn't be significantly different, though there will of course be some variation. It's the fact that it seems to take 2-3 days to kick in, and effects are mostly prevalent in the evenings, that has me most confused. I considered it may be artificial environmental (something in the living quarters, f.e.) rather than flora, but the effect still occurs when I avoid the abode. It seems to vary slightly throughout the year, but not as much as I'd hope it to be if it's vanilla hayfever. It's very strange, especially as it only started occurring for me about a decade ago - in my mid 30's. Still, this anecdote is not compelling evidence goop isn't a steaming load of hoohar.
- Chris2048 9y agoThere's a positive bias here too - there are all sort of surprising things that happen in life. Some you miss because you don't pay attention to everything. Some you dismiss as relevant. But alternative therapies at least put the thought of causation in you head, which make you track it more than anything else. Then survivor bias makes random positive results more visible. How many people did alternative treatments not work for? But then, such a result would be inconclusive for dismissing the treatment, right? That means the domain has a natural positive bias if negative results are not weighed equally against positive ones.
- grafporno 9y agoYou know hay fever is an allergy, right? And that you are allergic to specific pollen? These pollen are _seasonal_. It's not suprising that your symptoms are now gone, it's very probable that the allergen is just gone (for the season). The snake-oil has done nothing. Get a proper allergy test. > I think that to dismiss everything that's not evidence based medicine as snake oil, like this article does, is just as bad as dismissing mainstream medicine like Goop appears to do. I really don't think you are in a position to judge that.
- maxxxxx 9y ago"I really don't think you are in a position to judge that. " Neither are you. You can't just dismiss someone's experience as bullshit.
- Retric 9y agoThey provided a completely rational explanation for what's going on. Simply waiting 4-8 weeks treats the vast majority of common issues. Either because they get better, the environment changes, or because the brain ends up ignoring repeated stimulus. Which is the secret to much of this stuff, they don't say just wait but because treatments are designed to take a while a significant number of people will make the association. PS: Some include useful diet changes and exercise, but people often ignore their doctors giving the same advice so YMMV.
- bmelton 9y agoA completely rational explanation that may or may not be the answer. If my car disappears from my garage, it may be because it was stolen, or maybe because it was transported to an alien planet by extra-terrestrial life forms. My assertion that it was E.T. does not mean that your counter-assertion that it was stolen is true. Maybe I lent it to a friend and forgot, or my wife took it to be pimped out on Overhaulin', or that it was repossessed due to some bank error. It's quite appropriate to raise additional possible explanations. It's quite inappropriate to tell someone that their treatment is in no way causative to the amelioration of symptoms, especially when they cannot know for certain that they were not.
- criddell 9y agoAre you a curious person? I think if I were in your situation, I'd go for some allergy testing. If the results come back clear, I'd for sure declare victory and credit your girlfriend (sounds weird, but you know what I mean).
- skrebbel 9y agoNice idea. That said I never dove in (she did), and I don't even know whether the supplements treat the allergy at the core or just the symptoms. But if they're supposed to treat the allergy itself then that's a nice idea indeed. Thanks :-)
- Jedd 9y agoPerhaps I haven't looked hard enough, but I can't see anywhere in this, or your subsequent half-dozen replies to this thread, where you specify what the actual food supplements were that you took that cured your hayfever. I know of one non-orthodox treatment that's meant to be very effective, but relatively hard to come by, and certainly comes with its own set of challenging side-effects - hookworm. Anyway, it sounds like it was more than just moringa tree extract and acupuncture -- so in order to allow your fellow HN'ers to conduct their own experiments for hayfever (those of us in the southern hemisphere are about to revel in the joy of same in the next few weeks), that'd be great.
- Consultant32452 9y agoThe placebo effect is so powerful it works even when the patient knows they're getting a placebo. https://www.theguardian.com/science/2010/dec/22/placebo-effect-patients-sham-drug https://www.theguardian.com/science/2010/dec/22/placebo-effe... The things you mentioned have been studied scientifically and have been found wanting. The most likely scenario here is the placebo effect. This is why doctors don't complain too much when their patients take on the more relatively harmless fake medicine. If it makes you subjectively better, isn't causing real harm, you aren't avoiding real medical treatment (like the chemo you might need), and isn't bankrupting you... then go for it.
- thinkingemote 9y agoDoesn't the placebo effect mean it makes some people objectively better (rather than subjectively) ?
- chasing 9y agoImagine this scenario: "My computer stopped working one day so I kicked it hard and it started working again! Maybe kicking computers works." And you, as a "computer person," are like: "I can't say what happened in your specific case, but generally speaking kicking your computer will probably cause more harm than good. Maybe you caused it to restart or something or got lucky and something that was loose inside the machine got pushed into a tight fit. Or maybe it was a total coincidence. Who knows. But I'm glad it's now working for you." That's probably what someone in the medical community thinks when they hear stuff like the above. (And now here comes GoopTech offering to fix your computer by kicking it for $50/kick.)
- tomp 9y agoThe difference is that usually, the "computer person" is able to fix the computer without kicking.
- TheCoelacanth 9y agoThere actually have been clinical trials for managing IBS through diet, e.g. the low-FODMAP diet. Oatmeal doesn't sound like a very plausible cure for IBS, but whatever they used to eat for breakfast being a problem food for them seems very plausible.
- cholantesh 9y ago>Many forms of irritable bowel syndrome (a disease defined by a list of symptoms, for which "there is no cure") can be fixed simply by changing your diet. A syndrome isn't a disease, it is a list of correlated symptoms. And IBS can't be cured, only managed. That's what 'fixing' it is: finding out what triggers your symptoms by trial and error and adjusting accordingly.