SGU Episode 102

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SGU Episode 102
3rd July 2007
(brief caption for the episode icon)
SGU 1                      SGU 300
Skeptical Rogues
S: Steven Novella
B: Bob Novella
R: Rebecca Watson
J: Jay Novella
E: Evan Bernstein
P: Perry DeAngelis
Quote of the Week
The primary tool of science is skepticism, whose light shrivels unquestioning faith.
Mike Huben
Links
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SGU Podcast archive
Forum Discussion

Introduction

You're listening to the Skeptics' Guide to the Universe, your escape to reality.

S: Hello and welcome to the Skeptics' Guide to the Universe, and today is Tuesday July 3^rd 2007, and this is your host Steven Novella, president of the New England Skeptical Society. Joining me this evening are Bob Novella -

B: Hey everybody.

S: Rebecca Watson -

R: Hello everyone.

S: Perry DeAngelis -

P: (mumbling) Good evening

S: Jay Novella -

J: Hey guys.

S: And Evan Bernstein.

This Day in Skepticism (0.33)

E: Welcome to the dog days of summer everyone.

R: That's the best you've got?

E: Well, today's the official first dog day of summer.

R: The, what, that's not even a thing, you made that up.

E: No it's not, I'm looking at it right now on the internet, it must be true.

J: Rebecca, you've never heard of that?

R: I've heard of the dog days of summer, I -

S: You don't think it's real?

R: I don't think there's an official dog day.

E: According to this website.

S: And tomorrow is a very special day as everybody knows. Tomorrow July 4^th is Bob's birthday.

B: Yeah.

R: Ohhhhh.

J/R/E: Happy birthday, Bob

B: Thank you. Also Independence Day.

J: Bob, how old are you?

B: Ah, according to that carny, 32, the blind carny.

J: Do you smell like cabbage, Bob?

S: You don't have to tell us how old you are in reality Bob if you don't want to.

E: You're younger than the country.

S: And of course happy Independence Day out there to all of our fellow Americans.

J: Yeah, that too.

News Items

Barry L. Beyerstein 1947-2007 (1.24)

S: Unfortunately we have to start this show with some very sad news. Barry Beyerstein who we SGU_Episode_94 interviewed actually just a couple of months ago, a very nice guy, passed away last week very unexpectedly. From what I hear he had a massive heart attack. Apparently, the story that I have so far is that he passed out the week before, was admitted to the hospital, was evaluated, was essentially cleared. But because of the episode a cardiac work-up was planned, but before it could be completed he then had a massive heart attack and died.

J: Steve, what would have happened if they gave him the exam before the heart attack?

S: Well, it depends, they could have had either a by-pass or angioplasty and it could have prevented it. If the work-up was done quicker of if he just didn't have a heart attack so quickly after his initial symptoms.

P: Do you know if an autopsy is performed?

S: I have not heard either way but I doubt it. Unless the family requests it, it's not something that would be done routinely.

P: It's another kick in the teeth for the skeptical movement, that's for sure.

S: Yeah, it stinks to lose good people so young, he was only 60, so it was definitely a premature and unexpected death. Of course our sympathies go out to his family and his daughter. His daughter actually blogged about her father. We'll have the link to that, it was very nice. Barry was a fellow of the Committee for Skeptical Inquiry and they're putting out a retrospective and tribute to him as well.

P: Well you sound in your blog Steve, when you peel it all away, the sort of core of the skeptical movement really isn't all that big.

S: Yeah.

P: And we get to know these people. You in particular with Barry. It's a real loss, when we lose some of these people.

S: Yeah, it's a close circle, the inner circle of the skeptical movement, it isn't that many people really. You do get to know everybody and you do feel -

E: 4 or 5 of us. Some days it feels like that.

S: It hurts, it really is a big loss when you lose somebody like Barry. And I also said, he was, again without exaggeration, the single nicest guy I've met in the skeptical movement. He was just a really nice guy. I think if you listen to the interview that we did with him, it really comes across, he's just very very upbeat, cheery guy.

J: Yeah, he definitely was one of those people that everything was a good mood, everything was positive.

S: Mmm hmm.

J: And he just made me feel good just talking to him on and off the air.

S: Yeah.

P: He was surprisingly lively.

R: That's one of the people we most need in the skeptic movement because it shows people that we're not just all cynics, there are people out there who are enjoyable to be around

S: Yeah, we certainly don't do that.

(laughter)

R: I mean no, yeah, we do the opposite of that. He's definitely going to be missed though.

S: So this is our Skeptics' Guide tribute to Barry Beyerstein, he definitely will be missed.

P: So long Barry.

Herbal Link to Liver Failure (4.22)

S: The next news item is actually two herbal remedy-related news items. The first one has to do with black cohosh which is an herb that is used for women to treat the symptoms of menopause. The article discusses the fact that there have actually been quite a number of cases world-wide of sudden and total liver failure related to use of this herb, of the herb black cohosh.

P: Liver's one of those important organs, right?

S: Yeah, it's kind of an important organ. So this discusses four new cases in Australia of complete liver failure requiring liver transplant. That's complete - basically they would have died without a liver transplant. We point this out because yet again it makes the point that herbs are drugs, there is nothing magical or different about them, they're not somehow not drugs just because they're dried from plants. They're drugs - they can have the same risks as drugs, they can have organ toxicity just like drugs do, and they really should be researched, marketed and regulated like drugs. I think -

R: The thing is, I think at this point, correct me if I'm wrong, we're not positive that the black cohosh caused the liver damage, right, because from what I've read it seems like it just hasn't been studied enough at this point and we don't even know the extent of what it will do to a person's liver, and there are a lot of other possible side effects it might have, but because it's not studied in depth in the way that your regular medicine would be, we just don't know.

S: Well, that's sort of true, we don't have the kind of clinical trials that we would do prior to a drug being on the market. But even when drugs get out on the market, there is still the "after market" research that is done, and this kind of information that we have on black cohosh is exactly the same as the kind of information we would have after the market for drugs.

R: Right.

S: If the same number people taking a prescription drug had liver failure and had to get liver transplants, the drug would be pulled from the market or at the very least the data would be reviewed, it wold probably get a black, what we call a "black box warning" in the United States where the FDA puts a black box warning on the drug. They might include the requirement for monitoring of liver function tests while on the medication. But none of those safety precautions are now in place with black cohosh because it's not a drug, it's a "supplement."

R: Yeah, I think that the worst that's happened is that Australia's put some kind of warning on the label saying that the product might contain black cohosh which might cause harm to the liver.

J: Steve, do they know what the doses were? Because almost anything can damage your liver if you take too much of it.

S: Yeah, that's a good point, and in general we don't really have a good idea of what the dose is in the herbal preparations because they're not controlled well enough to know what the actual dose is in an individual pill or preparation or water or whatever. So the answer to that is "no," though generally the amounts of active ingredients tend to be on the low side because they're not purified. It tends to be lower than prescription drugs. But the bottom line is you don't know, and it could be that this is cropping up in those products that may have a higher than average concentration of certain constituents in the black cohosh, certain chemicals. Again, lots of questions we don't have the answer to because research is not required prior to marketing these things.

P: Because our laws are insane when it comes to supplements, that's why.

S: They're not in line with the science.

P: No. The Supplemental Safety Bill's been languishing in Congress since '03, you can't get anything passed. It really has created an insane environment.

J: Unfortunately it will probably take a lot of deaths before people really start seriously considering regulating these supplements.

S: Yeah, we joked about the fact that it will take probably a celebrity death to really bring the issue to the forefront. Just regular deaths may no be enough unless it's actually a large number. Actually didn't it, there were about a hundred or so deaths linked to ephedra and that didn't really change the market at all -

B: Wow.

S: - but it was enough evidence for the FDA to pull it from the market, so the FDA can't block herbs from getting to the market but if the FDA meets a burden of proof that it's harmful, then they can use that to pull something from the market and since 1994, ephedra is the only thing the FDA's been able to pull from the market because of evidence that it wasn't safe. And that's being challenged, that's being challenged by some of the companies who make ephedra. So, we'll see if the FDA, I mean 6 deaths or a dozen deaths probably are not enough evidence for the FDA to pull black cohosh from the market in the United States. Again, they have a pretty high burden of proof to prove something is unsafe before they can take it off the market. Again, it is completely backwards to what would really make sense based upon a scientific approach.

P: Maybe Paris Hilton can do something useful with her life. Just a thought, just a thought.

(laughter)

Echinacea Meta-analysis (9.40)

S: Alrighty. The other herbal news has to do with echinacea. There is a recent meta-analysis, ooh, it's almost a bad word on this podcast -

R: You know how we feel about those.

S: - published, looking at 14 studies, looking at the efficacy of echinacea as an herbal extract or herbal supplement in the treatment of the common cold. And the researchers concluded from the meta-analysis that the research supports the use of echinacea for the treatment of the common cold, that it reduces both the risk of getting the cold and the duration of the cold if you do get it. Of course this has been now widely touted in the media and of course by people who sell echinacea and promote herbs in general as the vindication or evidence that echinacea actually works. But the lay media has basically missed the point that this is not new evidence - this is just a re-analysis of old evidence, and it's not a particularly good analysis or re-analysis of this data because all of the weaknesses of meta-analysis are in play: these are different studies with different preparations, different outcomes. They did try to use reasonable selection criteria, (only the abstract has been published at this point, I could't find the entire article at the time we're recording this, this was sort of a pre-online publication, press release with the abstract, so the full paper's not available yet,) but from what I can find, they made the reasonable attempts to do a decent meta-analysis but the problem is in the data itself - that these 14 studies have serious problems. A meta-analysis is just the wrong way to look at this complex set of data. This is the kind of thing that's generally missed outside of epidemiologists or researchers or medical experts, that when you have a question such as this, such as "do preparations of echinacea treat the common cold?" and the research evolves over many years with different kinds of studies getting done and then those studies get criticized, better studies are designed and then hopefully eventually you have some large, well-designed consensus trials where the results are robust and fairly definitive. Those kinds of trials, those placebo-controlled, what we call "Class 1 Trials" have been done with echinacea and they were all negative - all of the recent studies that have the best design were in fact negative. A couple years ago the New England Journal of Medicine published an excellent study looking at three different preparations of echinacea with an experimental form of rhinovirus (that's a common virus causing the cold) and showed absolutely no effect in any outcome measure of the echinacea.

B: To that point, Dr. Craig Coleman of the University of Connecticut, regarding that point he said that that study only looked at part of the picture.

S: Yeah, they always say that.

B: Well, yeah.

S: Reading some of the sites, what they say is "you can use extracts from different parts of the plant, different ways of preparing it." Any negative study you can always criticize by saying "well, they looked at the root and not the flower", whatever, "they looked at this kind of species" (there's actually 3 species) - "they looked at this species and not the other two species." So you're never going to be able to look at every possible preparation of echinacea, so any negative study you can always say it's only looking at part of the picture.

B: Yeah, what he, but what he's saying regarding this New England Journal of Medicine result was that this doctor was saying that there're more than 200 kinds of viruses that cause colds and the team that did this particular study only looked at a rhinovirus. That's what he says at this point.

S: Right, again. Again, you can't study absolutely every permutation of echinacea with every permutation of the common cold. So the best studies that were done in a very reasonable representation of the common cold, a common virus that causes it with various preparations of echinacea showed no effect. I don't think it's really a valid criticism. That actually comes around to bite them in the behind too because whenever they use that argument to say that the negative studies are not definitive, it also means that well, if you have a cold and you get some random echinacea product off the shelf, the probability that you're getting the right matchup of the right preparation with the right virus is also pretty minimal too. And yet most of the evidence is anecdotal but by their same argument, that anecdotal evidence has to be unreliable. I think that a better way to analyze this data is with what is called a systematic review, because that takes into consideration things like the consistency of different studies, the way the research evolves over time, the quality of the studies and how that relates to the chance of it being positive or negative, and there has been a systematic review of the same data that they're now publishing the meta-analysis on plus more studies, again that's so-called systematic by so-called Cochrane Review which is linked to evidence-based standards. And they basically found that the evidence does not support the use of echinacea for the common cold.

R: Surprise!

S: The data is inconsistent and not sufficient to say that it works.

R: Once again we demonstrate that the word "meta-analysis" is just there to send big sirens off in your head every time you read it, that's like your little skeptic alarm.

J: Steve, I have a question for you.

S: Yeah.

J: A lot of times when you hear the drugs like this, where there's a very good indication that they don't work, like echinacea's a perfect example, if a real pharmaceutical company did real testing, as if they were going to create a brand-new drug out of it, wouldn't, you know, if you think of it that way, wouldn't it be blazingly obvious that it doesn't work? Instead of it being like "well, you know, we're not really sure and there's all this meta-analysis and they re-did this and that." If it was done the right way the first time the way that drug companies do it to get ready for FDA approval, it would be 100% unequivocally it doesn't work.

S: Well nothing's 100% unequivocal, but what you're saying is if they went through the FDA process where they had to have trials that were monitored, that had to have a rigorous design, that were multi-center, that were statistically large trials, then yes, you're going to get a much better result out of those and much more likely the results are going to reflect the underlying reality.

J: You see my point though?

S: Yeah, and this is where the waters are muddied because there are a lot of crappy studies.

J: But all of these types of drugs are, it's always like the waters are muddy situation.

S: Yeah.

J: Why don't they just do one definitive study, spend the money and that's it, and be done with it.

E: Because you've got to find someone willing to invest hundreds of millions of dollars into something that probably isn't going to work.

J: The onus should be on the people who are selling it, who are making the hundreds of millions of dollars feeding the world this crap.

E: That's a fair point.

P: Wait a minute, you're saying we should have better supplemental laws?

E: That's a great idea, Perry, that's a great point.

R: That's a new one.

P: Stick it in Congress and let it rot.

R: Somebody going to write that down.

E: Tell the FDA that.

S: The research is generally not going to get done if the industry's not required to do it. The NIH does fund some of this research, and the research that is being done that's of any quality is largely government-funded. So that's how we get what information we do have. It's enough that if you are an unbiased scientist you can look at the data and say "yeah, this is not supported by the evidence." It's not enough to completely silence the proponents. I don't know that anything would be.

E: That's right.

Questions and Emails ()

HIV and Condoms ()

Hello my skeptic warriors,

I am Christopher from Chicago Illinois. Well close enough at least. Anyways, I have been listening since this May and finally caught up with all your podcast's. I am sure you get enough thanks, but, thank you for your show. It really does bring hope into my life, as I am sure it brings hope to all your other listeners.

I do not have a microphone so an email will have to do.

QUESTION:

There are two parts to this question.

I hear from my only friend that latex condoms has little tiny holes that the HIV virus can travel through. Therefore, he chooses not to ever have sex, ever! This frustrates me since I took the time to look up this information on the internet and pretty much found nothing. The only thing I found that said condoms do not protect was religious websites.

Also, even if you have unprotected sex with someone that is HIV positive, is it true that it is not a for sure thing that you will get HIV. I am sure the risks are extremely high, but as I hear Penn and Teller say on their abstinence episode, it exposes you to a 1 and 500 risk. Is that true or pretty close? My good friend common sense tells me that they are close.

One more thing you do not need to read off but if you must...this friend of mine works in a hospital as a computer technician, but he ignorantly will not talk with real doctors about this matter. He has a few views I disagree with. He believes in ghosts from personal experiences when he as 7...and he thinks the whole field of psychology is, for lack of a better word, crap. I feel there is hope with him, but I need some better proof that this myth is bunk. Then I will work on his waking dreams he has told me about, er I mean his ghostly experiences.

I really hope you can answer my question (on or off the show). As I know, you have young listeners that listen to this show. I do not want the school's ignorance only, er I mean abstinence only education to scare people out of having sex. Which I fear is happening in some or most our schools these days. Sex is a wonderful and beautiful experience. Sadly control freaks want to scare us out of doing such, "sinful" things.

Am I right to think, that using condoms properly greatly reduces your changes of getting an STD, but most importantly, that the evil HIV that cannot pass through the holes of latex condoms?

Thanks guys, peace,

Christopher...NOT Chris!

My links I found that were good enough for me: http://www.everything-condoms.com/condom_qanda/condoms_protect_against_std.htm http://www.communityactionkit.org/pdfs/Getting_Ready_To_Advocate/Debunking_C ondoms.html http://www.cdc.gov/nchstp/od/latex.htm http://www.unknownnews.net/031010vatican.html

From Steve's reply to Christopher: Here is a review of the evidence by the CDC: http://www.cdc.gov/hiv/resources/qa/condom.htm

Chiropractic and Colic ()

My sister, after dealing with a crying and screaming baby for several long days and nights, decided to take the baby girl to a chiropractor.

I'm not a medical expert, but I've read enough to be skeptical, so I questioned her about it. We had a long discussion, but here's the main point I don't entirely understand:

My sister says all the nerves coming off the spine control different parts of the body, so if a nerve is pinched and causing pain somewhere, a chiro can "unpinch" that nerve and relieve the pain.

I know some chiros claim that they can affect, say, things like asthma by manipulating the part of the spine connected to the lungs, which I'm fairly certain is nonsense.

However, if the baby does have a pinched nerve (the type of nerve that can cause pain if pinched), can the chiro actually unpinch that nerve and kill the pain (which may or may not be causing the baby to cry)?

My sister claims this is true because her husband suffered a brain injury a few years ago, and during his recovery they stiumlated various parts of his spine to see if he could feel in other parts of his body.

I'm just trying to wrap my head around all of this, and I'd like to know what, if anything, a chiro can offer in this instance.

Also, I was concerned about a chiro handling a two-month old, but my sister claims he's very gentle. I'm still not convinced it's a good idea, though.

Thanks for the great podcast, Adam Finley Minneapolis, Minnesota

Sagittarius Dwarf galaxy and us ()

This link: viewzone.com/milkyway.html tells us that the Solar System actually came from the Sagittarius Dwarf galaxy, currently orbiting and being eaten by the Milky Way. I've researched on the Sagittarius Dwarf galaxy and found out that it is true that the galaxy is currently interacting with the MilkyWay, and it is true that it is actually raining down stars in the area where Solar System is now, which I found surprising and very interesting: en.wikipedia.org/wiki/Sagittarius_Dwarf_Elliptical_Galaxy http://www.solstation.com/x-objects/sag-deg.htm

What I don't buy is the conclusion taken that the Solar System was actually a son of this galaxy and not the Milky Way, apparently explaining why our System is not aligned with the Milky Way, and the Milky Way is seen sideways to us in the sky.

I then reached a paragraph at the end that concludes that this interaction between the two galaxies is raising the 'energy levels' of the Milky Way, causing the Sun to burn hotter. Ahh, the Plot thickens. Parry is now probably liking this guy.

It seems to me that this is the result of one more attempt to explain away Global Warming as not caused by human action, now that the latest IPCC report has left less room for the Global Warming Skeptics (I think Parry is one of them) to maneuver.

I definitely do not have enough astronomical knowledge to argument with most of the stuff these guys are saying, but it looks like crap to me. I would love to hear your take on this, maybe an astronomer guest could also shed more light in the subject and tell us more about the very interesting story about the SagDEG and our other close neighbors.

Late congratulations on the 100th episode, I'm holding my breath for the 1000th, 17.3 years from now.

Petrucio Brazil

Bad Astronomy Blog entry on this topic: http://www.badastronomy.com/bablog/2007/06/28/alien-sun-followup/

Sickesz Followup ()

Dear Skeptics,

Thank you for a good podcast and in the latest edition drawing my attention to a case that happened in my old country the Netherlands (I have been living in Israel for nearly 10 years). The case of Sickesz vs. the Vereniging tegen de Kwakzalverij is indeed a terrible miscreant of Dutch justice. I very much hope the VtdK will appeal to the supreme court.

I have blogged about this at: anneisaman.blogspot.com/2007/07/perry-deangelis-is-right-sgu-podcast.html anneisaman.blogspot.com/2007/07/perry-deangelis-is-right-sgu-podcast.html

Cheers, Anne Frid de Vries

Name That Logical Fallacy ()

Hello guys!

Thank you for a very entertaining podcast. I tune in every week only because of its entertainment value. And you are doing a great job....

To assume the role of arbiters as to whether it is science or pseudo-science, on almost everything under the sun... it is simply arrogance...

You are using very simplistic arguments, which you call "logical reasoning", when in many cases things are much more complex...

You are acting as if you know everything... every subject matter. Come on guys a little humility...

The fact that you do not grasp certain concepts does not make them wrong and candidates to ridicule... Couldn't this be a measure of your own intrinsic limitations? Just a question...

Best regards,

Athanasios Zacharakopoulos

Athens, Greece

Skeptical Puzzle ()

This Week's Puzzle:

In 1967, a famous building was attacked. The attackers attempted to use supernatural abilities to drive out its evil spirits, and to disfigure and displace the building with its occupants inside. The attack failed.

Name the building.

Last Week's puzzle:

Identify the 6th number in this sequence:

.426
.424
.420
.420
.409
????

Answer: .408 (highest batting average of baseball hitters since 1900) Winner: Kanuck

Skeptical Quote of the Week ()

The primary tool of science is skepticism, whose light shrivels unquestioning faith.

Mike Huben, an American educator of some note.

S: The Skeptics' Guide to the Universe is produced by the New England Skeptical Society in association with the James Randi Educational Foundation. For more information on this and other episodes, please visit our website at www.theskepticsguide.org. Please send us your questions, suggestions, and other feedback; you can use the "Contact Us" page on our website, or you can send us an email to info@theskepticsguide.org'. 'Theorem' is produced by Kineto and is used with permission.

References