Sniffle. It's allergy season again. Do those shots work?

Ah, spring is in the air. The flowers are blooming and the trees are bursting into leaf.

For many of us, this time of year means one thing: allergies. The price of going outside for any length of time is sneezing and itchy eyes that last for many hours, even after we return indoors. Rather than going out and enjoying the warm air and colorful vegetation, we close the doors and windows and stock up on antihistamines and eye drops. Studies show that 20–40% of people in the U.S. have allergies.

Your local pharmacy has shelf after shelf of allergy treatments, ranging from mildly effective (Zyrtec and its equivalents) to laughably ineffective (anything homeopathic). But even the best pills have side effects, and they only serve to suppress the symptoms. As one study put it:
"Patients struggle to alleviate their misery, frequently self-adjusting their treatment regimen of over-the-counter and prescription medications because of lack of efficacy, deterioration of efficacy, lack of 24-hour relief, and bothersome side effects."
Isn't there a way to tell your body to just stop it already? After all, pollen is not a pathogen. Our misery is caused by our own immune system's over-reaction: it ramps up in response to the foreign particles (pollen) in our eyes and airways and creates a histamine reaction, which is simply not necessary.

None of the over-the-counter pills prevent this reaction, but they can dampen it–hence the term "antihistamine." However, what if there were a way to tell your body to simply chill out and ignore the pollen?

Well, maybe. You can get allergy shots. This is a surprisingly simple procedure: your doctor takes a small, diluted amount of the allergen (pollen, cat dander, etc.) and injects it into your arm. Over the course of many months, your doctor will very gradually increase the amount being injected. You have to go for the shots every week, and continue them for several years.

The question is, do they work? The answer is a qualified yes.

NIH and the Agency for Healthcare Research and Quality (AHRQ) have put together a long explainer of the evidence for and against allergy shots, which you can find at PubMed Health. The NIH study looked at 74 clinical studies of allergy shots. To save you some time, I'll cut to the chase: the evidence is quite good that shots work. Or, as the AHRQ study put it,
"we found high grade evidence that subcutaneous immunotherapy reduces rhinitis/rhinoconjunctivitis symptoms."
This might seem like pseudoscience, but it's not: what's happening is that your immune system is being de-sensitized to the allergen. It doesn't work for everyone, but in many people, this gradual de-sensitization trains their immune system not to react so badly. It's not necessarily permanent, either: after stopping the shots, allergies might re-appear after a few years.

So if you're looking out your window at the beautiful spring weather with a box of tissues by your side, maybe you have a way out. Talk to your doctor or visit the AAAAI site to find an allergy specialist. Don't expect miracles or a quick fix, but allergy shots are the best we've got, for now.


Anti-vaxxers use religious exemptions as false cover for their beliefs

History of measles in the 20th century.
For several years now, anti-vaxxers have been claiming that they have religious objections to vaccines. This is nonsense.

Just last month, the New England Journal of Medicine featured an article describing how the federal Equal Employment Opportunity Commission (EEOC) has been suing hospitals that deny employee requests for religious exemptions to the hospitals' vaccination requirements. The NEJM documented 14 cases where employees sued claiming that they had religious objections to the flu vaccine. Six of the cases were settled, and in the other cases, sometimes the hospital won, sometimes the employees. It's a mess.

The NEJM article focused on the legal perspective, advising hospitals on how they might avoid lawsuits. That's understandable, but it misses the broader point: there's virtually no such thing as a religious objection to vaccines. All of the world's major religions support vaccination, and only a few tiny, extremist sects teach their followers that vaccines are contrary to their faith.

What's really going on is that anti-vaxxers are using religious exemptions as cover for non-religious (and erroneous) objections to vaccines. The anti-vaxxers have convinced people that vaccines are harmful, or scary, or both. They are wrong.

Vaccines are the probably the greatest success story in the history of medicine. They've saved millions of lives. Consider that in the decade before the measles vaccine was introduced in 1963,
"3 to 4 million people in the United States were infected each year [and] an estimated 400 to 500 people died, 48,000 were hospitalized, and 1,000 suffered encephalitis (swelling of the brain) from measles." (Source: CDC)
And that's just measles. People no longer suffer and die from smallpox and polio, which have been eradicated worldwide (except for a few countries where polio still has a foothold). Vaccines protect us from multiple other formerly common childhood infections, and they've been so effective that people are no longer afraid of these diseases. That very success is the opening that the anti-vaxxers use to spread disinformation and fear.

It's not just the EEOC that has been enabling anti-vaxxers. Many U.S. states have passed laws that allow religious exemptions to vaccination. (Note that vaccines are required before children can enroll in public school systems, an incredibly important public health requirement. The exemptions refer to this requirement.)

Here, though, there are signs of hope. After suffering from repeated outbreaks of preventable diseases like measles, many states have recently awakened to the risks caused by unvaccinated children in public schools, and they are moving to remove or tighten these exemptions.

New Jersey is the latest state to act. While the bill introduced in the New Jersey legislature last week doesn't quite eliminate religious exemptions, it makes them harder to get, requiring considerably more documentation from parents claiming a religious exemption from vaccines for their children. NJ took action after realizing that these so-called "religious" objections had risen dramatically, from 3,865 in 2009 to 10,407 in 2016. That rise was fueled, apparently, by anti-vaxxers taking advantage of the loophole in the law, not by any genuine religious objection to vaccines.

It's worth noting that all states allow medical exemptions to childhood vaccination, which are legitimate and necessary. For example, a child undergoing leukemia treatment may have a severely weakened immune system, and a vaccine would be ineffective and possibly harmful. These children are precisely the ones who can only be protected by requiring all the other children in their school to be vaccinated.

Meanwhile, the EEOC should stop suing hospitals. Hospitals are filled with very sick and vulnerable people, and employees have an obligation not to expose patients to possibly deadly infections. If a hospital employee doesn't take that obligation seriously, then s/he should find another job.

Here's $142M we'll be wasting on pseudoscience in the new US Budget

After much unnecessary drama and 6 months late, Congress finally passed a budget last week funding the government for the fiscal year that started in October 2017. While much of the news is good, or at least not too bad, the 2,232 page budget contains lots of goodies for special interests.

I downloaded the whole thing so you don't have to.

One of the worst pieces of wasteful spending is tucked away on page 934: $142,184,000 for the National Center for Complementary and Integrative Health. Incredibly, this is a 9% increase over the NCCIH's 2017 budget of $130.5 million. Is this because they've discovered new and effective treatments? Alas, no.

NIH has been spending money on so-called alternative medicine since 1992. Over the years, the budget has increased from just $2 million to the very hefty $142 million this year. NIH has now spent a total of $2.366 billion dollars on its alternative medicine center.

The NCCIH started as an "office," funded by a $2 million earmark by former Senator Tom Harkin, who later elevated it to a National Center called NCCAM. On Harkin's retirement in 2015, his buddies renamed it as NCCIH, adopting the buzzword "integrative" as a jazzier word than "alternative." It's a classic (and sad) example of how once something gets started by Congress, it grows relentlessly, creating its own constituency of people and industries who consume the funding and clamor incessantly for more.

What have we learned for our $2.4 billion? Have new cures been developed, new medicines been discovered? Has NIH provided good scientific evidence that any of the "alternative" methods–which include acupuncture, homeopathy, naturopathy, Ayurveda, therapeutic touch, reiki, aromatherapy, and others–actually work? The answer to all these questions is no.

On the other hand, the real work of biomedical research, funded by the rest of NIH, has yielded tremendous progress on a wide range of diseases. These include cures that we could only have dreamed about 10 or 20 years ago, such as this amazing stem cell cure of a 7-year-old boy with a devastating skin disorder, or this leukemia treatment reported in 2013.

After 26 years and $2.3 billion spent trying–and failing–to prove that alternative medicine works, it's long past time to end this nonsense and shut down NCCIH, as I and many other scientists have been saying for years. That $142 million could be used far more effectively studying real treatments for real diseases, rather than imaginary treatments that have failed, time and again, to prove their merits.

$142 million. To those who argue that it's only a small percentage of the NIH budget, I would point out that a typical NIH research grant is under $500K. This means we could fund at least 300 additional biomedical research projects every year if we got rid of this giant special-interest earmark that has utterly failed to produce anything useful.

Instead, someone in Congress managed to sneak in the largest budget increase that NCCIH has seen in 15 years. What a waste.

Starving science: a petty, shortsighted national "strategy"

This image taken approximately 438 miles above the earth's
surface provides a spectacular view of the Lena Delta in
Russia. Image courtesy of the U.S. Geological Survey, whose
 images are all in the public domain.
150 years ago, passenger pigeons were so numerous that they could black out the sky when their flocks passed overhead. The last passenger pigeon, a female named Martha, died in the Cinncinnati Zoo in 1914. All we have left of this species are specimens held in museum collections.

One of the most extensive collections of animal specimens in the world is managed by a tiny unit of the U.S. Geological Survey, called the Biological Survey Unit. A small group of curators maintains a collection of more than one million animals collected over the past 130 years by scientists and ordinary citizens across the U.S.

Now, for reasons that are at best mysterious, the USGS is planning to eliminate the Biological Survey Unit. The BSU has a very small budget, a mere $1.6 million out of the USGS's budget of $1.1 billion, and an even tinier fraction of the country's $4.4 trillion budget.

What the heck are they thinking? Shutting down the Biological Survey Unit won't save enough money in the vast government budget to even be noticed, but the loss of its precious collections will reverberate through the decades. Does someone in the USGS or the Department of the Interior have a grudge against the BSU? Or are they just petty?

The BSU's collection resides in the Smithsonian Museum of Natural History, one of the great museums of its type in the world. The collection contains some 370,000 birds, 300,000 mammals, and 390,000 amphibians and reptiles, many of them dating back to the late 19th century. These specimens represent a unique view back in time, illustrating the natural history of our continent and the animals that have lived on it over the years.

It's only through collections like this that scientists can understand how human activities have affected our natural world. For example, historical collections of eggs from wild birds allowed scientists to document the thinning of eggshells caused by the pesticide DDT, which was made famous by Rachel Carson's book Silent Spring.

Just a few weeks ago, the presidents of three of the leading animal science societies in the U.S. wrote a letter to Science magazine pleading for the USGS to continue funding its Biological Survey Unit. So far, the USGS has not responded to them.

Museum collections may not be as flashy as some areas science (perhaps we need a new Indiana Jones movie to raise their profile), but that doesn't mean they are not critically important to our understanding of the natural world. Once the BSU disappears, it's not coming back: the curators will retire or find other jobs, and the collection will become inaccessible, even if it still exists somewhere in the bowels of the Smithsonian.

The plan to shutdown the Biological Survey Unit seems indicative of a larger trend of neglecting investment in our future. It may reflect a particular form of neglect by the USGS, as pointed out by Cynthia Ramotnik in a 2015 article. It also reflects the severe cut to the USGS budget proposed by Donald Trump last month: he requested a total budget of $860 million, which represents a 20% cut from the current year's budget of $1.08 billion. But in the case of the BSU, the budget impact is so small that it seems worse than neglectful to cut it: it is shortsighted and petty.

When asked by the Washington Post, former House speaker (and current Trump enthusiast) Newt Gingrich admitted that the cutting the BSU's $1.6 million budget wouldn't matter to the larger budget, but he then went on to comment, “if this collection is that valuable, there are probably 20 billionaires that could endow it.”

Great: let's hand over our national resources to billionaires, and if they're not interested, well, it must be that the resources weren't that valuable in the first place. Not.

This is ridiculous. We're still a rich country, and we shouldn't be eliminating projects like the Biological Survey Unit just to give a massive tax cut to rich people, or just to make a point about budget cutting, or whatever the reason that the USGS and the Department of the Interior might offer. (The USGS hasn't responded to my inquiries.) Maintaining our museum collections not only shows respect for the thousands of people who built them over the years, but it benefits the countless scientists, educators, school children, and others who will learn from these collections in the future.

Coffee causes cancer. Coffee prevents cancer. Who to believe?

California might soon start requiring Starbucks to warn its customers that coffee causes cancer. Has  California gone nuts, or is there something to this?

A lawsuit filed in 2010 by a group called the Council for Education and Research on Toxics is in its final stages, and the judge might rule soon unless the plaintiffs settle the case. Several of the plaintiffs, including 7-Eleven, have already settled and agreed to post warnings in their stores.

The basis for the lawsuit is that brewing hot coffee produces acrylamide, which is on a list of substances that California claims cause cancer or reproductive toxicity. (It's a very long list.) Even though acrylamide has been on the list since 1990, it wasn't until 2002 that Swedish scientists discovered that acrylamide is present in many foods.

As the American Cancer Society explains,
"Acrylamide is found mainly in plant foods, such as potato products, grain products, or coffee. Foods such as French fries and potato chips seem to have the highest levels of acrylamide."
Uh oh. Coffee, french fries, and potato chips. Where's the joy in life without these?

But wait a second: how come people aren't keeling over with cancer left and right, especially in our coffee-loving, french-fry-loving society? (And what about the French?)

It turns out the evidence against acrylamide is pretty sketchy. If you give it to mice in the lab, at doses 1000 times greater than the amounts found in food, it does seem to increase their risk of cancer. But mice are not people, and 1000 times is a whole lot of acrylamide. The ACS concludes that
"it’s not yet clear if acrylamide affects cancer risk in people."
It's just as easy to find claims that coffee prevents cancer. A 2017 review found that one cup of coffee a day is associated with a slight reduction in the risk of liver cancer and endometrial cancer. A 2010 review of over 500 studies found the same reductions, but a slight increase in the risk of bladder cancer among heavy coffee drinkers. Another large review in 2017, by Robin Poole and colleagues in the UK, found not only a reduced risk of cancer, but a reduction in heart disease and overall mortality.

The Poole study concluded:
"Coffee consumption seems generally safe within usual levels of intake, with [the] largest risk reduction for various health outcomes at three to four cups a day, and more likely to benefit health than harm."
Coffee lovers, rejoice! But let's not kid ourselves: no one is drinking coffee for its health benefits, are they? The stuff just tastes good.

Finally, in answer to my own question at the top of this article: yes, California has gone a bit nuts. Or, as the nonprofit American Council on Science and Health put it:
"If coffee is deemed carcinogenic, then the State of California will be required to give up all pretense at common sense and sanity."
An afterthought: the lawsuit may be just about money. As Bloomberg News explained last October, in a story about the California coffee case: "Unfortunately, it is very easy for ‘bounty hunters’ to file Prop. 65 lawsuits against even small businesses and the cost of settlement and defense often exceeds other types of abusive litigation." The American Council on Science and Health was even more blunt, calling it an attempt to grab "a giant bag of money."

Let's hope the judge in the California case pays attention to the science. Meanwhile, the rest of us can focus on more important questions, such as: dark roast or light? French press or drip?

The federal government is wasting over half a billion dollars a year on chiropractic and osteopathic manipulation

A book on the abuses of chiropractic,
written by a former chiropractor
Here's a quick way for the U.S. government to save over half a billion dollars. Stop paying for coverage of medical procedures that have little or no evidence to support them.

The Centers for Medicare and Medicaid Services (CMS) now releases annual reports of how much it spends, broken down according to the procedures. Their latest data, for the year 2015, reveals that Medicare spent $564,165,721 on pseudoscientific medical practices.

I'm talking about chiropractic and osteopathic manipulation. These are similar but distinct belief systems, both involving bones, and both with little high-quality evidence to back them up. Most people think that chiropractors' spinal "adjustments" can relieve pain from injured or aching backs. It turns out that it's just an elaborate placebo: a back rub at home is likely to work just as well. And that home treatment is probably safer–I'll get to that below.

Osteopathic manipulative therapy (OMT) was invented out of whole cloth in the mid-19th century by Andrew Still. Still believed that every part of the body was linked by a mysterious "myofascial continuity" and that manipulating it could treat a vast range of aches, pains, and other ailments. Most of this is not true. (There is some evidence that OMT can be beneficial in carefully selected cases of lower back pain, but the evidence is quite thin (see this review), and the CMS codes don't distinguish different uses of OMT.)

Osteopathic manipulation is what Larry Nassar, the now-convicted sexual predator, claimed he was doing to the hundreds of young girls whom he molested over the years when he was a sports doctor at Michigan State University and a doctor for the U.S. Olympic gymnastics team. (Osteopathic physicians, which is what Nassar was, generally practice real medicine, and I don't mean to suggest that any of them endorse Nassar's awful abuses. However, OMT is a relic of their pseudoscientific past, and Medicare should not be covering it.)

Chiropractic is no better than OMT. It was invented by D.D. Palmer in the 1890s, around the same time that Andrew Still was concocting OMT.  Palmer mistakenly believed that misalignments of the spine, which he called subluxations, caused a vast range of health problems, even infectious diseases. As retired chiropractor Samuel Homola has written,
there is "no evidence at all to support chiropractic subluxation theory," 
but thanks to clever marketing, chiropractors have convinced millions of people to see them on a regular basis. (See chirobase.org for much, much more.)

Even more alarming is that chiropractic adjustments carry a small but frightening risk of causing a stroke, as a result of tearing the vertebral artery, as I've written about before. In fact, the American Heart Association issued a warning in 2014 that "neck manipulation may be associated with stroke". Not surprisingly, the chiropractors association strenuously denied this, but the evidence speaks otherwise. Indeed, a 2015 study that I described when it appeared showed that Medicare patients–the same cohort whom we are paying half a billion dollars a year to provide chiropractic treatments–suffered a significantly higher risk of stroke after seeing a chiropractor than those who instead saw a real doctor.

And a 2003 study in the journal Neurology show an equally alarming increased risk of stroke due to tears in the vertebral artery after chiropractic in younger patients. The lead author of that study, Dr. Wade Smith, warned that
"physicians and patients should be aware of spinal manipulation therapy as a rare but potentially causal factor in stroke."
[Update: note that a 2016 study, in the journal Cureus, found that the link between chiropractic neck manipulation and arterial dissection was not causal; i.e., that chiropractic did not appear to cause arterial tears. However, concerns remain, as demonstrated in this 2017 case report of cerebral hemorrhage following chiropractic activator treatment.]

The 2015 numbers from the Centers for Medicare and Medicaid Services show that the vast majority of the wasted funds, $545 million, went to chiropractic treatments, with another $19 million going to osteopathic manipulation. Neither amount is justified by scientific evidence.

Let's stop wasting our money on procedures that don't help, and may harm, Medicare patients. If we want to help patients, let's insist that Medicare spend our money on real medicine.

The flu is getting worse, just as the government shuts down.

Uh oh, this is not good.

The flu season is looking particularly bad this year. We already had signs of trouble back in November and December, when it emerged that the flu vaccine was not very effective against the dominant strain that is circulating this year, which is called H3N2.

Until this past Friday, it seemed that the peak of the flu season might have occurred just around the new year, as shown in this chart from the CDC:
The chart shows a peak in the very last week of 2017, and then the number of reported cases seemed to decline. But then on Friday the CDC reported this alarming trend:
That red line spiking upward in the middle of the chart shows the number of flu-like cases reported by the CDC's national network this year. Rather than going down, the trend shows a sharp rise over the past two weeks. We don't know exactly what it is (these are not laboratory-confirmed flu cases), but more people are getting sick.

Even more alarming are the reports of young, healthy people dying of the flu. This past week the Washington Post reported on a healthy 10-year-old boy who caught the flu and died within just a few days. Just before Christmas, a healthy 21-year old young man in Pennsylvania came down with the flu, and went rapidly downhill until he was rushed to the emergency room on Dec. 27. The hospital was unable to save him, and he died the next day. These cases are truly alarming, and even though the CDC hasn't seen a statistically significant increase in deaths among young people (not yet, at least), everyone needs to take the flu very seriously this year.

With the government shut down, a difficult situation becomes worse. Most of the CDC staff will be forced to sit on their hands when they could be working–and many of them want to work, but they won't be allowed to. What's especially frustrating (and wasteful) is that the U.S. will almost certainly pay all federal employees for this forced time off, as it did in previous shutdowns.

We also need a better way to make the flu vaccine. The U.S. still relies on vaccines that are produced by growing the virus in chicken eggs, a decades-old method. This sometimes requires us to use a strain that doesn't match the circulating virus, because some strains just won't grow in eggs. So instead we manufacture a mediocre vaccine, rather than investing in new, modern technology that wouldn't need eggs and could produce more effective vaccines at lower cost. (Why are we stuck with old technology? It's a long story, but essentially it boils down to the fact that we rely completely on private companies to make the flu vaccine. The government doesn't make vaccines and has no plans to do so.)

With the right technology, we should be able to produce a universal flu vaccine, one that we can take once and never need again, like most other vaccines. Scientists are getting closer to that, with much help from the (currently shut down) NIH.

Meanwhile, we are looking at a particularly dangerous flu season, with few weapons to guard against it other than the not-very-good vaccine. (Aside: ineffective doesn't mean useless. Even if the vaccine is only 30% effective, as some estimates have it for this year, it's still a good idea. Everyone in my family got it.)

Oh, and one more thing: the flu shot cannot give you the flu. I only mention this because anti-vaxxers continue to promote this particular myth. 80% of people who have come down with the flu this year did not get vaccinated.

The #1 bogus argument that quacks and the government use to promote pseudoscience

This does not reduce pain.
Chairman Mao would be delighted, if he were alive to see it. He now has the U.S. government buying into arguments that he used to hoodwink his own people, decades ago. Never mind that the arguments are all bogus.

This morning, the front page of The Baltimore Sun describes how the U.S. Veterans Administration is using acupuncture to treat chronic pain in veterans. The VA especially likes something called "ear acupuncture," the creation (out of thin air) of a VA doctor who claims that a few needles inserted in your ear will cure pain anywhere in your body. The VA also calls this "battlefield acupuncture," and it is not only fake but also dangerous, so much so that in 2011 I labelled it the worst quackery of the year.

And yet it hasn't gone away, as the Baltimore Sun reports. The VA uses acupuncture "across the country," offering it to veterans who have little choice about their health care provider. A few years ago, the VA argued this could help veterans manage chronic pain from war injuries. Now they're claiming that acupuncture will help solve the opioid epidemic. Whether it works or not seems beside the point: a VA doctor quoted in the story argues that "if patients believe that it’s helping their pain, then it is." Unfortunately for her patients, she seems unaware that science has shown that acupuncture does not work–for anything (as Yale neurologist Steven Novella succinctly put it).

Why is the VA offering quack treatments to veterans? One reason is that these treatments are popular. The same argument appears in countless forms, but it boils down to: "the people want this, so we should give it to them."

I get it: popularity is good news if you're an actor, or a writer, or a singer, or an athlete, or especially a politician. But it means nothing when we're trying to decide if a medical practice is effective. Doctors in medieval Europe used to bleed their patients, often killing them, in the belief that sickness was caused by "ill humors" in the blood. Bleeding was popular, but it was a very bad idea.

It's not just the VA. This past fall, two Colorado Congressmen, Jared Polis (D) and Mike Coffman, (R) announced the creation of a bipartisan Integrative Health and Wellness Caucus, explaining that:
"While at least a third of Americans use complementary or alternative medicines, access is often inconsistent."
It's not surprising that Polis and Coffman believe that we should give people whatever treatments they ask for. Neither of them is a scientist, so they live in a world (politics) where popularity counts for a lot. How ironic that, in the hyper-partisan U.S. political scene today, the parties have come together to support something that is flat-out wrong.

Just stop it already. Stop arguing that just because something is popular, it must be true, or at least worth investigating (at taxpayer expense). For centuries, most humans believed the Earth was flat, but that didn't turn out to be true, though it was popular. We figured it out and moved on.

Today's versions of medieval bleeding include acupuncture, homeopathy, naturopathy, chiropractic, reiki, Ayurveda, healing touch, various "detox" treatments, and more. Science has figured out that all of these are nonsense, and moved on. (And by calling them "nonsense," I am being generous. Some of them are dangerous.) But people who make money off these practices have been waging a decades-long campaign to keep them going.

Acupuncture is a scam foisted on the Chinese people by Mao Tse-Tung, whose country was too poor to provide real medicine to its population. Instead, Chairman Mao launched a marketing campaign to convince them that the old, traditional medicine was just as good. Kimball Atwood wrote a 4-part history of these events; in part 3 he reveals this gem, from Mao's personal physician:
"Publicly, the Chairman was the leading advocate of traditional medicine, but he refused to use it himself."
And now the U.S. government has fallen for the same scam.

Universities are prey to this as well. This fall, we saw the University of California at Irvine announce a $200 million gift to create a new medical center dedicated to integrative medicine, a disturbing intrusion of junk science into the academic mission of the university. One of the donors, Susan Samueli, argued that "The public is not only interested [in integrative medicine], but they are clamoring for it.”

There it is again–the argument from popularity. And even though this might be privately funded, it is based at a public, state-funded university.

One might hope that the NIH would help set things straight. Think again. Here's an example from NIH's National Center for Complementary and Integrative Health (NCCIH:
"Many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches developed outside of mainstream Western, or conventional, medicine."
NCCIH's website is careful not to state explicitly that popularity is equivalent to evidence. But then what are they saying? That NIH thinks that 30% of Americans are wrong? (By the way, that 30% number is highly dubious. It includes a wide array of practices, some reasonable and others wacky.)

Why do we even have an NIH center devoted to integrative medicine? It's not because there's any science behind it. On the contrary, NCCIH is a monument to a deep misunderstanding on the part of former Senator Tom Harkin, who created it back in 1991. For an excellent summary of NCCIH's history, see this short video from Reason TV:

or my own talk from a 2015 conference, here. Harkin earmarked a few million dollars to create a small Office of Alternative Medicine in 1991, and with his help it grew over the years into a large, money-wasting administrative behemoth.

NCCIH's website is replete with misleading statements. After pointing out that "millions of Americans use complementary health approaches" (there's that popularity argument again), they offer this sage advice:
"Choose a complementary health practitioner, such as an acupuncturist, as carefully as you would choose a conventional health care provider."
Face, meet palm. No one shouldn't be choosing a "complementary" health provider in the first place, and NIH shouldn't be telling people to do it carefully, whatever the heck that means.

Yes, this stuff is popular. And its popularity has enriched the numerous practitioners of bad medicine, many (most?) of whom may genuinely believe that their snake oil works. But popularity doesn't make something true. Or maybe it does–I hear that the tooth fairy is very popular.