Out in the ozone

Sometimes I run across alternative health therapies that are so freakin' weird I suspect, at least for a time, that the alt-med crowd is trolling us skeptics.  The sad truth is that when I look a little harder, I find that they're almost always completely serious.  And that includes the one that I just found out about yesterday, wherein just about anything that ails you can be cured by...

... blowing ozone up your ass.

Despite the disclaimer in the first paragraph, I feel obliged to reiterate that I'm not making this up.  "Ozone therapy" is a big deal; I've found that it's recommended for sterilizing wounds, treating SARS, AIDS, Ebola (for a third time, I'm not joking), Crohn's disease, rheumatoid arthritis, and various cancers.  Some treatments (as in the wound sterilization) merely wafts ozone over the affected area.  Others involve treatment with "ozonated olive oil," the aforementioned treatment of running a tube up your ass and blowing ozone therein, and (in one case) injecting a bubble of ozone directly into your vein.

The last-mentioned made my jaw drop.  A bubble in your blood vessels is known as an "air embolism," and can kill you.  It doesn't matter what the bubble is composed of.  If it migrates around until it gets into one of the arteries in the brain, you'll have a stroke.

Which means you now have an additional concern beyond a wound, SARS, AIDS, or what-have-you.

But the blow-it-up-your-ass method (known to the alt-med community by the more genteel name of "rectal insufflation") seems to be the most popular, which raises a question; how did anyone ever think of doing this?  I can't imagine being a medical researcher and thinking, "Wow, this ear infection could easily be cured if I just pump a toxic gas up the patient's butt."  Because any way you slice it, ozone is toxic.  It's O₃ (normal oxygen is O₂) and unsurprisingly is an unstable, highly reactive strong oxidizer. It does kill bacteria -- thus the suggestion that it'd be a good wound sterilizer -- but the problem is, the same properties that make it toxic to bacteria make it toxic to healthy cells.  Hell, single malt scotch kills bacteria, and I don't hear anyone proposing single malt scotch therapy.  (Although after doing this research, I'm seriously considering it.)

In fact, ozone is produced by electrical and gas-powered equipment (including car engines), and is considered a pollutant by the EPA.  According to the fact sheet about ozone, it "can trigger a variety of health problems including chest pain, coughing, throat irritation, and airway inflammation.  It also can reduce lung function and harm lung tissue.  Ozone can worsen bronchitis, emphysema, and asthma."

So positive health effects?  Not so much.

An ozone molecule [Image is in the Public Domain]

After spending over an hour searching, I only found one legitimate-sounding paper that took the idea of rectal insufflation seriously.  Titled "The Effect of Rectal Ozone on the Portal Vein Oxygenation and Pharmacokinetics of Propranolol in Liver Cirrhosis (A Preliminary Human Study)" by Saad Zaky, Ehab Ahmad Fouad, and Hassan Ibrahim Mohamad Kotb of Assiut University in Egypt.  The study was published back in 2011, and the authors kind of disappeared from the world of research publication afterwards, which says something.  Also, I notice that the one major effect they mention is that in their fifteen patients (yes, the sample size was that small), they saw an increase in oxygenation in the hepatic portal vein.

Oh, did I mention that what they blew up their patients' asses was 40% ozone -- and 60% oxygen?  Funny how that might increase your blood's oxygen saturation.

Of course there were plenty of sites advertising ozone machines and ozone therapy clinics and equipment so you can "insufflate" your own ass.  But it's unsurprising those weren't exactly peer-reviewed research, given that these people are making a bundle from the desperate and the gullible.

On the other hand, the sites explaining the complete lack of evidence that this has any therapeutic effect were numerous and vitriolic.  Here's what Andy Lewis, over at The Quackometer, has to say:

O₂ is what we breathe and absorb in our lungs for transport to our cells.  O₃ is a highly oxidising form of oxygen that has very harmful effects on our respiratory systems.  As such, if you squirt ozone on cancer cells on a dish they will die – but then so will all cells.  Cancer therapies work, in the main, by exploiting poisons that kill cancer cells faster than non-cancer cells.  This is pretty hard in practice as cancer cells are very, very similar to normal cells.  The mere fact that a poison kills cancer cells in a test tube does not mean that it can form a therapy...  Ozone has been proclaimed as a miraculous cure for over a hundred years.  There is yet to be any meaningful evidence that it can help cancer patients.  The available good evidence so far suggests that harms will outweigh any potential benefits.

Then there's Paula Kurtzweil, at Quackwatch, who tells the story of a couple in Florida who were fined and sentenced to prison terms for claiming people with AIDS and cancer could be cured by their magic ozone machines:

Proponents of medical ozone generators believe ozone can kill viruses and bacteria in the body. While ozone is used as a germicide in the cleaning of manufacturing equipment, FDA is not aware of any scientific data that supports the safety or effectiveness of ozone generators for treating medical conditions. In fact, the agency believes that at the levels needed to work effectively as a germicide, ozone could be detrimental to human health.

"These devices keep popping up," says Bob Gatling, a biomedical engineer and director of the program operations staff in FDA's Center for Devices and Radiological Health.  "We always tell their makers, 'Show us some data,' but no one ever pursues it." 

FDA's knowledge of [alternative medicine practitioner Kenneth] Thiefault's involvement in ozone generators dates to at least 1990, when Thiefault was interviewed during an FDA criminal investigation of one of Thiefault's associates.  This associate was later prosecuted and imprisoned for, among other things, manufacturing and selling ozone generators for treating medical conditions.  After release from prison, he returned to making and distributing ozone generators for treating medical conditions but fled the country before he could be prosecuted again.

Also from Quackwatch, here's Dr. Saul Green's take on it:

In 1991, Wells et al. reported that gaseous ozone inactivated cell-free HIV-l in cell-free culture medium.  Using escalating concentrations of ozone, they showed that a l200 ppm dose delivered into the solution for two hours, reduced the number of infectious viruses... and detectable virions about 85%.  However, there was also a significant reduction in infectivity after virus exposure to nitrogen.  Other factors influencing the rate and degree of inactivation of HIV-I by ozone were protein and plasma components in the culture medium.  (HIV is known to be inactivated by a host of relatively inactive substances.)  While ozone might be useful in rendering commercial blood products free of infectious organisms, more extensive analyses of the HIV-I life cycle was needed before ozone's usefulness as an in vivo anti-retroviral agent could be defined.  Poiesz, Wells' co-author, wrote, "No further in vitro work has been done and to my knowledge no in vivo work has been done."

The alt-med monitoring site What's the Harm? lists thirteen people who sought out ozone therapy -- one of them paid $23,000 for it -- instead of legitimate treatment modalities, and found out that it is definitely not a miracle cure.

Because they died.

So anyhow.  If you have a chronic disease, and (for some reason) decide that the best treatment would be to insufflate your rectum with toxic gas, I would exhort you to reconsider.  There is no reliable peer-reviewed research that it provides any benefits whatsoever, and (cf. the word "toxic" in the previous sentence) can kill healthy tissue.  Now, y'all will have to excuse me, because I think I need some single malt scotch therapy after all.

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This week's book recommendation is a brilliant overview of cognitive biases and logical fallacies, Rolf Dobelli's The Art of Thinking Clearly.  If you're interested in critical thinking, it's a must-read; and even folks well-versed in the ins and outs of skepticism will learn something from Dobelli's crystal-clear prose.

Chopra on AIDS

At what point does someone cross the line into giving advice so dangerous that the people involved in promoting him are morally culpable if they participate?

Look, it's not that I'm against free speech.  I also believe strongly in the caveat emptor principle -- that people have a responsibility to be well enough informed on matters of science and medicine that charlatans can gain no traction.  But influential people also have a responsibility, and that is to use that influence with care, to consider the harm their words could do, to make certain that what they're saying is scientifically correct (and making amends when they misspeak).

Of course, the most egregious example of how this can go wrong is the current measles outbreak in California, which has sickened 84 people so far and is still accelerating.  The CDC states that the outbreak is "directly attributable to the anti-vaxxer movement," and notes that even with treatment, measles "is a miserable disease" that can cause serious complications and death.  And we can lay the blame for the resurgence of this disease at the feet of such purveyors of unscientific bullshit as Andrew Wakefield and Jenny McCarthy, who despite mountains of verified, reliable research are still claiming that vaccinations are unnecessary at best and dangerous at worst.

But we've talked about the anti-vaxxers before, and they're hardly the only example of this phenomenon.  Just a couple of days ago, for example, we had none other than Deepak Chopra putting his two cents in (although that's vastly overestimating its worth), and he gave his opinion about AIDS...

... and said it wasn't caused by HIV.

The HIV virus [image courtesy of the Wikimedia Commons]

Chopra was being interviewed by Tony Robbins, and the following exchange took place:

Chopra: HIV may be a precipitating agent in a susceptible host. The material agent is never the cause of the disease. It may be the final factor in inducing the full-blown syndrome in somebody who’s already susceptible. 

Robbins: But what made them susceptible? 

Chopra: Their own interpretations of the whole reality they’re participating in. 

Robbins: Could that be translated into their thoughts, their feelings, their beliefs, their lifestyle? 

Chopra: Absolutely.

He goes on to say, "I have a lot of patients with so-called AIDS... that are healthier than most of the people who live in downtown Boston.  They haven't had a cold in ten years...  Someone's told them they have this disease, and they've bought into it.  The label is not the disease, the test is not the disease."

Robbins responds with a comment about a doctor who has stated that HIV is only capable of killing "one helper-T cell out of ten thousand," and Chopra agrees, saying that to get sick from it, we have to "facilitate the process with our own thoughts and beliefs, convictions, ideas, and interpretations."

Then they have the following discussion:

Robbins: There's a test that doesn't even test for the virus, and when they get a positive test, what happens to them? 

Chopra: Then they make it happen. 

Robbins:  Maybe they take something like AZT, a side effect of which is immune suppression...  What keeps us locked into this trap?  What keeps us locked in this trap where we keep promoting a philosophy of fear where we must depend on someone or something outside of ourselves to keep ourselves healthy? 

Chopra:  It's the collective belief system.  It's the hypnosis of social conditioning.  It's cultural, religious, social indoctrination.  

The way out, Chopra says, is realizing that "you are the field of all unbounded possibilities."

Are you mad yet?  I hope so.  Chopra is using his influence -- which is considerable -- to push people away from conventional treatment into accepting vacuous psychobabble, risking their own lives in the process.

You have to wonder how he explains the millions of deaths from AIDS in central and southern Africa.  Many of those people don't have access to medical tests and treatments; a considerable number of them don't have the scientific background to understand what the virus does to the immune system.

You also have to wonder how he'd explain the deaths of young children who contracted HIV from their mothers.  Was their disease due to their parents' lack of acceptance of "the field of unbounded possibilities?"  Or did the children themselves have problems with their "interpretation of the whole reality they were participating in?"

Chopra once was simply a laughable purveyor of woo-woo pseudoscience, of the kind that he evidenced by a statement made earlier in the interview: "You go beyond the molecules, and you find atoms.  You go beyond the atoms, and you find particles.  You go beyond the particles, and you find nothing.  You go beyond the nothing, and you find absolutely nothing."  But now he's crossed the line into endangering people's lives with his claptrap.

I'd much prefer it if people would come to recognizing how dangerous this man is through a greater understanding of science; but the unfortunate truth is that there will always be gullible, credulous, and poorly-educated people out there, and it is immoral to allow people like Chopra to prey on their lack of understanding.  I wish fervently that radio and television stations who are giving this man air time, and book publishers who are promoting his views in print, would say, "I'm sorry, sir, but you are a quack, and you're hurting people, and we're not participating."

But the sad truth is that even if what he's saying is garbage, it's lucrative garbage.  Given the profit motive that drives most of our society, I suspect that Deepak Chopra is going to continue to get richer at the expense of people who are ignorant enough or desperate enough to buy the nonsense he's selling.