Strychnine for your child's cold - courtesy of your friendly homeopath

I was in the pharmacy section of my local grocery store last week, looking for children's ibuprofen, when I stumbled upon Children's ColdCalm, a homeopathic product from Boiron.

This stuff isn't cheap - it's $12.49 at RiteAid, and the price is similar at my local grocery stores (Giant Foods and Whole Foods). If you follow the instructions, you'll give half the package (40 pills) to your child in the first 12 hours.

Not only is it expensive, but it doesn't work - or at least there's no evidence that it does. Boiron is selling parents sugar pills and telling them that it will cure their children of colds. Here's what the package says, right on the front: "Multi-Symptom Cold Relief, Sneezing, Runny Nose, Nasal Congestion, Minor Sore Throat."

Since it's in the "Colds" section of the pharmacy, most parents probably assume this is just like any other medicine. But it's not. It's a homeopathic drug.

The manufacturer, Boiron, makes very specifc claims on their website. Here's a partial list of ColdCalm's ingredients with their claimed benefits:
Belladonna 6C HPUS * Relieves colds with a sudden onset
Eupatorium perfoliatum 3C HPUS * Relieves sinus pain
Gelsemium sempervirens 6C HPUS * Relieves headaches associated with colds
Kali bichromicum 6C HPUS * Relieves nasal discharge
Nux vomica 3C HPUS * Relieves sneezing attacks
Phytolacca decandra 6C HPUS * Relieves sore throat associated with colds
Pulsatilla 6C HPUS * Relieves colds with a loss of taste and smell
What the heck are these? Belladonna sounds familiar - oh yes, that because it's an extremely toxic plant, also called Deadly Nightshade, one of the most poisonous plants in the Western hemisphere.

And "nux vomica": that sounds suspicious. Maybe that's because it is actually strychnine! Yes, that's right, strychnine, once used as rat poison, which is fatal to adults in doses as small as 30 milligrams. I wonder how much Boiron recommends that we give to children?

According to the American Cancer Society:
"Strychnos nux-vomica has not been proven effective for the treatment of any illness. Since the seeds contain strychnine, which is poisonous to humans, conventional medical practitioners do not recommend it as a medicine. Some research has shown that the level of poison in nux vomica preparations may depend greatly on how the seeds are processed."
Need I say more? Pulsutilla, another ingredient in ColdCalm, is a poisonous plant that produces toxins that slow the heart and can cause convulsions.

Is this how they want to cure my child's cold?

But wait, these are homeopathic medicines, which means they've been diluted down to nothing. So perhaps there's so little strychnine in the pills that it won't hurt your child, at least not too much. In ColdCalm, though, the dilutions aren't as tiny as the ones used in typical homeopathic preparations: 3C is one part in 1 million, so there might be some strychnine left in these tablets. We really don't know. A huge problem here is that none of these claims have been tested, so no one (including Boiron) knows what strychnine at these dilutions does to a child. Nor can they say precisely how much strychnine is in each tablet.

You might have noticed the abbreviation HPUS in that ingredient list: this refers to the Homeopathic Pharmacopoeia, a list of homeopathic drugs. HPUS drugs cannot be regulated by the FDA. Yes, you read that right. Homeopathic drugs are approved automatically as long as the homeopaths themselves list them in their "pharmacopoeia." No evidence of efficacy is required. We have Congress to thank for this - specifically, the Food, Drug and Cosmetics Act of 1938, which granted a special exception to homeopathic drugs. The Act was authored primarily by a Senator who believed in homeopathy.

I wrote about Boiron's ridiculous Oscillococcinum flu "cure" last year, but I didn't realize they have a whole line of bogus treatments for colds and flu. And Boiron isn't some small mom-and-pop operation: it's a huge multi-national company selling nothing but homeopathic products, making huge profits selling treatments that don't work.

So parents, if you see "homeopathic" on that package in the pharmacy, you might want to look a little harder at what they're selling you.

Alternative medicine debate at The Atlantic

Over at The Atlantic, one of my favorite monthly magazines, there's a feature article by David Freedman in which I'm quoted at some length, titled "The Triumph of New-Age Medicine." As readers of this blog might guess, I have some disagreements with the title and with many of the points in Freedman's otherwise very well-written piece.

Rather than blogging about it here, The Atlantic invited me to post a response in an online debate they are having. My response, which just appeared today (June 16), is titled "A 'Triumph' of Hype Over Reality" and you can read it here. I encourage you to post comments at the Atlantic site.

Several more experts' responses will appear on this page at The Atlantic over the next few days, if you want to follow the debate. I know I will.

Chronic fatigue syndrome hypothesis collapses further

Two years ago, a team of scientists announced with great fanfare that they'd found the cause of chronic fatigue syndrome: a mouse retrovirus called XMRV. There were many media reports and much excitement, and at least a dozen studies were launched to look for this virus in more patients. Unfortunately for patients, the findings turned out to be seriously flawed.

New results published this week seem to be the final nail in the coffin for the XMRV hypothesis. The editors at Science have taken the unusual step of publicly asking the authors of the 2009 study to retract their findings. As reported in the Wall St. Journal, Science sent a letter to the authors stating:
"At this juncture, Science feels that it would be in the best interest of the scientific community'' for the co-authors to retract the paper."
In addition, the editors published an "expression of concern" this week, which is their way of warning everyone that the results are wrong. Judy Mikovits, the leader of the study, steadfastly insists that she is right and all the others are wrong.

Despite Mikovits' claims, the evidence is very clear that she is wrong. Study after study has found no trace of the virus in CFS patients. Where Mikovits' original study found 67% of the patients had XMRV, followup studies found 0%. A set of three papers in the journal Retrovirology, published in December, showed conclusively that the finding was due to laboratory contamination. The XMRV virus turned up as a contaminant in cancer cell lines that are widely used in laboratory research. As I wrote in January:
"It turns out that a common tumor cell line called 22Rv1 is infected with MLV-X. It also turns out that all the XMRV sequences from human patients are far more similar to the exact same strain of MLV-X that is in the mouse cell line. The tumor cell line was in the lab doing the experiments: ergo, it's contamination. Elementary, my dear Watson."
Two new papers in Science this week found the same thing. One of them, titled "No Evidence of Murine-Like Gammaretroviruses in CFS Patients Previously Identified as XMRV-Infected" looked at patients who had tested positive for the XMRV virus, and found that they didn't have it all. The second study provides new detail on how the XMRV virus got into the cancer cell lines.

So why does Mikovits cling so fiercely to her claims? (She posted a long letter defending herself at the Whittemore Peterson Institute, where she works.) What she doesn't say is that she has gone far beyond her original findings: she and her institute are actively promoting the use of anti-retroviral therapies for CFS patients. As Nature News reported in March,
"The WPI owns a company that charges patients up to $549 to be tested for XMRV, and Mikovits believes that patients who test positive should consult their doctors about getting antiretroviral drugs normally prescribed to those with HIV."
This is a blatant conflict of interest, and it perhaps explains some of Mikovits' stubbornness.

It gets worse. As Trine Tsouderos reported last summer in the Chicago Tribune, Mikovits claimed at the Autism One conference that XMRV also causes autism. She has no evidence to support this startling claim. Mikovits stated to the Tribune that "unless we do something now this (XMRV) could be the worst epidemic in U.S. history."

Mikovits also believes there is a conspiracy against her. In March, she told Nature "I had no idea there was that much bias against this disease." Nonsense. The collapse of the evidence about XMRV and chronic fatigue syndrome is just science doing what it is supposed to do: when a study cannot be replicated, then the hypothesis is abandoned and we move on.

This is a classic tale of a scientist gone bad. Unfortunately for CFS patients, Mikovits is distracting attention from efforts to find the real cause. By speaking at the Autism One conference, she has joined the ranks of pseudoscientists and anti-vaccinationists. It's pretty clear now that she will never retract her findings, despite the pressure from the editors at Science. I can only hope that CFS patients, who are understandably desperate for a treatment, won't be fooled into taking ineffective and possibly harmful therapies based on the failed XMRV hypothesis.