Conflicts of Interest and Fraud in Medical Research | Chris Kresser
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Behind the Veil: Conflicts of Interest and Fraud in Medical Research

by Chris Kresser

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Recent reports have revealed that conflicts of interest and research fraud are rarely reported in the scientific literature or announced to the general public, which raises questions about the integrity of clinical trials and the reliability of public agencies like the FDA and CDC.

In this article, I’m going to discuss two other reasons that the public mistrusts scientific research: fraud, and conflicts of interest.

Why conflicts of interest and fraud harm the public’s trust of medical research.

Fraud in Medical Research: “Out of Sight, Out of Mind, and Out of the Peer-Reviewed Literature”

A large part of the subtitle above comes directly from a paper published in JAMA Internal Medicine, authored by Charles Seife. (1) In short, Seife discovered that clinical trial data determined to be fraudulent or mishandled by the FDA is rarely excluded from research studies published in scientific journals.

One of the FDA’s roles in the drug approval process is to inspect clinical trial sites to determine whether these sites are complying with FDA regulations. A typical inspection might involve auditing the records of the site, verifying that investigators adhered to the trial protocol, and comparing an investigator’s notes in hospital records with data reported to the study sponsor to ensure that there aren’t any discrepancies.

If there is a violation, the FDA classifies it in one of two ways: Voluntary action indicated (VAI) means the inspectors have found violations, but the problems aren’t serious enough to require sanction. Official action indicated (OAI) means that the inspectors have found violations significant enough to warrant official action.

Siefe and his assistants used the Freedom of Information Act to request information from the FDA, and supplemented that data with Google searches of the FDA database. They found 57 clinical trials that were directly linked to an OAI inspection.

The misconduct identified by the FDA in these cases included:

  • Falsification or submission of false information
  • Underreporting of adverse events
  • Failure to follow the investigational plan or other violations of protocol
  • Inadequate record keeping
  • Failure to protect the rights, safety, and welfare of patients
  • Use of experimental compounds in patients not enrolled in trials
  • Failure to supervise clinical investigations properly

The 57 trials Seife identified were in turn linked to 78 research articles published in the peer-reviewed scientific literature. 96 percent of these articles failed to mention the violations identified by the FDA inspection—despite the fact that in the majority of cases the inspection was completed at least 6 months before the article was published.

Doctors, researchers, and other health professionals rely on scientific studies to establish treatment protocols and public health policies. If the data in some of these studies are fraudulent, but the doctors and researchers have no way of knowing that, the decisions they make may be unsound and even put people at unnecessary risk.

I’d like to make the significance of these omissions even more clear by sharing a couple of examples mentioned in Seife’s paper.

One case involved a researcher who falsified lab test results to hide a patient’s impaired kidney and liver function in a trial comparing two chemotherapy regimens. The first dose of the regimen proved to be fatal to this patient, and the researcher was sentenced to 71 months in prison. Despite this episode being described in both FDA and court documents, not one of the studies in the peer-reviewed literature associated with the chemotherapy trial have any mention of the falsification, fraud, or homicide.

Another case involved a clinical site in China participating in a large trial of apixaban, an anticoagulant (i.e. anti-clotting) drug. The FDA determined that this trial site had altered patient records and falsified data. If the data from this site had been excluded, the mortality benefit for the drug would have disappeared. In other words, the “proof” that this drug saved lives was dependent on this fraudulent data. Yet none of this discussion appears in the scientific literature. In fact, studies since 2011 have consistently relied on the full data set (including the fraudulent data from the China trial site), and this was even true for an article published nearly 18 months after the fraud was discovered.

How can such egregious cases of fraud and misconduct go unreported in the scientific literature and in the media? The answer is almost hard to believe. The FDA does not notify journals when a site participating in a clinical trial receives an OAI inspection, nor does it typically make any announcement which would alert the media and general public to the issues it identified.

What’s more, the documents the FDA produces about these OAI inspections are heavily redacted, which makes it extremely difficult even for researchers like Seife who’ve invoked the Freedom of Information Act to determine which published clinical trials are tainted by misconduct. The FDA redacts these documents because it considers the identity of the drug company involved in the trial to be “confidential commercial information” that it is bound to protect.

In other words, the FDA appears to believe that it’s more important to protect private, commercial interests than it is to protect public health.

Seife’s says as much in the conclusion of his paper:

However, failing to notify the medical or scientific communities about allegations of serious research misconduct in clinical trials is incompatible with the FDA’s mission to protect the public health. Such allegations are relevant to include in the peer-reviewed literature on which physicians and other medical researchers rely to help them choose treatments that they offer to patients and other research participants.

The issues highlighted here raise serious concerns not only about the trustworthiness of the data in clinical trials and published research, but the reliability and motives of the agencies tasked with protecting public health.

Which takes us to the second reason that public mistrust of scientific research is sometimes well-founded: conflicts of interest.

Conflicts of Interest in Research Are Common—and Often Unreported

In my article about the disconnect between scientists and the public, I mentioned that two-thirds of medical research is sponsored by drug companies, and industry-sponsored trials are more likely to report favorable results for drugs because of biased reporting, biased interpretation, or both. (2) This is a well-established phenomenon, and it has been explored in both the media and the scientific literature:

Is it really a big surprise that the source of funding influences study results? After all, as Upton Sinclair famously said, “It’s difficult to get a man to understand something, when his salary is dependent upon him not understanding it.” The time-honored saying “don’t bite the hand that feeds you” also applies here.

Unfortunately, just as research misconduct and fraud is often not reported, conflicts of interest in academic research are rarely disclosed. According to a 2009 report issued by the Department of Health and Human Services, very few universities make required reports to the government about the financial conflicts of interest of their researchers—and even when they are reported, the universities rarely require those researchers to eliminate or reduce these conflicts.

In fact, 90 percent of universities relied solely on the researchers themselves to decide whether to report their potential conflicts of interest, and half of universities don’t even ask their faculty to disclose the amount of money or stock they make from drug or device makers.

This isn’t likely to change anytime soon, according to Eric G. Campbell, an associate professor at Harvard Medical School that was quoted in this New York Times article covering the report. He said that “universities had no interest in putting real limits on the incomes of their star researchers for fear that those researchers would leave for institutions with fewer restrictions.”

But conflicts of interest aren’t just a problem in academia; they’re also a problem on expert advisory panels that influence public health policy. For example, back in 2008 Dr. John Briffa linked to a web page disclosing the conflicts of interest in members of the National Cholesterol Education Program, a government organization that creates the official blood cholesterol target values for the U.S..

Are you ready for this? 8 out of the 9 doctors on the panel had direct ties to statin drug manufacturers. Here’s the complete list, excerpted from a post written by Dr. Stephan Guyenet in 2008 (the companies in bold are statin manufacturers):

Dr. Grundy has received honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb, and AstraZeneca; he has received research grants from Merck, Abbott, and Glaxo Smith Kline.

Dr. Cleeman has no financial relationships to disclose.

Dr. Bairey Merz has received lecture honoraria from Pfizer, Merck, and Kos; she has served as a consultant for Pfizer, Bayer, and EHC (Merck); she has received unrestricted institutional grants for Continuing Medical Education from Pfizer, Procter & Gamble, Novartis, Wyeth, AstraZeneca, and Bristol-Myers Squibb Medical Imaging; she has received a research grant from Merck; she has stock in Boston Scientific, IVAX, Eli Lilly, Medtronic, Johnson & Johnson, SCIPIE Insurance, ATS Medical, and Biosite.

Dr. Brewer has received honoraria from AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Esperion, and Novartis; he has served as a consultant for AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Sankyo, and Novartis.

Dr. Clark has received honoraria for educational presentations from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer; he has received grant/research support from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer.

Dr. Hunninghake has received honoraria for consulting and speakers bureau from AstraZeneca, Merck, Merck/Schering-Plough, and Pfizer, and for consulting from Kos; he has received research grants from AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, and Pfizer.

Dr. Pasternak has served as a speaker for Pfizer, Merck, Merck/Schering-Plough, Takeda, Kos, BMS-Sanofi, and Novartis; he has served as a consultant for Merck, Merck/Schering-Plough, Sanofi, Pfizer Health Solutions, Johnson & Johnson-Merck, and AstraZeneca.

Dr. Smith has received institutional research support from Merck; he has stock in Medtronic and Johnson & Johnson.

Dr. Stone has received honoraria for educational lectures from Abbott, AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, Pfizer, Reliant, and Sankyo; he has served as a consultant for Abbott, Merck, Merck/Schering-Plough, Pfizer, and Reliant.

Another 2009 report, also from the Department of Health and Human Services, revealed similar issues with expert panels that advise the Centers for Disease Control (CDC) on vaccine safety. The report found that 64 percent of experts who served on advisory panels in 2007 to evaluate vaccines for flu and cervical cancer had potential conflicts of interest that were never identified or resolvedThe report also revealed that the CDC failed nearly every time to ensure that experts adequately disclosed that they were being paid by vaccine manufacturers.

Can you see how these conflicts of interest might be a problem, when the advisory committees mentioned above strongly influence the sales of both statin drugs ($30 billion a year) and vaccines ($20 billion a year)? 

Sadly, these financial relationships between experts who influence or formulate guidelines and drug companies whose drugs are being considered are not the exception, they’re the rule. A study published in JAMA shows that 59 percent of the experts participating in guideline creation have such financial ties. (3)

Another related problem is the “revolving door” between public agencies like the CDC and FDA or institutions like the U.S. Congress, and pharmaceutical companies. A year after leaving her position as the director of the CDC in 2009, Dr. Julie Gerberding took a position as president of Merck Vaccines. Another former CDC employee, Dr. Thomas Verstraeten, took a position with GlaxoSmithKline (a vaccine manufacturer) while he was still involved in completing a major study on the possible negative side effects of thimerosal (a mercury-containing compound used in some vaccines) at the CDC. Finally, over half of the lobbyists employed by the pharmaceutical industry in 2008 had worked in Congress or another branch of the federal government, and 35 had been former members of Congress. (4)

These conflicts of interest do not necessarily lead to fraud or misconduct. There are surely many honest and unbiased researchers and physicians investigating controversial topics like cholesterol targets and statin drugs, vaccines, and genetically-modified foods. However, studies have confirmed what common sense and an understanding of human nature would also suggest: conflicts of interest can and do influence both individuals and institutions. For example, the financial interests of researchers are positively associated with outcomes favorable to the sponsor in medical studies, and research institutions can be influenced by industry sponsorships such as grants, endowed chairs, and other gifts. (5, 6, 7, 8)

Concluding thoughts

My purpose here is not to attack the credibility of scientific research as a whole, or scientists as a group. But science is a human endeavor, and like all human endeavors, it is subject to the vagaries of human ethics and behavior. There is good science, and bad science; there is honest science, and dishonest science.

If you’ve been following my work for several years, you’ll know that my blog used to be called “The Healthy Skeptic.” I called it that because I believe that skepticism is healthy when it comes to science. Yet all too often I see this skepticism being applied in a biased or inconsistent manner.

For example, I’ve noticed that some people who are indignant about conflicts of interest in government agencies responsible for bank bailouts or among experts responsible for establishing blood cholesterol targets are completely unwilling to consider how similar conflicts might affect research on, say, genetically-modified foods.

I’ve also encountered people who are skeptical of any challenge to the status quo, but don’t apply their skepticism with the same rigor to the the status quo itself. On the other side of the coin are those that accept unconventional or alternative ideas (regardless of whether there is evidence to support them), and tend to reject anything that could be remotely construed as conventional or mainstream. 

Someday, perhaps we’ll be able to extricate the financial interests of Big Pharma from the behavior of medical scientists and regulatory agencies. Until then, our responsibility—whether we are clinicians, patients, researchers, or members of the media—is to acknowledge the influence these relationships may have on scientific research, and take that influence into account when considering controversial issues—especially when large amounts of money are at stake.

Now I’d like to hear from you. Were you aware that research misconduct rarely gets reported on in the media or scientific literature? Are you surprised by the extent to which conflicts of interest are present on advisory panels responsible for creating guidelines? How do you feel about this subject after reading this article? Let us know in the comments section.

126 Comments

Join the conversation

  1. I have personally been put in this position. Not with drugs but with physical therapy.

    As the product Manager of a Vibration Training Plate company ( PP ). I recalled an entire line of products because of multiple faults , that essentially meant that even 20kg body weight caused a dampening effect on the vibration as to make it almost completely ineffective.

    The company refused to recall the product. And it was sold to people with disabilities. Plus sent to researchers already promised machines.

    Most of the researchers knew immediately there was an engineering issue. But carried on regardless. Publish or die right ?

    Hundreds of papers are invalid. They should be retracted.

    It has taken 10 years for this to start to gain some recognition.

  2. Certainly lots of interesting discussion here. Science, greed, lies etc. We all need to find some common ground that is beneficial to health and wellbeing. Lets for example sake take 100 average healthy individuals who are not taking any medications or nutritional supplements, herbs, tinctures etc. Lets randomly pull 10 naturopathic tablets out of a hat and 10 pills from the local pharmacist. Lets prescribe 5 of the pharmacy meds to 50 people to take daily for 30 days straight. Now lets do the same with the naturopathic tablets.

    Lets do this experiment with the same people using another randomly picked selection of pills and repeat the process over a period of one year.

    Which group do you think will suffer damages? I think you can easily answer that.

    Now lets take a trip to the grocery store. Why is the pharmacy section larger than the whole foods section? You got it! The food promoted and sold in the store is meant for profit not necessarily health. How many people do you see that are shopping in the store look healthy and vibrant? Not many. We need to change our diet to improve our health. Shopping wisely and preparing our own food from whole organic, unadulterated ingredients is the best way to start.

    If the sales go down on the boxed processed foods the stores will eventually quit selling it. If the sales go up in the whole foods then they will make sure to increase the supply.

    Lets take responsibility for our own health and then pill popping becomes a mute point.

  3. I find it amusing that so many anti-progressives feel that us scientists are all just out for a buck and that we would do and say anything to further our agenda and yet at the same time, they say nothing about the nutraceutical industry. There are a handful of cases of fraud or drugs/vaccines that later have to be pulled from the market, whereas hundreds of herb and other nutraceuticals have been pulled from shelves for various reasons and it has been shown that the majority of supplements out there either don’t have what they say they do or in the concentrations claimed, and/or a large amount actually have toxic substances in them. This just goes to prove your point (that business looks out for itself) but, unlike the drug companies, medical and scientific community, there really is no oversight of the nutraceutical or natural health system and thus much more fraud. I think the answer here is not to demonize one particular industry (especially when much of what is being said is incorrect), but rather to put more money into public research (that isn’t influenced by corporations) and to assure better oversight of all of these industries.

    • I agree 100% that there is fraud in the nutraceutical industry and a disturbing lack of regulation, and I’ve acknowledged that elsewhere and in the comments section below.

      That said, the nutraceutical industry does not have nearly the influence on research, public health policy, or standard of care that Big Pharma does. That is why conflicts of interest and fraud in conventional medicine are arguably more significant in their impact.

    • I am afraid more money put into the research would only echo and exacerbate the problems more. Money and greed appears to have created the problem in the first place. Private corporate interest continues to exert pressure on the scientific community and hence the solution must consist of serious attempts to isolate private intetest from the entire deal. Govermental or public funds must be available to conduct the research without fear of bias and politicization.

    • The good old…… “Look over there, they are doing it to ” trick.

      Yes we all know there are marketers out there willing to pray on desperate people to make a buck. We know they get caught often and so they should.

      What is news to lots of people is how high a % of scientists and researchers are corrupt or incompetent. And how far you guys will go to cover each others asses.

      Science put itself on a pedal-stool, telling us to trust them. And the evidence suggests out of every 100 of you, only 1 is honest and ethical.

  4. Here’s yet another recent example of what I discussed in this article:

    Deeper Ties to Corporate Cash for Doubtful Climate Researcher
    http://www.nytimes.com/2015/02/22/us/ties-to-corporate-cash-for-climate-change-researcher-Wei-Hock-Soon.html

    The story reveals that a researcher (Wei-Hock Soon) who is often cited by those who claim that human activity has played little role in climate change has accepted $1.2 million from the fossil fuel industry over the past decade while failing to disclose that conflict of interest in most of his papers.

    In correspondence with his funders, he referred to his scientific studies as “deliverables” that he completed in exchange for their money.

    Conflicts of interest can affect research that supports the consensus, and research that attacks it.

    • This was really well written and presented clearly. I do not say this lightly. I have been plowing through articles, blogs and rants that make my brain hurt, for several months now.

      Your article is clean, clear and well organized. My tired wee brain thanks you. Great information, good food for thought.

    • Chris – Your article was very good and you do great work. However, linking the NY Times article re Dr Soon was a mistake. You must know that you need to do more research before you recommend an article from NY Times, especially on a hot button issue which has only one politically coorect opinion. All of the $1.2 million went to the Smithsonian, Dr Soon’s employer and Dr Soon received $40,000 for his work. And under the rules Dr Soon was not required to report this. Plus Dr Soon was correct and truthful. I would like to add more but am writing this from memory.

  5. None of this surprises me. “Conflict of Interest” is the name of the game in Washington. In a recent petition to President Obama, Move On .org stated, “President Obama has appointed former Monsanto VP and lobbyist Michael Taylor to become senior advisor to the FDA’s commissioner. This unthinkable linkage between food safety and corporate interests that have little regard for the public health must be stopped. This example of a “fox watching the henhouse” is inexcusable. President Obama must reverse this unimaginably dangerous policy and isolate the FDA from corporate influence.” I personally remember clearly President Obama appointed Michael Taylor to the FDA in 2009, shortly after he took office, Shortly after he promised all of us who got him elected, one of the first things he was going to do when he became president would be to get GMO’s labeled, then he put the FOX in charge of the HENHOUSE….Unconscionable!

  6. Thanks Chris. I am a Health Coach and very aware of the problem of unreliable information from government agencies like the FDA and CDC. This article underscores the need to educate ourselves about what we should eat or not eat. What’s tragic is that many people don’t have the education or the time to do this for themselves. I am grateful for your articles and also hope to be a part of the effort to get the truth out!

  7. Great article. Doctors use hand held devices to prescribe. I’ve had wrong lowest doses, been told a popular med had to work when it doesn’t because I don’t fit the norm, and accused of trying to cheat the drug companies for asking to halve larger doses. The comments are great, too. Thanks for your help!

  8. Chris, thanks for the well thought out article. I really enjoyed it and there were a few new talking points that I was glad to learn. Also, thanks to the other readers who included a link to the informative and entertaining TED talk by Ben Goldacre. I’m becoming more and more skeptical the older and more educated I get. The sad part is that there are only so many hours in the day so ultimately I have to place my trust in a few people because I can’t effectively do an in depth research on everything that is important to me and my family.

  9. Very good article Chris. I have believed that this type of unscrupulous behavior by big Pharma and our government has existed for sometime. As a pharmacist it sickens me and saddens me. Also probably one of the main reasons why every day I am becoming more and more a natural pharmacist.

  10. I enjoyed this article, Chris, and interestingly just saw today that Mark Zuckerberg is having his ‘Facebook online book club’ read “On Immunity” today because, as he says, “the science is very clear” [that vaccines are safe and effective].

    http://www.theverge.com/2015/2/19/8060017/mark-zuckerberg-vaccine-denier-facebook-book-club-on-immunity

    Have you read this book, and if so, what did you think of it?

    I’m hopeful that new research (re: Human Microbiome, Toxicology, Immunology and Environmental Science) will help us move western medicine in general (and vaccine science in particular) into the 21st century. Baby steps, e.g.

    http://www.mountsinai.org/about-us/newsroom/press-releases/mount-sinai-childrens-environmental-health-center-publishes-a-list-of-the-top-ten-toxic-chemicals-suspected-to-cause-autism-and-learning-disabilities

    Today many Oncologists will admit that we’ll look back and find it barbaric how we treated cancer patients with chemo, radiation and surgery… and I suspect soon more Pediatricians will start to question and then publicly say that we’ll look back and find it barbaric that we injected 69 doses of 16 vaccines before age 18 in a ‘one-size-fits-all’ approach to our kids and added to their system overload.

  11. Whenever I want to learn about something, I gather information from multiple sources and then form an opinion. Whenever the person or company presenting the information stands to make profit the information is probably skewed towards their favor for making a profit.

  12. Hi Chris.Wow. Love the way you’ve presented this. Such great info. There really is a disconnect in how we blindly accept research as ‘news of the day’ and we focus on the headline. If we shift this thinking into creating conversations and integrating ideas we might start to learn more. We are letting others decide for us rather than sharing the power.

  13. I have spent a bit of time recently reading material such as you offer mostly because I had a few pounds I wanted to get rid of and keep off, so that led me to the eating health side. Concerning this article’s subject, It finally dawned on me that the information, studies, etc. that is found thru studies and the like are put out to everyone as a group [how else would they do it.] But of course we are all individuals with different requirements but we consume the information as if it’s directed at us. It’s not their job to get it to the right consumer, but there is a part of where the public disconnects, not thinking of that, in general I’m speaking. thanks Mickey

  14. Great article on the FDA. I heard Charles Seife’s piece on NPR. I totally agree. Question is what can we start to do about cleaning up this mess? We dependant on having access to good sound unbiased science.
    Any suggestions on where to start? The problem has been well framed.
    Thanks Darcie

    • Didn’t realize this article was on the FDA. The article is on corporate scientists and scientists who receive funding from corporations and the potential conflicts that arise because of it.

  15. Chris, I recommend your site to all my patients and read it everyday. I tell everyone that you are the Yoda of human nutrition. Thanks for your work, it is much appreciated. As a neuroscientist and old hippie, I know what crap goes on among researchers with a passion to become famous, publish, and make more money.

  16. This is a truly excellent write-up of the fraud and misconduct in the scientific/medical world.

    I disagree with Chris on some aspects of metabolism and there being a distinction between ‘alternative’ & conventional medicine, but…this article is a good example of why I continue to read his material.

    So, thanks!

  17. I quit posting here because your site is f’d up. I just composed 2 replies, both wiped out. Do you not have an auto save?

    I like the site, I am in agreement with most of it. But I have problems with posting to it. But then I am not a medical person I do not even LIKE Drs. There is nothing that you can come down with that lifelong regimen of Scrips cannot cure according to them. BS. I take nothing not even Aspirin.

    I will continue to read but replies may be few and far between.

    George

  18. It’s not that I don’t believe vaccines are good (in theory) but it’s hard to support what is going on with the cheap materials, lobbying and profiteering. There is a lot of ego, personal bia, and bureaucracy in medicine, a subject that should have nothing to do with politics.

  19. Thank you for a wonderful article, and also thank you to everyone here who posted thoughtful, non-attacking responses. This is the first time I’ve read responses to an article and not wanted to bang my head against a wall. What intelligent readers you have! 🙂

  20. Yes, I was aware of this, after losing 20 years of my health and vitality and ability to function in life due to psychiatric medications. In the process of figuring out what had happened to me I read the book Anatomy of an Epidemic by Robert Whitaker, which I would add to your book list above. It’s specific to psychiatry and psychiatric meds but it’s so well-researched and readable that if you have any interest in the subject of pharmaceutical industry infiltration of medical education and marketing, it’s a must-read. This whole situation–in psychiatry and all other areas of medicine–is tragic, and criminal. And I think if doctors understood, first, that their education and their sources of information are not as reliable as they believe, and second, that they are rapidly losing the trust of patients (I can’t tell you often I hear survivors of antidepressant treatment say they will never trust a doctor again), that this would change a lot faster than otherwise. Unfortunately the culture of medicine and medical education includes a big component of “patients don’t know anything and can’t be trusted.” Doctors are trained to be gullible, way more gullible than an educated citizenry, in my opinion.

    Well enough of this rant, but this is a very, very important subject that cannot be emphasized enough. The medical/pharmaceutical/medical device complex is just as corrupt as the tobacco industry, and doing just as much harm, or more.

  21. Bravo Chris! Another reasoned, thoughtful and level-headed post. A few weeks back I posted on my fb timeline a few Green Med articles that questioned the recent media frenzy surrounding the measles outbreak and the call to remove the rights of parents to choose for their children. Wow! Emotions ran high just by suggesting there is another side to this issue, brought forth by intelligent and learned folks and by parents who care deeply for their children’s health.
    The Healthy Skeptic rides again!

  22. I feel it safe to say, I would never intentionally hurt anyone, many of my medical and nursing colleague’s hold the same ideal. The difference between side effect and adverse reaction, it is so laborious to report a reaction and when something is listed as a side effect we are endoctored to believe it is just the unfortunate person who has a difficulty with the drug, so we switch drugs. Vaccine history is rarely discussed, the time lapse is not something we consider, but we have chronically challenged immune systems, and manipulation of research can be seen in Louis Pastures claim to fame, poor Felix Pouchard was probably on the right path but Louis had an ego and a church in his pocket. So we got to treat the germ instead of promoting the good health of the organism is the human body. One in three children expected to be treated for cancer by the time they reach twenty, that is not fair. I applied to go to Sierra Leone four months ago. Ebola vaccine was patented by the CDC years ago, I think they tried to run another campaign of fear, mass vaccination, their prediction of 1.4 million by Jan, last I checked the figure was 8,200. No sense to a rapidly mutating blood bourn all of a sudden aeroslised virus, be cheaper to import the flying fruit bats?

  23. Chris,
    Thank you for this article. It should go to the editor of every newspaper in the country. I will see it gets to mine. I have 30 years of experience in Chiropractic and Alternative Medicine. I can’t tell you how many times I have seen this happen. Just in the past year our city got a ballot issue for voting on continuing to infuse our municipal water supply with toxic fluoride or to remove it. There was continuous dialog in the editor’s column prior to election and one of the favorite statements was that the science behind removal of fluoride was “junk science”. I provided the editorial column with many PubMed referenced articles. PubMed research is considered to be the “gold standard” in scientific literature. Still, removal of fluoride failed. I am also currently doing a lot of research on the product “salvestrols”, which is an alternative medicine treatment for cancer out of Canada and the U.K., which shows promising results. However, it continues to be blasted in the scientific community because it “lacks scientific data”. I agree that traditional allopathic medical “scientific literature” is ridiculously corrupt. The only saving grace will be when the medical system becomes so expensive that it cannot be afforded. Data.worldbank.org published 2012 data that places the US health care expenditures at 17.9% of the gross domestic product. In other words 18 cents of every dollar that gets spent is on health care. What happens when it reaches 50%? And it will, it’s just a matter of time. The system cannot sustain itself. That’s just my opinion! I could be wrong!

    • If every paper with a PubMed entry is considered “gold standard,” we’re in trouble. I read through some of that stuff for a living — not just the abstracts, but the full text of published papers, and an astounding number of them are pretty awful. I’m not saying they’re *all* bad, only pointing out that peppering things with links to PubMed doesn’t necessarily lend legitimacy. It will *look* legit, and more “impressive,” especially to people who have neither the time nor the inclination (not to mention the access) to go and read the full text, but that doesn’t mean it *is.*

      Again, not knocking your efforts to get the fluoride out of the water at all. (I support that, in fact.) Just saying that PubMed isn’t all it’s cracked up to be, unfortunately.

  24. I was not aware of this information about research misconduct or conflict of interest, so I’m grateful for your exposé. It is most interesting to me that you mentioned the conflict in the National Cholesterol Education program. I took myself off the statin drug I was on because I learned that the issues I was having with muscle weakness and cramping were most likely the result of being on a statin drug. I know that as a healthy older female, I do not fit the profile of the study group which was determined to get benefit from statins. I may be in for a fight with my doctor next week, but I’m staying off of that and the other unnecessary drugs that I was on. I feel that my quality of life is better, not to mention less expensive, when I’m on only vital drugs (like thyroid replacement since I have no thyroid).

    • Glad to hear you’re off the statins – Try doing some homework on the effects of Omega 3 and Salmon/Fish oil as a blood thinner and cholesterol reducer, the side effects are great – like better hair and skin and better GI function, been off statins for 3 years and life is a whole lot better – I’m a 50 year old woman.

  25. Chris, Your articles are always so thoughtful and balanced. Skepticism is always a good thing in balance with an open mind…if that makes sense. I always learn something valuable from what you write. This time I also learned a great deal from the comments made by so many people. This is a discussion that needs to continue.

  26. The new “scandal”, unbelievable in scope, is that the FDA, and the USDA condone the comprehensive spraying of American wheat with Round Up herbicide (a licensed product for this use). This is a “legal and established” practice by American wheat farmers to ensure a “mature, harvestable crop”. Of course, Round Up is made by Monsanto. This practice has been going on for about 8 years (ostensibly). Have you noticed the astronomical increases in celiac disease, “digestive issues”, and conceivably, non Hodgkin’s Lymphoma? Did anyone tell the public from the FDA or the USDA that this was going on? We, as Americans have every right to know what goes in our food and what is “sprayed” on it.

    • It is not only GMO crops that are sprayed with Roundup. And wheat is only one of many such non-GMO crops. Roundup is used by many farmers as a “harvesting aid”, to desiccate the foliage and non-valuable parts of the crop to make it easier to machine harvest the desirable parts.

  27. As said many times in the comments section below, your observations and factual conclusions are excellent. The irony is that fixing the problem(s) are like fixing the government. Everyone is aware of the problems but they are so insurmountable that no sincle person or group can effectively undertake. The desire is there but the solution(s) to “right the ship” are absent.

    Basically, the human body has the ability to heal itself naturally. If you are afflicted with a malady, then read and do research on your personal issues. It is hard work but the information is available and the rewards are plentiful. You cannot expect any doctor, specialists or government official to solve your problems. They are your problems, so own them and start today to be a better and healthier person with an objective clearly focused for your future. This holds true with governmental issues also. They only show up for work 50% of the time. Add in a multitude of time off for vacations; fundraisers; campaigning; trips for research and development and you expect them to worry about you and your issues? Grow up and learn how to solve your own problems. The government can’t and won’t help you-it’s up to you and you alone!

    Make today a beginning because it is not how long you live but how you live…………

  28. Great article and sums up why I react to the statement “the science is in” as I’ve heard a million times in the last few weeks. I am so hopeful you will write that series on vaccines, I know it’s such a charged topic and it’s everywhere right now… but due to recent events so many kids are running to get boosters, etc. Would be great to see a series on testing to do beforehand (gut health, genetic markers, etc.) and immune boosters/supplements do give prior and after. For some parents they are going to vaccinate no matter what the research says (or doesn’t say) and it would be great to help elevate the level of mindfulness about this medical procedure. I know you have studied the research on vaccines extensively so I’d love to see a post on that too. In all your spare time 🙂 Thanks for all the work you are doing. You make this world a better, healthier place and I am grateful!

    • I would also love to see your take on vaccines. I know with you having a daughter yourself it has been a well researched topic. I greatly appreciate your perspective and ability to spell things out clearly. Im also very excited about your practitioner training program and anxious to hear the details.

      THank you Chris!

    • I agree. Testing before vaccination should become standard. I argued unsuccessfully with my doctor that because my family is rife with autoimmune disease and gut problems that perhaps my daughter should forego or spread out her vaccines. She developed Type 1 after a round that included the new chicken pox vaccine. The science refutes that there is a link, of course, but how can that stand in the face of so many vaccine injuries, and in the face of evidence that gut health is the seat of overall health?

    • This Movie is heartbreaking! Thank you, and thank you Chris for exposing the lies. I had worked in the Medical industry for 35 years and saw first hand what the drug Companies did with their meds, how they wooed the Dr.s and gave out millions of dollars of samples and lunches and dinners for “free”. There is so much deceit in so many areas relating to our lives now. God help us.

  29. I was very aware of the dire state of the research industry. A friend was a senior researcher at the NCI. He was forced to take his senior to court for attempts to sabotage his work. His prime witness died of a heart attack the morning the trial was due to begin. They settled out of court. My friend pretty soon left the NCI. Self-interest is endemic, I feel.

  30. Thanks for the great article Chris. Here are a few more issues. Please tell me which ones are mostly myth vs mostly true.
    1 – The gov’t science behind Keynesian
    economics is garbage.
    2 – The gov’t science behind climate warming is
    garbage.
    3 – The gov’t science behind the sustainability of public
    employee pensions is garbage.
    4 – The gov’t science pushing wind energy
    is garbage.
    5 – The gov’t science pushing bio fuels is garbage.
    6 – The gov’t science behind the low fat USDA food pyramid is garbage.
    7 – The gov’t science behind allowing trans fatty
    acids in our diet is garbage.
    8 – The gov’t science saying we can have Quantitative Easing without robbing savers and creating financial bubbles is garbage.
    9 – The gov’t science encouraging vaccinations is garbage.
    10 – The gov’t science encouraging statin drugs is garbage.
    Can you add to this list. Please do.

    • The government science…to the extent that the government is privately controlled by corporate interests you are dead right. It is important, however, to note that corruption of this magnitude does not occur equally in all nations and in this one at all times. Much of this corruption was warned against by multiple Americans…in government. Blaming government, per se, is playing into the playbook of those same corporatists…who are essentially anarchists. They want your help in destroying government…not in fixing it.

  31. 2/18/2015

    Thanks for the thorough article. I did not know of all of these conflicts, but the ones I was aware of was enough for me to distrust conventional meds long ago. I have been med free for 30 yrs and am not immunized. I live a very active and health life.

    This situation is actually worse when you consider:

    1. Meds namely damage the liver in someway which is good for revenue. Since the liver is instrumental in 100’s of body functions, getting on one prescription will ensure the need for other meds and specialists.

    2. Blood Lab normals (Reference Ranges) are manipulated not always considering age, gender, race of patients, as well as, manipulation of ranges from lab-to-lab, year-to-year, and country-to-country. The “norms” may not be normal for you.

    3. Disregard and/or Manipulation of the power of our minds in healing or damaging our bodies. Health care, drugs, treatments, prognosis, and diagnosis are strategically presented to lure patients and outcomes psychologically to the advantage of health care providers. Google Placebo and Nocebo Effects.

    Thanks again Chris.

    Glad we’re wise.

  32. An example that keeps coming to my mind of when the companies and “experts” tell the population how to live:
    My mother went to Haiti a few years ago, after the earthquake, and spent time in a shelter helping women learn to care for newborns. Most of these women had NO IDEA that breastmilk was the primary food for babies. They would starve themselves, saving what little money they had to buy expensive packaged formula for the newborns, instead of nourishing themselves and in turn, their children. It seems downright post-apocalyptic to us, but we could be headed down that path too if we don’t keep our corporate monsters in check.

  33. And supplements? How does this apply to them and the practitioners that sell them? I take a handful under the advisement of a functional med practitioner. But before I had him review my labs, I was self-treating using supps from an MLM that has clinical trials to support their products. The practitioner dismissed the products outright because it was was MLM but essentially prescribed the same things. Who’s to say the products he recommends are better than what I was taking? Many people claimed to be helped on the MLM products. The main criticism was you couldn’t trust them because they were making money off these MLM products. So how is that different when a practitioner sells supplements?

    • Because the practitioner isn’t being paid by the supplement company (in the vast majority of cases) to sell the supplement, or conduct research/serve on advisory committees related to the supplement’s efficacy or safety.

      But if your point is that there is also fraud and conflicts of interest outside of conventional medicine, I would absolutely agree. You will see that in any human endeavor.

      • The practitioner isn’t being paid? I guess I just assumed a retail model wherein a practitioner is purchasing supps at a wholesale cost and selling them at retail. And if so, then the person selling me the supplements has as much interest in seeing me purchase a bunch of things from him, as does an MLM counterpart, which he dismisses. It goes to credibility, and while MLM has none in most people’s eyes, I’m not sure who to trust anymore. Not trying to be a PIA, just looking for clarity because either way it costs a lot of money.

        • I thought you were asking what the difference was between doctors on advisory panels accepting money from drug companies and practitioners who sell supplements.

          If you’re asking what the difference is from MLM supplements and others, I’d have to say that in general I find the quality of MLM products to be inferior to reputable, clinician-grade products sold by companies like Thorne, Pure Encapsulations, etc. This is a generalization and I’m sure their are exceptions, but personally I find the entire MLM business model, as well as the many documented cases of fraud with MLM companies, to render them less trustworthy overall. You are of course entitled to a different opinion.

            • Multi-level marketing. Many people consider it to be little more than a pyramid scheme, but there are probably some reputable items being sold this way as well.

          • Thank you for these thoughtful responses.Yes, I was asking what the difference was and I guess I was also asking why it’s okay to sell supplements (or not, as in MLM). Asked and answered, again thanks. I was asking because I’ve heard similar things about clinical trials in the supplement industry that skew to favor the desired results and I was wondering if you heard similarly and saw this as the same thing (which I think you don’t, if I understood correctly, since the payout isn’t there). In any case, I appreciate the clarification, from you and your readers. Keep on…

        • Molly, I’m a nutritionist who uses supplements in my practice. I do recommend specific products from practitioner-only companies, because I know they do rigorous third-party testing for quality, purity, and potency, so that my clients can be assured that what’s in the bottle is what the label *says* is in the bottle. Yes, I purchase these items at a certain cost, and then sell them for more, but the difference between that — me, having this contribute to the exceedingly modest income I make as a nutritionist — and MLM is that I do not have any sort of profit sharing or “network,” such that I get any increased amount of money/residuals by bringing other practitioners into the company to make money off *their* sales, and those of new people *those* people bring in. It’s one-on-one, me and a client, with me making the best recommendations I can for their individual needs and goals.

          And I can’t speak for other practitioners, but I always, *always* provide suggestions for similar brands/products clients can purchase more cheaply from a health food store or corner drugstore, with the caveat that I cannot ensure quality or potency, so their results might come more slowly, or not at all.

          I am very sympathetic to budget concerns and I don’t require my clients to use supplements. I inform them that they are one more tool in the toolbox to get them feeling better, and it’s up to them whether they think it’s worth a little extra money to come at things from multiple angles.

          It is almost impossible to make a living wage doing private nutrition consultations. Connecting clients with supplements that might really help them is one additional contributor, not to mention the (unpaid) time I invest in learning about the specific ingredients, drug/nutrient interactions, pharmacology, etc. And at the moment, I am extremely small potatoes in terms of practice size. I’m a one-woman operation, just trying to help people and, at some point, be able to transition from my unrelated day-job to doing this work full-time, and even so, I have no problem if a client isn’t interested in purchasing the specific items I recommend. I always provide those suggestions for more affordable and more easily accessible products. Not everyone is trying to make a fortune by exploiting consumers and clients who trust them. I don’t recommend products because they’re going to make or break me, financially. They won’t. Not even close. I recommend them because I think they’ll be effective, and *this* is how I want to grow my practice — via word of mouth from satisfied clients.

          • Thanks Amy for the detailed response. All helpful information so I can feel better about the $$ I spend on supps, even if I don’t actually feel better (yet, it has only been a month or so).

  34. Thank you for this very nuanced and thoughtful approach to this issue. Scientists and physicians are human beings. They have the same human, emotional, nonrational biases like everyone else. They need money, wish to advance their careers and like adulation like any other person. This and the fact that virtually no group successfully self-polices its own behavior, whether it is the banking industry, teacher unions, the military, lawyers, or in this case, the medical-industrial complex. The food movement in this country has come from outside mainstream dietary advice and has been catalyzed by the Internet and people’s self-empowerment. Likewise, I believe medicine and the academic science as well will be “disrupted” by forces from outside. Can we take what is best in our modern health system (acute surgical care, some vaccinations, sanitation, and appropriate antibiotic use) and combine it with what our evolutionary biology demands (natural unprocessed food, good activity, lean body mass, good sleep, social bonding, enough but not too much stress to grow mentally and physically)?

    Only if we can each acknowledge the biases through which we view the world and how that affects us and others. And finally use the scientific method to see what truly, pragmatically works for humans and our larger ecosystem.

  35. This is really a great article, Chris. You’re extremely fair in your analysis maybe to the point of ceding too much. Personally I find much of the behavior should be labeled criminal.

  36. I really like the article, but what can you as a Dr. and I as a consumer do about this. I love editorials, but love actionable things even more. What are your thoughts Dr. Kresser?

    In good health!

    • The changes will likely have to be legislated. They could include:
      — prohibiting agencies that promote medications (including vaccines) from overseeing drug/vaccine safety
      — prohibiting government officials from working for drug manufacturers
      — managing the influence of drug manufacturers on medical journals (another huge problem I didn’t go into in this article)
      — mandatory (not voluntary) disclosure of all conflicts of interest with researchers and physicians.

      • As long as gov’t has authority without accountability we cannot expect a change. As long as gov’t is large, we have no chance. We choose computers and shoes and places to eat and where to live from our own list, not the gov’t list. . We can choose our own private providers, and our own private certifying companies.

  37. Bravo. As a cancer physician, I have had a growing disgust with the mutually escalating costs and side effects (toxicities) of cancer care. I believe we all now must try to “be a Healthy Skeptic”, to the point of it becoming a mantra. No one should merely “do as they are told” by physicians, you must do your due diligence and make carefully informed decisions. Keep up the good work, Chris.

  38. Great article. I knew about this. Its frustrating though trying to convince family and friends about the influence of big pharma on medical schools and federal agencies. What is scary is that the big pharma are using their skewed data to make big profits at the expense of sick people. When corporations use the government to impose regulations, we have facsim.
    Yet, I feel there is hope with the power of the internet that allows us to communicate and pass on useful information and to petition our politicians.
    I do read several years ago that 80% of funding of most medical schools in the U.S. comes from big pharma. Also,in the New York Times a few years ago, I read that many of the young medical students at Harvard were being intimidated by big pharma and professors if they questioned the safety and effectiveness of certain drugs.

  39. Thank you for weighing in Chris. I appreciate your healthy skepticism and the humble way that you approach your knowledge. I’m so tired of hearing that vaccines are perfectly safe and effective. I am not anti-vaccine. I’m longing for a more sophisticated conversation where we can hold two distinct thoughts, that vaccines may be beneficial but also cause harm to some individuals.

    • Great article, Chris, and very insightful comments which I wholeheartedly agree with.

      Another book which takes a look at Big Pharma:
      The Truth About the Drug Companies: How They Deceive Us and What to Do About It, Marcia Angell, MD, Harvard Medical School lecturer and former editor of the New England Journal of Medicine.

      Publication date was 2005, but not that much has changed in 10 years, other than more drugs have killed and injured more people. If you watch TV, surely you notice the ambulance chasing attorneys ads designed to attract people who have been killed or injured by product X. Attorneys wouldn’t be buying these expensive ads if they didn’t get results from them.

  40. Great article, Chris. Well researched and eye-opening. I think much of the slight of hand in medical research now explains some of the confounding recommendations and about-face moves we see with guidelines. It is easier to say we “now know more” or “we failed to recognize this or that”, than it is to unhook entirely from the gravy train just as long as your turn comes around soon. Right?

  41. Very disheartening stuff, but so important to make people aware of.

    Regarding even more reasons why fraud & deception occur, I think there is probably a great deal of just plain laziness among researchers and study authors. There’s so much pressure to “publish or perish,” and to conduct studies that show the “right” results” (*cough, cough*), that sometimes contradictory findings are downplayed or outright ignored, while supportive ones are emphasized. And let’s not forget the critical difference between statistical significance and *clinical* significance, never mind that the average person out there is almost clueless about statistics and relative risk vs. absolute risk.

    I do health research & writing for a living, and I am often stunned by the poor quality of papers I read on Pubmed — and I mean read, from start to finish, not just skim the abstract. (Far too often, the abstracts really do NOT reflect the actual findings, when you take the time to look at the data.)

    Another big, BIG issue, I think, especially at the highest levels of pharmaceutical companies, universities, and government health advocacy and regulatory agencies, can be summed up in two words: REVOLVING DOOR. When leaders float from agency to company, back to agency, to university, back to company, it becomes, for lack of a better word, incestuous.

  42. Remember Don Poldermans, a famous Dutch fraudulent researcher, a.k.a. Con Poldermans? More info at http://drmalcolmkendrick.org/tag/don-poldermans/

    Dear Donny has never been prosecuted, he’s still working as a ‘doctor’ at a hospital in Spijkenisse in the Netherlands.

    Should he not be in prison – like all other criminals? No, Dutch authorities (“Inspectie Volksgezondheid”) don’t hand over the facts, not even to an investing TV program. Big Pharma gangsters…

  43. This article does not surprise me. I was poisoned by Botox as have many other people. The product is not safe and despite hundreds of reports of adverse effects nothing has been done about taking this product off the market.

  44. Recently I read “Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare” by Peter C. Gotzsche. What you describe is general practice all over the world. Goetzsche’s advice is to only get medication that has been on the market longer than 7 years. The trials are falsified anyway and the really dangerous stuff is taken from market within the first 7 years.

    • For me the best thing to do is go one step further: treat all medicines as an absolute last resort after all other possible treatments options are exhausted. I have unwittingly taken part in an uncontrolled trial for the last 15 years (long term use of PPIs for GERD) believing there was no alternative. During those 15 years I’ve been a patient to a dozen or so general practitioners (I’ve moved around a lot). I recently experienced a complete remission of all symptoms by eating a carb and gluten restricted diet. No PPIs for 4 months now. Why didn’t any of my doctors suggest trying this?

      • “WHY ARE STATINS STILL ON THE MARKET”

        The statin study that propelled statin drugs to the biggest selling class of drugs of all time…

        Only 1 % of study participants benefitted, yet the FDA allows them to claim 36% less risk of heart attack based on the unbelievable SCAM of “Relative Risk”…

        In Lipitor newspaper ads there is an ASTERISK after 36%* And in tiny print at the bottom is says that this means (approx) 3% of people taking the drug, and (approx) 2% of people on the placebo benefited. The difference between (approx) 3% and (approx) 2% is 36%.

        Billions upon billions spent on these drugs for 1% benefit and lots of debilitating side effects, including increased risk of death.

        ANYONE put on a statin drug, or ANY drug should ask their doctor if the PERCENTAGE OF PEOPLE WHO BENEFITTED from the drug in the studies is based on “RELATIVE RISK”??? I have had 2 different doctors drop their jaw and not answer me when I asked them this question. I just looked at them waiting for a response until they changed the subject.

        • Pharma’s response when the newspapers exposed this was something like “Even if only 1% are protected, the more patients taking cholesterol lowering medicines, the more will benefit, and this will add up to a lot of people being protected.”
          WOW, so lets spend a few more billion on drugs that will send more people to an early grave than will benefit.

    • “… THE REALLY DANGEROUS STUFF IS TAKEN FROM THE MARKET WITHIN 7 YEARS”

      The FDA’s own statistics currently list prescription drugs as the 4th leading cause of death. (And the number of people who live with diseases and disorders caused by drugs is even greater.)

      See this FDA page:
      “FDA Why Learn About Adverse Drug Reactions (ADR)”

  45. For the best ever summary of what’s wrong with medical research you cannot do better than see Ben Goldacre’s brilliant
    17-min TED talk on the subject. No one should miss it.

  46. It is probably no coincidence that the examples are all from clinical trials. They decide on a specific medication and thus have the financial interests of a specific firm behind them. The result is also somewhat arbitrary, it is mostly statistics, there is no model to predict what should happen. (Within limits: to report no heart problems for a pill of a type that normally gives heart problems would be suspicious.)

    This is very different from (medical) research where the scientists want to understand the mechanisms, the reaction path ways, the communications within the body, and so on. That kind of research is interlinked, if someone does something wrong, the next studying that or a related problem things no longer fit together.

    In that respect, I hope that we move from evidence-based (clinical trails & pills) medicine to science-based (understanding and solving root cause) medicine.

    • I hope I see this change in my lifetime, but I am skeptical. Why? Because 2/3 of research funding comes from Big Pharma. Until we address that, I don’t think it’s likely to change much.

      • You are so right Chris, “He who pays the piper dictates the tune”. That is really unfortunate as they are simply putting money over human life ( the very same thing they are supposed to be protecting). What a sad irony.

  47. Hey Chris. This type of article really elevates your status as a medical practitioner. I’ve often tried to share your work with my old man who’s very analytical and he generally comes back with “He’s not an MD” and the consensus view of MD’s is X. This article shows clearly that the consensus has some pretty serious contamination issues. What really sells the article though is the calm and methodical approach you take to this stuff which I find consistent with all of your work. If you’d be willing to take some advice I’d say keep writing these types of articles! And thanks for your great work.

  48. Now who can and when can we make some changes? I mean why can’t the pharma companies donate money to fund these studies anonymously so that the scientists in question don’t know who contributed thereby concentrating on what’s important “the science” – money has to come from somewhere?

    Regulation needs to be more stringent and a private body needs to start implementing some strict changes, repercussions need to be swift to eradicate the soft handed action to date from FDA

    What also comes to mind is maybe by changing the way we research could it change the outlook of the results/studies? currently we look for conventional medicine to treat symptoms but what if research went deeper to treat the underlying cause? Research would be undeniable when a cure is explored.. The data could not lie. I understand how this is quite difficult but what if we try? Else scientists will forever look fr a quick fix and symptom chaser because that’s all that’s expected these days to show statistical significance?

    Just a thought ..

    • Wouldn’t it be nice to live in a world where Big Pharma would contribute money to a general research fund without any connection to the studies, researchers, or results? A fantastic idea, but one might argue that it’s more likely to snow in Houston in July.

  49. Also, make sure you read Harvey W. Wiley, M.D.’s
    “THE HISTORY OF A CRIME AGAINST THE FOOD LAW

    THE AMAZING STORY OF THE NATIONAL
    FOOD AND DRUGS LAW INTENDED TO
    PROTECT THE HEALTH OF THE PEOPLE

    PERVERTED TO PROTECT ADULTERATION
    OF FOODS AND DRUGS”

    Written in 1929. Wiley was the first Commissioner of the FDA writing about the corruption of the FDA from day one.
    http://www.soilandhealth.org/03sov/0303critic/030305wylie/030305toc.html

    This is nothing new. It is a systemic problem with the very nature of regulatory agencies. It cannot be fixed by reform and regulation.

  50. I think this was a great effort at investigative reporting Chris. Thanks for being one who is speaking in the public interest and who continues the quest to have some kind of oversight of our health oriented institutions. The current FDA can’t do it in spite of the funds they have at hand.

    We need reporting like this to help minimize the disease and degeneration that is spread by the current establishment that claims to be improving our health, but is doing nearly the opposite.

  51. Best article you’ve written Chris (at least in my opinion) because this is something I find concerning about skepticism and many “pro-science” blooggers.

    It seems that we have people embracing science not to further their own understanding but to attack people with opposing view points.

    I’ve seen so much ire and rage directed at Bill Nye & Michael Pollan because they questioned the use of GMO’s. They didn’t question the safety, just that the technology was being misused.

    I do find it concerning that many skeptics out there on the Interwebz are just defending the status-quo and challenging anything that’s new.

    Many skeptical writers are still hostile to dietary cholestrol, low carb diets etc. As I started diving more deeply into research myself I realized that the skeptic blogs I read were largely full of it on so many key topics.

    Somehow skepticism has become a movement and a tool to defend and preserve the status quo. It really undermines the revolutionary potential of scientific research.

    And now, the people who should be promoting truth and disturbing ideas are just relentlessly “debunking” anything that’s a threat to them.

    On my Facebook feed, I see dozens of groups formed around running coordinated attacks against the Foodbabe blogger. I’m all for people pointing out she’s wrong or perhaps has the wrong priorities – but the attacks are vile and really against any sort of activism at all (as if our food supply is perfect).

    Anyway, great post. It really hit home with me. This is why I love your site.

  52. One question I have is what percentage of clinical study sites are visited by the FDA? Do they actually visit 100% of the sites conducting trials, or only a random inspection of some? This makes a difference if not all trial sites are visited. The actual number of violations could be greater and underreported.

  53. Hmmm… I’m certainly not the researcher or the expert you are Chris, but I’m hoping to see a follow up to this series with something about vaccines. Obviously a controversial topic and one that I think is probably misunderstood by both sides of the argument when considering factors like microbiome and SNPs. I find myself flip flopping on both sides quite a bit and try to remain skeptical of the alternative medicine crowd as much as I do the mainstream the mainstream one.

    • Vaccines’ interaction with the gut microbiome is poorly understood, but what research there is suggests that vaccines are not only dependent on gut flora to be effective, but also not to cause great harm. In a recent polio outbreak in Pakistan children who had been vaccinated SEVEN times for polio acquired it due to their dysbiotic guts rendering the vaccination useless.
      Cuba has a very similar vaccination rate to the US’ schedule, with almost 100% compliance (no religious or personal exemptions) but almost none of the autism or explosion in autoimmune and chronic disease that the US is undergoing (almost 50% of US children now suffer chronic illness.). There are some fundamental differences between the two countries. Cuba reined in its use of antibiotic drastically in the 90s – only hospitals can dispense them and they don’t dump them all over their life stock, the fate of 80% of antibiotics in the US. Also, glutathione-depleting Tylenol is very hard to acquire – it’s prescription only there. They also eat a gut-supporting traditional diet.
      So many tales of autistic regression I’ve heard entail a sick child visiting the pediatrician, being given a bunch of catch-up vaccinations and antibiotics and then Tylenol for pain.
      Here is a great article, with links to many scientific studies, that describes vaccinations’ effect on gut flora: http://www.greenmedinfo.com/blog/vaccine-injury-biological-plausibility-microbial-predisposition
      In the article the author mentions the high rate of autism among Somali immigrants. This bears out in my son’s autism class. I live in a very homogenous county (almost all Caucasian) but almost all of his classmates are the sons of New Americans (Guatemala, Tunisia, Mexico, China). I suspect it’s something to due with an old world microbiome + the gut-harming standard American diet/lifestyle + heavy use of antibiotics + a heavy vaccination schedule.

      • Thank you for this comment. This is something I haven’t had time to research but feel it is one, possible the most important, white elephant in the vaccine saga. My personal experience reinforces the gut microbiome possibility. It is also the reason my first grandchild is not yet vaccinated as her mother and I believe her gut isn’t right and we r taking steps to heal it before any discussion on vaccines, spacings, etc takes place. Her diet is Not SAD but a whole foods, fermented foods great grandmother style diet and she still shows signs of gut disbosis. Scary but I believe epigenetics r at play as I am most likely the culprit in her microbiome unbalance. I have extreme gut issues, my daughter, born c section with antibiotics and a case of thrush at approx 3 weeks, got “lucky” with my gut bacteria, or lack thereof, and passed it along. Our children and grandchildren really do need us to recognize the whole epigenetics theory, correct our guts and possibly, only then, pass along a long healthy life to them. Again, a great comment on the whole screwed up mess named Vaccines we have here in the good old, corrupted, USA.

        • I also feel epigenetics and gut health issues are ignored at our peril. I wanted to share some of my story with Jenny, to support her in trusting her instincts and resisting the pressures of a one-size fits all approach.

          My Great-grandmother was a permanent invalid, due to a hole in the heart. She was too ill to breastfeed my Grandmother, who had a whole host of gut issues – diverticulitis, colitis and such extreme constipation she perforated her bowel. My mother was a twin and I’m afraid the breast milk went to the larger, healthier looking twin, who was also a boy and generally thought to be more important.

          My mother had terrible digestion, IBS, chronic fatigue, dairy intolerance and unremitting constipation. I was delivered naturally but she didn’t breastfeed, as she had to go back to work after 3 weeks. I had intense hayfever from the age of 2 which lasted 6 months of the year, escalating allergies to food from the age of 10 onwards, borderline inflammatory bowel disease. I had literally 20 courses of antibiotics, some via IV, by the time I was an adult because I was always ill.

          My own children were born by C-section, which was unlucky (not that I probably had such great bacteria to offer anyway) and to compound things, I couldn’t breastfeed either (I’d had surgery on both breasts much earlier in my life the tubes weren’t properly connected anymore).

          Both our boys had severe milk allergies which made them projectile vomit and covered them in weeping eczema from head to toe. They cried and writhed in agony all day and night, until we got them on a special amino acid formula (the eczema was gone in about a month and the pain went almost immediately). Despite a rigorously careful diet since then, they are still intolerant to lots of food groups, which make them break out in hives or burn through their digestive system like they’d eaten a vindaloo.

          Our oldest had a bad reaction to his Dtp boosters aged 6 months and a terrifying period of regression followed. I managed to resist the intense and unremitting pressure from the medical establishment, our families and even our friends and didn’t do another vaccination on him or his brother. He slowly improved, by 12 months we were getting some fleeting eye contact back and by 15 months we were getting a bit of copying. Then things got better and better.

          There was a period when I really thought we had lost him and I don’t wish the agony of that experience on anyone. Now at 3.5, he is completely transformed. No vaccines, a chemical-free home, simple, natural food, lots of outdoor exercise, no TV at all and almost no other digital media. He is a bright, bold, strong and energetic little boy, who is now far ahead of his peers physically and mentally. He has taught himself to read to first year of school level and has a wide, subtle vocabulary. He is an excellent problem solver and surprisingly good at self-regulation at an age notorious for the opposite. More importantly, he is gentle and kind, and loving and secure. He is fully alive in a way I feared he would never be.

          What I mean to say is pharmaceuticals do not have your best interests at heart. Most doctors I’ve consulted have conformity closer in their minds than your health. And even those that don’t, can’t seem to see you as a person, just a list of symptoms that can be paired with drugs. Keep your courage in defending your family! I wish you all great happiness and health.

  54. Hi Chris! Love your site so much. I’m curious – given the rampant issues present in medical research, how do you personally go about verifying which studies to trust? It seems there are so many layers to verify before trusting the data. Can we ever really trust it, then? If you have a method, maybe you could share in a future post? (You know, in your abundant spare time…) 😉

    • It finally has to come down to patient progress. Chris is of the character where that will determine his actions. I don’t know why so many people go back to their doctor just to fall into further sickness. If people are getting sicker and feeling like crap all the time, who cares what so and so studies show? Statins are NOTORIOUS for this! Oh, great, your total cholesterol is down, but now you have memory problems and lost your sex drive? Huh? It’s junk medicine. Most MDs are guilty of not seeing the living human being in front of them and being genuinely concerned with how they are faring, but rather are stuck with managing symptoms or chasing numbers they find troubling in their blood work. They don’t see the forest through the trees. Fortunately, Chris and other functional practitioners are bringing wholeness back to medicine and using tools properly to sort out health issues. I am glad he isn’t an MD because he isn’t tempted by the script pad and it’s all-too-common corruption.

  55. Of course, you’ve only scratched the surface of the problem. Add positive publication bias, ghostwriting, failure to register trials before completion, changing primary results or follow up times during the trial, industry funding of the majority of physician education, pharma reps ability to influence prescribing behavior, and the revolving door between industry and government…there’s just so much to talk about.

  56. The roots of all of this is deregulation of course. Universities were hard up for cash about 30 years as more and more public money dried up; desperate, they turned to the private sector to prop them up. Universities have bills to pay too. We have a big problem on our hands; any suggestions on how to fix it?

    • Well you can teach everybody how to read stats properly, or you change to an entirely socialist system and take profit motive out of it. Whenever there is money involved, corruption follows “Behind every great fortune is a great crime”

    • “The roots of all of this is deregulation of course. ”

      Come on Josh. Regulation itself is the root of all this. Did you not read anything Kresser just wrote? Consider “Who Will Regulate the Regulators?” http://mises.org/library/3-who-will-regulate-regulators

      If there were no FDA, these problems would be readily exposed, not covered up. Granting the FDA a monopoly on access to drugs, etc is simply a tool that corporations use to maintain their own monopoly. Regulation does nothing but help corporations limit competition and cover their corruption. As Jonathan Latham (http://www.bioscienceresource.org/about-us/our-staff/) put it Monsanto would not exist without the marketing job the FDA does for it and the laws that protect them. Consumers simply would not trust the company (or others like it).

      The FDA (and all regulation) gives people a false sense of security. People put their guard down when they hear there is a benevolent nanny-state protecting them from any and all danger. So they assume that whatever exists is safe, rather than doing due diligence themselves. Consider this analogy from bungee jumping in Africa:

      On Dec. 31, Australian tourist Erin Langworthy became one of thousands of people to try bungee-jumping off the bridge that connects Zimbabwe and Zambia, within sight of the tourist mecca Victoria Falls. It’s 364 meters of sheer gravitational pleasure, followed by a gut-wrenching jerk just feet above the rapids below. The only problem, for Ms. Langworthy, is that her bungee cord broke and she fell into the Zambezi, which, in its quieter areas, is infested with crocodiles…

      [The reporter went on to make a few comments about being safe in Africa:]
      One: Tourists who come from litigious societies such as the United States may have an assumption that an activity is safe, because it is allowed to exist. Such an attitude may be reasonable in the US or Australia, but it doesn’t necessarily work in a country such as Zambia, where civil court cases can take decades to resolve…

      Langworthy’s plunge reminded me of the anecdote of a friend in Johannesburg, who took his clients on a year-end corporate junket to Victoria Falls. The last event was to be a bungee jump off the Victoria Falls bridge. All but one of the clients took the plunge. The one who didn’t jump had asked the bungee operator what would happen if the bungee cord breaks. The tour operator grinned: “We’ll replace it.”
      http://www.csmonitor.com/World/Africa/Africa-Monitor/2012/0109/Oh-snap!-Bungee-jumper-plunges-into-Zambezi-River-at-Victoria-Falls

      Look at the doctors Kresser mentioned. If the FDA and the entire medical establishment, with its regulations, did not exist, then doctors would have to exercise their own due diligence and not simply trust the FDA. The removal of this personal responsibility is what creates the problem and the ability for corporations to hide behind the veil of regulation.

      Pretending like the profit motive can be ignored is what gives “benevolent” regulatory agencies their existence and their power. Instead, recognizing that it exists and allowing it to exist *openly* is the solution. Are supplement manufacturers not motivated by profit? Of course they are. What’s the difference between them and Big Pharma? Government connections. Cut off the government connections by ending “regulation” and supplement manufacturers can compete freely with pharmaceuticals, rather than being tied down by laws. Both sides will then compete to inform consumers just like Microsoft and Apple do. Consumers will educate themselves, rather than trusting a regulatory agency. Why don’t we have these kinds of problems in the personal computing industry? Because no one thinks we need to be protected from Microsoft and Apple’s profit motive (obviously regulation exists even there – don’t stretch my comment further than it should be).

      Chris, please read “Designed to Fail: Why Regulatory Agencies Don’t Work” written by a former EPA employee for the Independent Science News (Jonathan Latham) http://www.independentsciencenews.org/health/designed-to-fail-why-regulatory-agencies-dont-work/

      Also consider “The Regulated Consumer” by Mary Bennett Peterson http://mises.org/library/regulated-consumer

      As well as http://mises.org/search/site/regulation
      and
      http://mises.org/search/site/fda

      • Read Upton Sinclair’s The Jungle. That’s what society was like pre-regulation. Or Drehe’s Triangle The Fire that Changed America. Or any history around what life used to be without regulations. People injured on jobs were fired immediately because they had become useless. There was no minimum wage and no maximum hours. China has fewer regulations than we do. Look at all the suffering and deaths that could be prevented. Regulation – clean regulations – are essential to everyone’s well-being. The regulators need to be required to be transparent. If there were no regulators the pharmacy companies wouldn’t even bother with research. They’d simply put the drug on the marker and see what would happen. Just because some people run red lights and even more speed, driving would be horrific if all rules and traffic signals were simply removed.

        • Loved this article and loved your comment.
          I would like to add that any snake oil supplement company can tout the wonders of their product, and said product may not even contain the “miracle” producing elements, but nobody stops them. There is so much fraud in the health food industry too, I have personally been poisoned by flaxseeds at just a couple tablespoons a day. After the fact, my research revealed that no culture ever used it as food for themselves or their animals. The high levels of thiocyanate in them block iodine reception in the thyroid gland and you won’t make the thyroid hormone. Animals get sick on flaxseeds too. The Agriculture Department found it was unhealthy for animals ages ago and told farmers not to feed animals flaxseeds. I am sticking to sardines for my omega-3s now after recovering from the thyroid issues. Tiny fish have less toxins.

  57. Intended or not, the effect of your article is to call into question large swaths of scientific research and its conclusions. When I look at my mother and her huge vat of pills she takes without any thought or knowledge of why she is taking them, I cannot help but think she would be better of if they were all flushed . . . My thought is to avoid the medical establishment at all costs, and I am disgusted that I am being forced to pay for those who are slowly (but happily) killing themselves on the SAD . . . If we changed food and exercise, we wouldn’t need the vast majority of the pharmaceuticals out there . . . Instead, some dietician tells these oldsters, have your OJ, booze, and oatmeal, just all in moderation (looking at the glass half empty today).

    • Well said Colleen. Healthcare costs should be more like 10% of what they currently are. If only national health care were focused on education and encouragement of lifestyle changes, we might reduce costs a full 90%.

      I’d love to see people become ancient, but still healthy. I’m betting a high percentage of 90 year olds would happily pass away with minimal treatments after living such a long, fruitful life. This would further decrease health care costs compared to our current situation where so many 50 and 60 year olds are fighting for their life and paying every last dime to get another 10 years, yet have no hope of a really pleasant life from now on due to their degenerated, unrecoverable condition that is greedily maintained by the medical system.

      • Isn’t it sad? My parents and parents-in-law are already reaching that age and starting to have problems. It’s hard to be the kid and teach them what they’re doing wrong after so many years of thinking they’re right. I try to be gentle but sometimes I lose my temper thinking about how I’ll be taking care of them in ten years, when I’m also raising my own kids. It’s too much, too soon.

  58. “Even when a claim is disproved, it hangs around like a deadbeat renter you can’t evict.” a quote from Dr John Ioannidis head of preventative medicine at Stanford .“‘When you do thousands of tests, statistics says you’ll have some false winners,’.

      • The problem of lying becoming an acceptable part of life began in the 1960’s. I remember a management training movie which contrasted generations highlighting this as a stark contrast beginning with those born post-WW2. Prior to that lying led to immediate dismissal. Today most of us assume that everyone lies unless proven otherwise. Society has even invented a multitude of new names for it such as misrepresentation or obfuscation. The National Nutritional Guidelines are based upon invalidated claims based upon fraudulent research. The guidelines have led to an epidemic of metabolic syndrome and premature death on a large scale yet the entire nutrition profession and associated organizations persist in denying the basic underlying science, established years ago, common to all metabolism text books and supported in large study after large study. No wonder so many people no longer trust what they are told supported only by the statement “trust me I’m a doctor or a scientist”. Fortunately the current situation with measles has brought it to a head and open discussions have begun in the press and media. Its simply a lie to say that vaccinations in general are safe. Some are and some are not. Take the measles example, why do we not vaccinate at birth? apparently this is not safe, why not and how do we know the current designated age for vaccination is in fact safe for all children, is everyone developing in an identical fashion?. In Veterinary medicine there seems to be more honesty and for each vaccination there is a judgement of risk-benefit so that only certain vaccinations are given in each situation depending upon the balance of risk. Vaccination sites ultimately resulting in cysts and eventually in cancer are not uncommon and a general precaution is to remove such resulting lumps to limit the possibility of cancer. I’ve had that done and just yesterday a friends dog was so identified. Everything in medicine has a risk-reward condition, medicine seems to pretend such a thing doesn’t exist for vaccination. Te only way out of this is to do the studies, have them audited, not in secret, and publish the results. The “trust me” argument is worn out. Show me large study data audited by a population cross-section or quit the BS because believing nothing we hear is today probably the safest path. Even photographic evidence is today no longer acceptable in some legal situations since lying with photographs (Photoshop) is a common occurrence.

    • I call those “medical urban legends.” Like “you have to take an antibiotic for ten days to prevent development of resistant bacteria.” That makes absolutely no sense in terms of genetics (in fact it’s the best way to make sure that ONLY antibiotic-resistant bacteria survive), but I’ve been hearing it since I was a teenager, and that was over 40 years ago. I highly doubt it’s ever been supported by any kind of studies. I suspect it came from drug company marketing, even back then.

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