Every month a free 150 page glossy A4 magazine lands in my letter box, one of almost 17,000 distributed around Auckland’s inner suburbs. The Ponsonby News is essentially an enormous advertising feature, and being Ponsonby based, a number of the adverts are for acupuncturists and holistic spa’s.
The Ponsonby News has a couple of ‘health correspondents’: John Appleton, who has a website selling vitamin and other supplements, and ‘Dr’ Ajit, an Ayurvedic practitioner* with a couple of spa’s in Auckland. Mr Ajit’s column is usually pretty silly, like urging people with hay fever not to eat stodgy food in winter for fear it will clog them up. But John Appleton’s column usually worries me. A couple of months ago, he was inspired by an article he read in the Listener assessing the risks and benefits of hormone replacement therapy and which advised readers to avoid the internet and talk to their doctor instead. Unsurprisingly, Mr Appleton was somewhat horrified by this suggestion having ‘found the internet to be a fabulous resource’ for researching topics like hormone replacement therapy. Indeed, what he went on to write about was ‘bio-identical’ hormones which he implies are a safe and effective alternative to hormone replacement therapy. I wrote a letter to the editor to point out that the benefits of ‘bio-identical’ hormones were at best over-hyped and at worst pseudoscientific nonsense**, which prompted a reply both through his column and in person***. In it, I was accused of being part of the medical establishment, locked away in my ivory tower, only interested in ‘science for profit’, unlike those in the complementary and alternative medicine field, who he believes are doing ‘science for people’. It is worrying that the alternative health field has successfully propagated the belief that it is purely motivated by improving people’s health and wellbeing, completely glossing over the fact that it is an extremely lucrative industry.
One of the points I raised in my letter to the editor was that of conflicts of interest, suggesting that the Ponsonby News should inform its readers that Mr Appleton may suffer such a thing in relation to his vitamin and supplement sales. Neither Mr Appleton or the editor addressed this point. Instead, Mr Appleton said he stood by his article on ‘bio identical hormones’ citing a review paper by Dr Kent Holtorf MD published in a fairly obscure peer reviewed journal called Postgraduate Medicine****. Interestingly, under the ‘Conflicts of interest’ section, it states that Dr Holtorf has declared no conflicts of interest. This is despite the fact that he is founder of the Holtorf Medical Group which has offered ‘bio-identical’ hormone therapy for over 10 years. Science for people? More like ‘pseudoscience for profit’, if you ask me.
* A system of traditional medicine that originated in India
** ‘Bio-identical’ was just a phrase coined to describe plant-derived molecules believed to be identical to human hormones. No evidence has ever been presented to verify this fact. Many of the conventional treatments include similar plant-derived molecules. The difference is that the conventional therapies have been studied over many years so doctors know what the side effects and risks associated with them are. There is no evidence that ‘bio-identical’ hormones are safer or more effective; it is likely they have the same side effects and risks. As for it being pseudoscience, ‘bio-identical’ hormone treatment often involves blood or saliva testing to determine which hormones are deficient and hence tailor treatment to the individual. While this sounds like a good idea, there is no scientific basis or indeed evidence that such a strategy is useful or relevant. In fact, hormone levels in the blood and saliva vary from day to day and are unlikely to reflect the actual biological activity in specific tissues.
*** If interested you can see my letter and Mr Appleton’s reply on page 84 of the online version of the Ponsonby News.
**** I say obscure because none of the medics I asked had heard of it.