The problem with (NOT) giving medical advice in the Incestral Health Community

Just about every major blogger and guru in the IHC has a lengthy medical disclaimer page.  They are not providing medical advice on the internet because if they are an MD it's illegal (my understanding of the law, feel free to correct me if I'm wrong here),  and if they are not, it's illegal to practice without a license.  Same goes for nutritional advice and all that.  

Right after the medical disclaimer, where you've usually been given the "I have no special training in what I'm about to convey" spiel, or, the flipside, the disclaimer is signed with a name and a litany of letters after it.  And from time to time, you get nothing more than a telling of someone's story on how they cured themselves.  The IHC is big on this.  One of the more recent trends in the IHC is the promotion of ketogenic diets for curing cancer.  I consider this to be wholly irresponsible unless there is a focus on using the diet in conjunction with medical therapies that have been proven effective.  I don't see enough of that in this community, rather too much of the opposite of doctor bashing.  

People with the purest food supply still get cancer.  Unless you are going to live in a bubble somewhere you are going to be exposed to toxins and radiation.  There are any number of natural substances and agents that are toxic to the human body, and we cannot completely prevent exposure to the many man-made ones either.  Cancer cells are produced all the time for no apparent reason, just a "mistake"!  This is a personal thing with me, my mother just celebrated being a 20 year breast cancer survivor last month!  I recall when she was diagnosed how scary it was, Mom had always been a bit of a "health nut" and we didn't have processed crap in our homes.  One could call her a semi-WAPFer and we consumed many veggies that were grown in our garden year round (frozen/canned).  We ate brown organic eggs, shunned all food colorings, preservatives, etc.  I'm sure that some in the audience would love to analyze our diet and pick out some foods that caused her cancer because of something they read on the internet or the latest anti-cancer diet book.  

Whenever someone famous gets or dies of cancer, you can bet the IHC will blame the vegan diet if that person followed one.  Witness Steve Jobs death from pancreatic cancer.  At right is a Google search on Steve Jobs vegan diet (no cancer in the search terms, you can click to enlarge.)  A peddler of coffee around the IHC topped today's search, and Dr. CarbsCanKill Su came in halfway down the page using Jobs' death as evidence that carbs do indeed kill.

But Jobs death from pancreatic cancer might well have been prevented had he sought conventional therapy early on rather than going the alternative route.  

Alternative Medicine & The Death of Steve Jobs 

Did delaying traditional medicine lead to Jobs' early death?

I started my research career some 23 years ago working on pancreatic cancer. It is a relatively rare, yet ugly and often aggressive disease that usually is asymptomatic until later stages. The type Steve had was an "islet cell neuroendocrine" tumor, a somewhat less aggressive type that is more responsive to early treatment. When Mr. Jobs was first diagnosed in 2003, he chose to pursue alternative therapies, including acupuncture, herbal, diet and fruit juice therapy and spiritual consultations. Many of these therapies he found on the Internet. Despite pleading from his distressed family, friends and physicians, Steve chose to delay surgery and chemotherapy for 9 months. When dealing with aggressive cancers, a delay of this magnitude can shave years off of one's life. However, chemo and surgery are not without their unpleasant side effects either.

The author of this article in Psychology Today goes on to discuss risks and those unpleasant side effects and conveys her respect for those choosing alternative paths.   So she's not bashing Jobs here. However she does shed a light on what really contributed to his death -- if anything but the cancer itself.  The thing about conventional therapies is that we actually have some risk-benefit statistics to help us make our decisions.  In my mother's case, technology was already at a point where they could identify different types of breast cancer and different treatment approaches and the effectiveness thereof.  Ultimately she opted for lumpectomy, chemo and radiation but she opted out of tamoxifen after a short stint.  Her radiation was also cut a tad short as she didn't react very well and her tests were all pretty clean from the chemo, so it was a decision reached with her doctor.  I do believe she added a few supplements to her repertoire as well.  And she tightened up on her diet a bit, but is far less rigid now than I have ever seen her be.  

Which brings me to the impetus of this post.  A recent guest on the LLVLC show, that valuable conduit of information in the IHC:  The LLVLC Show (Episode 650): Elaine Cantin Beat Her Breast Cancer, Son’s Type 1 Diabetes With Ketogenic Diet.  Now Cantin is an interesting character as she wrote a book and somehow managed to create a "new" diet she slapped her name on out one that's been around for at least a century (for epilepsy) and likely long before.    I must say that what initially caught my eye was the claimed "cure" of Type 1 Diabetes, and we'll get to that shortly, but (and I didn't listen to this podcast) from the shownotes, Cantin discusses:

• Ketogenic diets have been described as “fed starvation”
• You can feed your body and still starve the cancer
• The hundreds of autoimmune issues her diet is good for
• ALS, Parkinson’s, Alzheimer’s and other brain diseases too
• What kind of response she’s seen from her ketogenic diet
• People are fed up with conventional treatments for cancer
• The woman who’s lung cancer tumor is shrinking
• It’s been two years since she’s been in remission from cancer
• She never did any chemo or radiation…just ketogenic diet
• She was told her cancer was aggressive and needed chemo
• They scared her into thinking it would move into her bones
• Her doctor says she is in complete remission from cancer
• She feels fine these days despite bucking convention

So I went to Amazon.com to see what her book was all about.  This review was on the sidebar:

If you've been diagnosed with breast cancer, be careful in interpreting this book. The author almost incidentally admits to having a lumpectomy and taking tamoxifen for a year to two years after diagnosis, while crediting her ketogenic diet for treating her breast cancer. This is important because both lumpectomy and tamoxifen are the two most effective treatments for estrogen and progesterone receptor positive, HER2 negative breast cancer. It has recently been established that a regimen of ten years of tamoxifen rather than the previously prescribed 5-year regimen is best in preventing recurrence. One must also take into consideration that the author's diagnosis of breast cancer in 2010 and the publishing of this book copyrighted in 2012 does not necessarily mean she is cured. She refused a mammogram in January 2012. Metastasis can reoccur in any part of the body, not just the breast, and may not show symptoms for some time. If the author had written this book ten years post-treatment, and undergone mammogram, MRI, and/or ultrasound with favorable outcome, it would perhaps be more convincing.

This reviewer is a "confirmed purchase" and she raises some key points that one would not get from the show notes (and presumably the podcast, sorry I can't listen to too much of this stuff).  Cantin essentially underwent the appropriate medical treatment for her cancer and used a ketogenic diet in conjunction with it.  Whether or not her keto diet is responsible for a very short-term, unconfirmed remission is unknown.   I would say that the "beating cancer" at this point is due to having it cut out, however.  Period.  As the reviewer points out, lack of any more sophisticated tests and the short duration of her remission hardly makes the case for her diet.  But Jimmy hears about someone using ketosis to cure stuff and he's on it for the interview!

But I think I am more bothered by her son's type 1 diabetes.  From the show notes:

• Her son was diagnosed with Type 1 diabetes and hospitalized
• He experienced having a lot of ketones while he was sick
• This enabled him to come off insulin for a few days
• Starvation actually produced an adequate amount of ketones
• You can replace starvation ketones with a ketogenic diet
• How her Type 1 diabetic son is doing on ketogenic diet
• She did test her diet on her son and he didn’t need insulin

When I read stuff like this I wonder if people in the LC wing of the IHC have any clue what the real problem is in T1.  What actually used to kill humans before insulin was discovered.  It is the KETONES!  Which does not mean that mild ketosis is dangerous, but diabetic ketoacidosis is what kills diabetics and it is due to very high levels of fatty acids that are converted to ketones.  As even one commenter on Jimmy's blog mentions, "nothing novel about starvation diets for treating type 1 & 2 diabetics… the tragedy is why the method had been forgotten about for so long. Here’s a book from 1916!!!"  Tragedy??  Here is a timely article on PBS:  How a Boy Became the First to Beat Back Diabetes:

On Jan. 11, 1922, a 14-year-old boy hovered between life and death. His name was Leonard Thompson and he was suffering the end stages of diabetes mellitus.

Because the only treatment available was a starvation diet, the boy weighed a mere 65 pounds when he was admitted to the Toronto General Hospital. Worse, Leonard was drifting in and out of a diabetic coma. His father was so desperate to save the boy that he agreed to let the doctors inject Leonard with a newly discovered wonder drug that had never been tried on another human being. The doctors called it insulin.

It was a starvation diet.  There are many case studies like Thompson's in the peer review literature (sorry, time doesn't permit hunting down the links, feel free to help me out).  Because of insulin, diabetics live much, much, longer now. It is a hormone of LIFE.   But the discussions of insulin in this community are so utterly ill informed and hostile towards this hormone, people fear it!  I blame Taubes and Eades and all the rest of these people who have demonized this hormone and contributed to widespread misunderstanding of it's purpose and action.  Even Bernstein doesn't shun insulin, he's just operating on his premise of the law of large numbers or something like that and feels better glycemic control is possible with smaller carb and insulin doses.  

Insulin saved Leonard's life as it has saved countless others since.  I only hope that Cantin's bragging of her son's T1 treated w/o insulin means he is not T1 but rather MODY or some other form where he makes some insulin endogenously.  What I find tragic is that people like Jimmy's commenter exist who think it is tragic that we've abandoned starvation diets in favor of insulin.  Jeez.  Why do these people hate diabetics so?  Really, I'm not fond of using that word, but there seems to be no greater evil on the planet to some of these people than the diabetic who chooses to eat a normal amount of carbohydrates and dose themselves appropriately with insulin.  Why the hell should they not be able to do that without your derision?  Your pancreas does it when you eat carbs, or when you did eat them.  I've made the analogy to thyroid here many times.  Nobody seems to have any issue with supplementing a malfunctioning thyroid, but the pancreas?  No that hormone is a last resort!!  Rosedale thinks it is criminal to give insulin to a T2, a position he did not waver on despite being shown studies on the efficacy of early insulin treatment in reversing diabetes.    

People are getting scare mongered out of seeking appropriate therapies for their diabetes.  On Jimmy's forum there were diabetics who just refused insulin or are prematurely taken off of it and other related drugs (like metformin) by doctors like Mary Vernon.  And people read this on the internet and they develop irrational fears of a life-saving hormone.  This is fueled by the enormous amount of misinformation about insulin bantied about this community.  And it's perpetrated by podcasts touting Cantin and responses like the one Jimmy made to Mr. Tragedy quoted earlier:  "Yep, it worked then out of necessity but it will work now out of prudence."  Prudence?   Prudence?  I don't think it is prudent to revisit starvation diets to treat diabetes.  Do you?  

Insulin therapy has come so far from the early days.  The biggest risk, hypoglycemia, is easily prevented by exercising prudence in diet and insulin dosing.  Those meters you are so fond of, Jimmy, are intended for diabetics so that they can best monitor their situation and treat their disease appropriately.  With the advent of insulin pumps, we are one step closer to approximating life with a functioning pancreas.  Much is left to learn and develop, but much has already been learned about insulin and its action.  Promoting people like Elaine Cantin in the face of such, who seems to advocate for a return to inferior treatments in every way (for diabetes), is not helpful, it is potentially harmful.  

In the coming weeks I hope to share with you two reviews from the peer-reviewd scientific literature  on insulin resistance, and begin anew a dialog on this topic that is so horribly misunderstood in the IHC.  It is far from a solved case in the medical/scientific realms, but this doesn't mean we don't know a lot about it thusfar.  Many times science is best at shooting down flawed hypotheses, and in this arena this is a repeated occurrence.