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Author Topic:   Holistic Doctors, and medicine
Asgara
Member (Idle past 468 days)
Posts: 1783
From: Wisconsin, USA
Joined: 05-10-2003


Message 271 of 304 (424209)
09-26-2007 8:56 AM
Reply to: Message 269 by Kitsune
09-26-2007 8:41 AM


Re: Linus Pauling
My daughter and I have been taking more vitamin C than this for 2 years and it has never been a problem. Nor has it been when my husband is taking it. They're quite simply wrong.

I was on Prozac for several years, my best friend was on Paxil for several years and neither one of us had any problems. In fact I credit the drug for getting my life back on track. Your ND is quite simply wrong.

Do you see how your argument is flawed?


This message is a reply to:
 Message 269 by Kitsune, posted 09-26-2007 8:41 AM Kitsune has responded

Replies to this message:
 Message 274 by Kitsune, posted 09-26-2007 9:52 AM Asgara has responded

  
Percy
Member
Posts: 18484
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.8


Message 272 of 304 (424215)
09-26-2007 9:17 AM
Reply to: Message 269 by Kitsune
09-26-2007 8:41 AM


Re: Linus Pauling
LindaLou writes:

That studies published in the most prestigious journals can be flawed.

First, it wouldn't be valid to base the rejection of science as a method for deciphering the real world upon the fact that the human beings conducting the science aren't perfect and make mistakes. Last time I checked, people were the only entities around for puzzling about the real world, whether they use the scientific method or not.

Second, no one study by itself is conclusive. Prior to replication a study on a new area can at best be considered "interesting" and worthy of further studies. When multiple studies (replications of the original study) reach the same conclusions then scientists can begin to develop some confidence that they've learned something that is actually true about the real world.

Third, whatever the faults of the scientific method due to the foibles of its practitioners, those same foibles also contribute to anecdote, and to a far greater degree.

It is not standard practice for an AD study not to include a placebo group.

Sounds like a red flag to me. If this study truly isn't valid then the solution is to repeat the study properly and not to rely upon anecdote.

This study does not show that ADs help millions of people, though I'll hazard a bet that many were put on the drugs anyway after this study was published. You see web sites crowing, "third time's the charm." What you don't see are studies on how stopping these meds abruptly and switching them affects the body and specifically the CNS. No one seems to be interested in doing those.

Sounds regrettable to me, too. There are dozens of flaws in the way decisions are made about which studies will go forward. Replication studies can be some of the most difficult to obtain funding for, because a grant application to repeat a study will often be denied because it repeats work already done. Well, duh! That's the whole idea. So grant applicants have to propose a variation around the study they intend to replicate, but that can make comparisons difficult. And there are many other such problems in medical research.

But the solution is not anecdote.

My daughter and I have been taking more vitamin C than this for 2 years and it has never been a problem. Nor has it been when my husband is taking it. They're quite simply wrong.

I couldn't hope for a better example of anecdote. Missing from personal endorsements like this is any reliable information about actual efficacy, side effects, cautions, impact on existing medical conditions, mixing with other supplements or drugs, or long term effects after 5 years, 10 years, 25 years across a diverse segment of the population. Only double-blind studies can accurately ferret out such information.

--Percy


This message is a reply to:
 Message 269 by Kitsune, posted 09-26-2007 8:41 AM Kitsune has not yet responded

  
Kitsune
Member (Idle past 2466 days)
Posts: 788
From: Leicester, UK
Joined: 09-16-2007


Message 273 of 304 (424217)
09-26-2007 9:31 AM
Reply to: Message 270 by Percy
09-26-2007 8:51 AM


Re: A Few Comments
Your discussion of peer-reviewed studies is sound Percy; faint praise coming from a non-scientist maybe, but I do see abstracts cited here as if they themselves represent the final proof of the issue. As I have said, these studies can potentially be flawed in a number of ways, and it behooves anyone to look at them critically before they accept what the scientists have said as fact. Case in point, as I mentioned above, was STAR*D.

That is what I meant by the "correct amounts" of vitamin C. Not that there are any such Platonic ideals out there, but that the scientists who do these studies need to verify the amounts that Pauling used if they aim to replicate his results. Pauling himself was continually frustrated by studies that received widespread media coverage claiming that he was wrong about vitamin C; time and time again he investigated them, and found they had used significantly less than the amount that he had used, or that the vitamin had been given orally instead of intravenously.

I take your point about there being few peer-reviewed studies about diet and vitamins. I want to see more research and more trials. Who will do them though, and who will pay? The mainstream is not interested. Look at what happened to Pauling. He won a Nobel Prize for his work on vitamin C. There should have been much more research done after this. Instead those flawed studies were conducted, interest dwindled, and now few people believe or are even aware of Pauling's recommendations. The money is all in the pharmaceuticals. It's a big motivator.

I also get your point about anecdotes. If you are a skeptic, correct me if I'm wrong, but you don't accept them as evidence. If 100 people say something, it might simply mean that 100 people are wrong. However, there's always the possibility that some of them are right. Or even all of them. By dismissing each person's testimony you are also possibly dismissing some windows to the truth. I and many other people I have met, have had powerful experiences brought about by the medications we took, and we support each other in healing. I repeat, that may mean nothing to a skeptical mind, but I know it works for me. I've been discussing skepticism in 2 other threads here as well. It's a topic I've never discussed with anyone before and I'm interested to find out how people apply it in their lives.


This message is a reply to:
 Message 270 by Percy, posted 09-26-2007 8:51 AM Percy has responded

Replies to this message:
 Message 276 by Percy, posted 09-26-2007 10:16 AM Kitsune has not yet responded
 Message 277 by Asgara, posted 09-26-2007 10:17 AM Kitsune has responded
 Message 288 by molbiogirl, posted 09-26-2007 12:19 PM Kitsune has not yet responded

  
Kitsune
Member (Idle past 2466 days)
Posts: 788
From: Leicester, UK
Joined: 09-16-2007


Message 274 of 304 (424220)
09-26-2007 9:52 AM
Reply to: Message 271 by Asgara
09-26-2007 8:56 AM


Re: Antidepressants
My ND helps people who have been damaged by these drugs. She knows what they can do to the body, but also that people have biochemical individuality and react in a huge spectrum of ways to them. So no, I don't see how she's wrong.

I also quite accept that many people do not have the sort of negative experience I had, and even feel that they've been helped or that their lives have got back on track, as you said. If that's the case for you and your friend then I am glad, and I hope that neither of you will have to feel that you need to take the meds again.

However, I said earlier here that naturopathy views mental illness (including depression) as a symptom, rather than a disease in itself. A number of things can cause it: nutritional deficienies, toxins in or outside of the body, stress, life circumstances, etc. (Please, no one ask me for peer-reviewed studies for this. I think we've established that people don't seem to want to do studies on these things.) Depression is often a signal that something in one's life needs changing. Sometimes even if a person feels that a drug has relieved their depression, it might also have relieved them of the need to take responsibility for putting right whatever had gone wrong and caused the depression in the first place. There are no guarantees that these problems won't still exist, or recur, once the drug is discontinued. Pain, whether physical or emotional, tells us that something is wrong. These drugs numb the pain.

If you feel you have addressed the underlying cause of the depression or whatever the reason was that you took the drug, then that's great. Sometimes it can take a person years to work this out, and some never do.

Too many doctors prescribe a drug without looking into the kinds of factors I mentioned above. Nutritional deficiencies can cause depression; sugar can cause it. Sugar acts on opiate receptors in the body. If you look up the definitions of deficiency diseases like pellagra or beri beri, you will find that mental illness can be a symptom. Most people in the developed world do not develop full-blown deficiency diseases, but according to most NDs many Americans have subclinical deficiencies due to the standard American diet (SAD).

I'm talking here from life experience, from the shared experiences of others who have taken these kinds of drugs, from the advice that my ND has given me, and from what I've read in books and articles by people like Dr. Breggin, Dr. Healy and Dr. Moncrieff. Again I know it's anecdotal, but it's the best I can do in the absence of clinical studies.

Linus Pauling's mother suffered chronic mental illness for years. It was only upon her death that her physicians realised that she had been suffering from pernicious anaemia. If anyone had thought to check her blood levels of B12 and given her an injection, it would have saved her. This was one possible motivator for Pauling's subsequent interest in vitamins.

Edited by LindaLou, : No reason given.

Edited by LindaLou, : No reason given.


This message is a reply to:
 Message 271 by Asgara, posted 09-26-2007 8:56 AM Asgara has responded

Replies to this message:
 Message 275 by Asgara, posted 09-26-2007 10:10 AM Kitsune has responded
 Message 289 by molbiogirl, posted 09-26-2007 12:31 PM Kitsune has not yet responded

  
Asgara
Member (Idle past 468 days)
Posts: 1783
From: Wisconsin, USA
Joined: 05-10-2003


Message 275 of 304 (424222)
09-26-2007 10:10 AM
Reply to: Message 274 by Kitsune
09-26-2007 9:52 AM


Re: Antidepressants
I think you misunderstood what I was trying to say. I was throwing your exact method of argument back at you. Your point was that since you, your daughter and your husband take megadoses of C with no problems that the medical establishment was "simply wrong." I simply did the same thing, stating that my experience showed you to be "simply wrong."

Side effects do not happen across the board and the effect that the drug is being prescribed for do not happen across the board. There are going to be those that a drug helps and those that it doesn't. There will be those that feel no effects and those that have every side effect possible happen to them.

This is why argument by anecdote is not convincing. The convincing issue is what percentage of those taking a particular drug experience relief, what percentage are harmed. What is the risk / benefit equation? These statistics are just not available for most alternative options as they have not been tested and are not regulated.


This message is a reply to:
 Message 274 by Kitsune, posted 09-26-2007 9:52 AM Kitsune has responded

Replies to this message:
 Message 278 by Kitsune, posted 09-26-2007 10:18 AM Asgara has not yet responded

  
Percy
Member
Posts: 18484
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.8


Message 276 of 304 (424224)
09-26-2007 10:16 AM
Reply to: Message 273 by Kitsune
09-26-2007 9:31 AM


Re: A Few Comments
LindaLou writes:

Your discussion of peer-reviewed studies is sound Percy; faint praise coming from a non-scientist maybe, but I do see abstracts cited here as if they themselves represent the final proof of the issue.

I'm familiar with the others participating in this thread, and none of them would conclude that studies represent proof, and further, they understand that within science there is no such thing as proof. You can introduce evidence from studies in support of a theory, but the theory remains always falsifiable through the discovery of new evidence and/or the evolvement of improved insights.

I think what other participants are trying to get it is: 1) how poor anecdote is on an absolute scale as a source of medical guidance; and 2) the vast superiority of the scientific method as a way of determining the effects of any medicine or treatment.

Here's an anecdote for you. Up until 15 years ago, my wife was a friendly but shy person with a few close friends who were also on the shy side. In fact, a majority of my wife's closest friends from college never married and might even be considered socially challenged. Then my wife went on antidepressants and the difference has been like night and day. She became suddenly social, a girl scout leader, a joiner and participator, and she developed a broader circle of friends (who though mostly married seem to have man-trouble in common, go figure).

What would I recommend from this experience? That people who think they might be depressed should seek professional medical help with whom they can develop approaches and protocols appropriate for them.

I also get your point about anecdotes. If you are a skeptic, correct me if I'm wrong, but you don't accept them as evidence.

I would resist labels like "skeptic", and I accept everything as evidence. But I understand the night and day difference between the quality of evidence from anecdotes versus double-blind study. People are extremely poor judges of the effects of treatments on their own health, not to mention that one's personal experience often does not generalize to others.

If combined with anecdotes from others you've trial-and-error'd your way into an alternative medical treatment regimen that works for you, then I think that's wonderful, but also lucky, and one must resist the conclusion that anecdote is a valid alternative to traditional medical approaches developed using the scientific method.

--Percy


This message is a reply to:
 Message 273 by Kitsune, posted 09-26-2007 9:31 AM Kitsune has not yet responded

  
Asgara
Member (Idle past 468 days)
Posts: 1783
From: Wisconsin, USA
Joined: 05-10-2003


Message 277 of 304 (424225)
09-26-2007 10:17 AM
Reply to: Message 273 by Kitsune
09-26-2007 9:31 AM


Re: A Few Comments
The mainstream is not interested. Look at what happened to Pauling. He won a Nobel Prize for his work on vitamin C. There should have been much more research done after this

Just a small nitpick. Linus Pauling did not win a Nobel Prize for his work on Vitamin C.

His Nobel Prize in Chemistry was for his work describing the nature of chemical bonds.

There was more research into vitamin C after Pauling. That is how we know that megadoses can cause nausea, vomiting, diarrhea, flushing of the face, headache, fatigue, disturbed sleep and rashes.


This message is a reply to:
 Message 273 by Kitsune, posted 09-26-2007 9:31 AM Kitsune has responded

Replies to this message:
 Message 279 by Kitsune, posted 09-26-2007 10:20 AM Asgara has not yet responded

  
Kitsune
Member (Idle past 2466 days)
Posts: 788
From: Leicester, UK
Joined: 09-16-2007


Message 278 of 304 (424226)
09-26-2007 10:18 AM
Reply to: Message 275 by Asgara
09-26-2007 10:10 AM


Vitamin C
What was said here was that 2000mg of vitamin C causes stomach pain and diarrhoea. It was not qualified, which makes this an absolute statement. The fact that I and people I know can take 10 times this amount with no stomach pain or diarrhoea would rather cast doubt on its validity.
This message is a reply to:
 Message 275 by Asgara, posted 09-26-2007 10:10 AM Asgara has not yet responded

Replies to this message:
 Message 280 by Percy, posted 09-26-2007 10:23 AM Kitsune has responded
 Message 284 by Vacate, posted 09-26-2007 11:02 AM Kitsune has not yet responded

  
Kitsune
Member (Idle past 2466 days)
Posts: 788
From: Leicester, UK
Joined: 09-16-2007


Message 279 of 304 (424227)
09-26-2007 10:20 AM
Reply to: Message 277 by Asgara
09-26-2007 10:17 AM


Re: A Few Comments
There was more research into vitamin C after Pauling. That is how we know that megadoses can cause nausea, vomiting, diarrhea, flushing of the face, headache, fatigue, disturbed sleep and rashes.

Can you link to an abstract at all? I think it's important to know the methodology, the amounts, what -- if any -- illnesses were present, what the study was aiming to discover, etc.


This message is a reply to:
 Message 277 by Asgara, posted 09-26-2007 10:17 AM Asgara has not yet responded

  
Percy
Member
Posts: 18484
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.8


Message 280 of 304 (424229)
09-26-2007 10:23 AM
Reply to: Message 278 by Kitsune
09-26-2007 10:18 AM


Re: Vitamin C
LindaLou writes:

The fact that I and people I know can take 10 times this amount with no stomach pain or diarrhoea would rather cast doubt on its validity.

Boy are you ever missing the point!

So let's say Asgara goes out and finds people who suffer adverse effects from megadoses of vitamin C. Anecdote contradicts anecdote. Now what?

--Percy


This message is a reply to:
 Message 278 by Kitsune, posted 09-26-2007 10:18 AM Kitsune has responded

Replies to this message:
 Message 281 by Kitsune, posted 09-26-2007 10:31 AM Percy has responded

  
Kitsune
Member (Idle past 2466 days)
Posts: 788
From: Leicester, UK
Joined: 09-16-2007


Message 281 of 304 (424231)
09-26-2007 10:31 AM
Reply to: Message 280 by Percy
09-26-2007 10:23 AM


Re: Vitamin C
I see. We're interpreting the statement differently. I have been taking it to say that "it is thus" with no exceptions. Looking at it in a more logical way, I can see now what you mean. I'd like to see where this statement originated -- one or two places?

I know someone who can't take any vitamin C supplements at all. She is an extremely ill person with a number of things wrong with her. My ND says that sometimes the body gets into a kind of defensive mode and rejects much of what is put into it, harmful or helpful, and in that case the helpful things need to be introduced very slowly and carefully. Again . . . anecdote. Maybe this isn't the best place to be saying these things, I'm not going to be winning any debating points.


This message is a reply to:
 Message 280 by Percy, posted 09-26-2007 10:23 AM Percy has responded

Replies to this message:
 Message 283 by Percy, posted 09-26-2007 10:48 AM Kitsune has not yet responded
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Modulous
Member (Idle past 270 days)
Posts: 7789
From: Manchester, UK
Joined: 05-01-2005


Message 282 of 304 (424236)
09-26-2007 10:42 AM
Reply to: Message 249 by Kitsune
09-25-2007 9:50 AM


Re: A Few Comments
Several studies, including the National Institutes of Health-funded STAR*D trial (Sequenced Treatment Alternatives to Relieve Depression), have shown complete remission rates as low as 7%. Most studies show that antidepressants have only a marginal efficacy above placebo. And it's easy to manipulate scientific studies when the company conducting them has an interest in getting a certain result.

Let's talk about STAR*D. They did four levels of treatment, and almost 70% of patients that continued on to all four levels became symptom-free. It concluded that different treatment strategies worked for different people, and that more research should be carried out.

quote:
The QIDS-SR(16) remission rates were 36.8%, 30.6%, 13.7%, and 13.0% for the first, second, third, and fourth acute treatment steps, respectively. The overall cumulative remission rate was 67%. Overall, those who required more treatment steps had higher relapse rates during the naturalistic follow-up phase. In addition, lower relapse rates were found among participants who were in remission at follow-up entry than for those who were not after the first three treatment steps. CONCLUSIONS: When more treatment steps are required, lower acute remission rates (especially in the third and fourth treatment steps) and higher relapse rates during the follow-up phase are to be expected. Studies to identify the best multistep treatment sequences for individual patients and the development of more broadly effective treatments are needed.

So, one drug might have a remission of 7% - I didn't see that particular stat, unfortunately. The study shows that the correct course of action is move to 'the next step' and that we should do research to help ensure we get the right people one right treatment as soon as possible. I'd agree with all of that, and it certainly doesn't seem to support your overall position that conventional treatment is ineffective.

Also, few people report side effects for a variety of reasons. I can dig around for a source for this if you want but I know I've read about it several times. Sexual side effects themselves were at first said to be rare on ADs, but I've seen estimates from more recent articles that put their occurrence as high as 80%.

And I know people who have reported likewise to me. And I asked them which they preferred, no libido and no depression or libido and depression. Turns out they prefer the former. As would I.

That's an impossible question.

Only because the naturopathy industry doesn't want to pay the money to do the study to find out of the job that pays their bills is actually worth it to the people who are getting treated. We agree that conflicts of interest are not good, I assume you agree likewise with the naturos as well as the pharmas?

All I am able to give is anecdotal evidence.

Exactly. Yet you are able to get scientific evidence on remission rates and effectiveness of allopathic medicine...

You mentioned that conventional medicine can "cure" by removing an inflamed appendix. I did say in one of my posts here that modern medicine can perform some amazing feats of surgery. I'd go to the hospital if I had a broken leg. And some drugs can be life-saving. Maybe I should clarify; What do MEDICATIONS, apart from antibiotics, cure?

Well, there are anti-viral medications that cure. Anti-cancerous medications that cure. Anti-inflammatory medications that give the body a break so it cure itself (indirect cure). Adrenalin can cure you in a situation you would otherwise die in. Anti-depression medication can cure, but psychological help is also recommended along with it. I had a massive amount of Amylase in my blood once, I was digesting myself alive (notably my own pancreas). They pumped evil medication into me and I was good within a few hours (though my body was knackered for several weeks afterwards).

You've been listening to the media and the brainwashed GPs. No psychotropic med "restores" normal brain function.

And you've been listening to naturopaths. Hurrah. Seriously though, since we don't know for sure the exact details behind every depression we can't know for sure. However, serotonin is linked to depression - and many anti-depressants suppress serotonin reuptake. This might be upsetting the balance, or it might be that the suppression isn't happening as it should.

Either way, the point I made still stands - they get you with it enough to undergo other treatments such as psychological if that is the root cause. If you are depressed its hard enough to get to the GP, let alone seek councelling.

Also, I know plenty of people who never functioned "well enough" to talk to a counsellor (if one is even offered; I can't talk to one on the NHS here). One of the people I know who successfully sued Glaxo tried to kill herself on Paxil, and tried to kill her husband with a knife. She didn't have a history of psychosis before she took the drug, and has not had any such episode since.

Right - and I know dozens of people who have functioned well enough afterwards.

I'm curious - what about none psychological medicines?


This message is a reply to:
 Message 249 by Kitsune, posted 09-25-2007 9:50 AM Kitsune has not yet responded

Percy
Member
Posts: 18484
From: New Hampshire
Joined: 12-23-2000
Member Rating: 2.8


Message 283 of 304 (424239)
09-26-2007 10:48 AM
Reply to: Message 281 by Kitsune
09-26-2007 10:31 AM


Re: Vitamin C
LindaLou writes:

I know someone who can't take any vitamin C supplements at all. She is an extremely ill person with a number of things wrong with her. My ND says that sometimes the body gets into a kind of defensive mode and rejects much of what is put into it, harmful or helpful, and in that case the helpful things need to be introduced very slowly and carefully. Again . . . anecdote. Maybe this isn't the best place to be saying these things, I'm not going to be winning any debating points.

This is the fallacy of special pleading, or more familiarly, concocting ad hoc excuses.

Examples of people caught up in this fallacy abound. For instance, someone puts their overactive child on ritalin. He has a good day, parents and teachers conclude the ritalin is working. He has a bad day, they conclude he isn't responding to the ritalin that day.

The special pleading here is that sometimes the ritalin works, sometimes it doesn't.

An alternative conclusion: short of evidence from a history that recorded his good and bad days prior to beginning medication so that one can measure whether his proportion of bad days has changed (for better or worse), a more valid conclusion is that the ritalin isn't doing anything.

--Percy


This message is a reply to:
 Message 281 by Kitsune, posted 09-26-2007 10:31 AM Kitsune has not yet responded

  
Vacate
Member (Idle past 2766 days)
Posts: 565
Joined: 10-01-2006


Message 284 of 304 (424243)
09-26-2007 11:02 AM
Reply to: Message 278 by Kitsune
09-26-2007 10:18 AM


Re: Vitamin C
The fact that I and people I know can take 10 times this amount with no stomach pain or diarrhoea would rather cast doubt on its validity.

I don't see why it would cast any doubt at all. I think it should simply add to the need for skepticism regarding claims that vitamin C (or any medication, vitamin, etc) has no adverse side effects. Some medications can have severe or deadly side effects and every person is different.

Though I do have a negative attitude to the pharmaceutical industry in general I believe that the rise of self medicating via herbs and vitamins is a very risky venture. Without studies to understand the potential risks to these treatments I tend to see them as Russian roulette.

Have you heard about Hydrogen Peroxide Therapy? Two of my uncles decided to do this, both swore that it had positive results and they felt much healthier as a result. One of them had no reaction, the other simply by building a deck developed arsenic poisoning, nearly died, and will suffer from the effects likely for life. His doctors believe that Hydrogen Peroxide Therapy was a possible contributing factor. (Without questioning him further I cant provide much details beyond this, exactly what ill effects he suffers I cant describe in detail) There can be a variety of reasons why he was more susceptible to arsenic than others, Hydrogen Peroxide Therapy may have nothing to do with it, but without real studies into the lasting effects of such things it becomes impossible to know for sure.

Though this story is also anecdotal it was convincing enough for me as a non-medical professional to be extremely skeptical when deciding to self medicate. I am much more comfortable knowing that real studies have been conducted by scientists when I am recommended a medication from my doctor.

Sorry for interrupting such an interesting discussion. I just wanted to add my two cents in support for the skeptics. :)


This message is a reply to:
 Message 278 by Kitsune, posted 09-26-2007 10:18 AM Kitsune has not yet responded

Replies to this message:
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Modulous
Member (Idle past 270 days)
Posts: 7789
From: Manchester, UK
Joined: 05-01-2005


Message 285 of 304 (424253)
09-26-2007 11:24 AM
Reply to: Message 284 by Vacate
09-26-2007 11:02 AM


Re: Vitamin C
Though this story is also anecdotal it was convincing enough for me as a non-medical professional to be extremely skeptical when deciding to self medicate. I am much more comfortable knowing that real studies have been conducted by scientists when I am recommended a medication from my doctor.

And even if the manufacturers skewed their results in a conscious or unconscious way - research doesn't generally end there because there is usually a governmental research team between the pharmas and the public, and as far as I am aware, a localised trial with the public before it goes out 'at large'. This can take years.

I think everyone here would be happy to agree that the system isn't perfect, and the possibility of corruption, incompetence or just wishful thinking can mean bad drugs get out there from time to time. However, given the choice of the two systems I'd pick pharma's system to the naturo's rigid anecdotalism, with its deeply entrenched confirmation bias possibility.


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