In a pattern that is becoming all too familiar – naturopath Christopher Maloney has allegedly forced the shutdown of a blog that was critical of his medical advice. Student Michael Hawkins wrote in the Kennebec Journal:

Naturopathic medicine is pure bull. Let’s not beat around the bush on this one. Those who practice naturopathy are quacks. They may be sincere quacks, but sincerity does not translate to evidence — or your health.

He expressed similar views on his blog, which was hosted by WordPress. Maloney allegedly responded with the British Chiropractic Association (BCA) maneuver, not by defending his claims, but by complaining about the content of Hawkins’ blog to WordPress, who responded by demanding that Hawkins censor his criticism. Hawkins apparently made changes, but not sufficient to please the WordPress censors, and so they shut him down. (Note – Maloney claims he never complained to WordPress and had nothing to do with the shutdown.)

By now you should know what happens next – fellow science and reality-based bloggers (most notably PZ Myers) got wind of the story and decided to amplify Hawkins’ criticism by many orders of magnitude.

What sparked Hawkins’ criticism of Maloney was this article, also in the Kennebec Journal, that was nothing but a thinly-veiled advertisement for Maloney’s practice, in which Maloney wrote:

It will have no effect on deadly complications in any population group (Cochrane). No study of flu vaccinations has shown any benefit for children under 2, and every year half of those killed from vaccine side effects are under 2 years old. (Cochrane and CDC data for the last 10 years). Those promoting vaccination should provide published research to inform patients. Parents waiting for vaccinations can provide their children with black elderberry, which blocks the H1N1 virus. A single garlic capsule daily cuts in half the incidence and the severity of a flu episode for children.

Maloney pulls the typical CAM fast one here. First he disparages the efficacy of the flu vaccine, then scaremongers about side effects, without providing any actual numbers. I prefer this summary of flu vaccine efficacy by Mark Crislip. Mark acknowledges that this is a complex question without a simple yes/no answer. The flu vaccine is not a great vaccine, as vaccines go, but it does have efficacy, and clear benefit in excess of risk. Serious vaccine reactions are “very rare”, according to the same CDC sources that Maloney is apparently referring to. Life threatening adverse events occur on the order of 1/100,000 to 1/1 million injections. Meanwhile, 30,000 or so people die each year from the flu.

After Maloney cherry picks information to scaremonger about the flu vaccine, he then recommends elderberry and garlic. Ironically, he exhorts mainstream practitioners offering the flu vaccine to provide published research – then he recommends two treatments without reference to published research. Let’s take a look at the published research, shall we.

First – elderberry contains chemicals (specifically flavonoids) that have pharmacological activity. So there is some plausibility for biological activity. And in fact there are in vitro studies showing that flavonoids from elderberry extract have anti-H1N1 flu virus activity. But, as I discussed just yesterday, it is not appropriate to extrapolate from such basic science data to net clinical effects. If these flavonoids turn out to be useful, it will be because they are isolated, purified, and then studied in specific doses – in other words, just like any other drug. Perhaps this will lead to the development of the next Tamiflu. Meanwhile, I would recommend using Tamiflu – which as already been purified and studied clinically.

There is also one clinical study showing some effect, but this is a small and preliminary study. Most such preliminary studies will turn out to be wrong, when larger better studies are done. We have been through this with just about every popular herbal remedy, from echinacea to gingko biloba – early studies showing promise followed by large definitive studies that are dead negative.

So, in essence, black elderberry shows promise as an eventual source for an anti-viral treatment, but it is still preliminary and therefore unreliable. So Maloney is recommending a treatment with unreliable evidence (one small study) in favor of one with far more evidence (literally hundreds of studies and thousands of published papers).

My PubMed search on “garlic” and “flu” or “influenza” gave 7 results total. There was only one paper that looked like a clinical study – a Japanese paper from 1973 (unfortunately no abstract is available online).

Maloney’s website has this to say:

Volunteers taking garlic capsules had half as many flus, and the flus were half as long. Adv Ther. 2001 Jul-Aug;18(4):189-93

But the reference cited was for the common cold – NOT the flu. Apparently, naturopathic training did not prepare Maloney to distinguish the cold from influenza.

Further, Maloney is massively cherry picking (even from evidence not relevant to the question). A Cochrane review of garlic for the common cold concluded:

There is insufficient clinical trial evidence regarding the effects of garlic in preventing or treating the common cold. A single trial suggested that garlic may prevent occurrences of the common cold, but more studies are needed to validate this finding. Claims of effectiveness appear to rely largely on poor quality evidence.

Once again we see the reliance on cherry picked weak evidence that may not even be relevant to the clinical question, while disparaging science-based treatments. This is the standard of science within naturopathy.

Conclusion

Hawkins was correct to criticize Maloney and his claims. Maloney, rather than defend his views, decided to silence criticism, and WordPress should be ashamed for caving to such obvious censorship of important public debate.

But in our brave new world at least there are science-based outlets that will not let criticism of pseudoscience be silenced.

Thanks to PZ for bringing this to wider attention.

Addendum:

This story developed rather quickly yesterday. We now know that it is Andreas Mortiz who is threatening lawsuits against Hawkins, and now PZ Myers as well, as an intimidation tactic.

PZ has the update here: http://scienceblogs.com/pharyngula/2010/02/andreas_moritz_is_a_cancer_qua.php