12 replies to this topic

[TTHQ Staff]

I'm just tossing this one out there to see if anyone has similar experiences and to get some general feedback. Six years ago I suddenly developed an alergy for beans. Lentils, to be exact. While making a lovely hamhock and lentil soup, I noted that my throat was closing up, my breathing was shallow, my skin began itching. It was what I'll now call a mild reaction. Fast forward three years. At the local outdoor grocery market, I sampled an almond. Then I rubbed my eye. It started with the throat closing up and inability to breathe, but now add non-stop sneezing, sinuses running, and the best of all.... my face began to swell. And I don't mean, "Gee, that's swell, Mr. Cleaver." I mean, "Who did you lose the boxing match to? Mike Tyson?" kind of swelling. So here I am, six years later, allergic to nuts and beans and now I'm noticing the allergy food plague spreading... kids and adults allergic to peanuts in particular, but also other nuts and beans. I never heard about this when I was younger, the adult onset of allergies. I mainly heard that kids were allergic to strawberries or shellfish, and often lost those allergies as adults (although some not). Is the adult onset of allergies increasing in adults, or am I just noticing it more in the media and conversation because it relates directly to me? (Like getting a new car and then suddenly getting the impression that everyone seems to be driving the same model because you're more aware of it.) Just curious what some other opinions are. BTW: My father-in-law just developed an allergic reaction to peanuts. He's in his 70's.

[maineman]

Here's a clip from my patient hand out. It is very basic, but helpful, I think. More details later when I get a minute.

MM

Food Allergies: Just the Facts Many of the things we think we know about food allergy are really just myths--stories that are commonly known but aren't based on science. This handout will help you learn the facts about food allergies.
Myth Number 1: Food allergy is very common.
Fact: Although 25% of people think they're allergic to certain foods, studies show that about only 8% of children and 2% of adults have a food allergy.
Myth Number 2: Most people with food allergies are allergic to strawberries and tomatoes.
Fact: Babies and young children are most often allergic to milk, eggs, wheat, soybean products and peanuts. Older children and adults are most often allergic to peanuts, tree nuts (like walnuts, almonds and cashews), fish and shellfish.


Myth Number 3: Some people are allergic to sugar.
Fact: A condition is called a food allergy when the immune system (the part of the body that fights infections) thinks a certain protein in a food is a "foreign" agent and fights against it. This doesn't happen with sugars and fats.
Myth Number 4: Milk allergy is very common in adults.
Fact: Many adults have trouble digesting the sugar in milk. This is called "lactose intolerance." It isn't a true allergy. The symptoms of lactose intolerance are bloating, cramping, nausea, gas and diarrhea. Milk allergy is more common in children than adults. By age 6, 8% outgrow the allergy. Symptoms of a milk allergy include hives, vomiting and respiratory problems after consuming a dairy product.


Myth Number 5: People with food allergies are allergic to many foods.
Fact: Most people with food allergies are allergic to fewer than 4 foods.
Myth Number 6: Food allergy makes people hyperactive.
Fact: The most common "sudden" symptoms of food allergy are hives (large "bumps" on the skin), swelling, itchy skin, itchiness or tingling in the mouth, or a metallic taste, coughing, trouble breathing or wheezing, throat tightness, diarrhea and vomiting. There may also be a feeling of "impending doom"--a feeling that something bad is going to happen, pale skin because of low blood pressure, or loss of consciousness (fainting). The most common chronic illnesses associated with food allergies are eczema and asthma.


Myth Number 7: Allergy to food dye is common.
Fact: Bad reactions to food dyes are rare. They may occur in fewer than 1 of 100 children and in fewer than 1 of 500 adults.
Myth Number 8: Food allergy is lifelong--or is always outgrown.
Fact: Children usually "outgrow" allergies to milk, eggs, soybean products and wheat. However, people rarely outgrow allergies to peanuts, tree nuts, fish and shellfish.


Myth Number 9: Food allergy is not dangerous.
Fact: Food allergy can be fatal if it causes a reaction called anaphylaxis (say: "anna-phil-ax-iss"). This reaction makes it hard for a person to breathe. Fast treatment with a medicine called epinephrine (say: "epp-in-eff-rin") can save your life. If you have a severe allergy, your doctor might give you a prescription for epinephrine in small, pre-filled syringes. Your doctor can show you how to use them and tell you when to use them. If your doctor thinks you might need to use this medicine, you'll need to carry a syringe with you at all times.

A person having an allergic reaction should be taken by ambulance to a hospital emergency room, because the symptoms might start again even after epinephrine is given. They might start again hours later.

Once a true food allergy is diagnosed, you should avoid the food that caused it. If you have an allergy, you must read the labels on all the prepared foods you eat. Your doctor can help you learn how to avoid eating the wrong foods. If your child has food allergies, give the school and other caretakers instructions that list the foods to be avoided and tell what to do if the food is eaten accidentally.

[maineman]

Here's a couple of clips from an article from my Alma Mater. Probably more information than you wanted, but interesting. I think the "hygiene hypothesis" is way interesting. Let me know if you'd like MORE info... this is only a small clip from the whole recent review article.

mm

Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY, USA
Jaffe Food Allergy Institute, New York, NY, USA
PREVALENCE
Food allergy affects about 6% to 8% of infants and young children and approximately 3.5% to 4% of adults [1], [2]. Children with moderate to severe persistent atopic dermatitis have a higher prevalence of IgE-mediated food allergy, estimated at about 35% [3]. The most common food allergens in the pediatric population include cow's milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish, whereas peanuts, tree nuts, fish, and shellfish predominate in adults. Recent studies report doubling of peanut allergy in young children. A 5-year follow-up study of peanut and tree nut allergy using a random-digit dial telephone survey found that, in comparison with the 0.4% prevalence of peanut allergy in American children aged 5 years or younger in 1997, there was an increase to 0.8% in 2002 [4]. Similarly, results reported from the Isle of Wight in the United Kingdom indicate a doubling of clinical peanut allergy and a tripling of IgE peanut sensitization in young children over a period of 10 years [5].

Food allergy remains the leading single cause of anaphylaxis outside the hospital, and an increasing trend has been noted in recent years [6], [7]. In addition, there has been a significant increase in reports of eosinophilic gastroenteropathies, such as allergic eosinophilic esophagitis and allergic eosinophilic gastroenteritis, which are due to dietary food protein hypersensitivity in a subset of patients [8], [9]. Finally, it has recently been appreciated that as many as 50% of episodes of gastroesophageal reflux in infants younger than 1 year are caused by hypersensitivity to dietary food proteins, primarily cow's milk and soybean [10].

The reasons for the increase in food allergy prevalence are not known, but, considering the short period over which the change occurred, environmental factors are clearly more relevant than genetic factors [11]. The hygiene hypothesis has been proposed as an explanation for the increase in prevalence of all allergic diseases and may also apply to food allergy. The hygiene hypothesis postulates that decreased early life-exposures to immunomodulatory factors, such as certain viral infections and endotoxins, may be responsible for the increasing prevalence of allergic disorders, including asthma, allergic rhinitis (AR), and food allergy [12]. It is likely that additional factors play an important role, such as early introduction of solid foods into infants' diets, diversification of diet to include a variety of tree nuts, seeds, and fish, propagation of peanut/peanut butter as a healthy nutritional supplement for pregnant and lactating women and young children, and alternative, noningestion routes of sensitization resulting from application of skin care products that contain food allergens (eg, peanut oil, milk protein) [1], [13], [14].

Recent reports demonstrate development of food–IgE antibodies and clinical reactivity in mice and in adult patients receiving medications that lower gastric pH [15], [16]. These findings highlight a possibility that liberal use of antacids may contribute to development of hypersensitivity reactions to foods, because reduced protein digestion in the stomach results in increased food protein allergenicity, both in pediatric and adult patients.



CHARACTERIZATION OF FOOD ALLERGENS


In spite of the tremendous diversity of the human diet, a few foods account for the majority of food allergies. In the United States, milk, egg, peanut, wheat, and soybean are the most common culprits in children, whereas peanut, tree nuts, fish, and shellfish are the most common culprits in adults [25]. Raw fruits and vegetables are responsible for the oral allergy syndrome that affects approximately 50% of adults with rhinitis caused by birch pollen [26]. Modern diets that routinely include exotic foods as well as a variety of fresh fruits and vegetables have resulted in an increase in allergic reactions to fruits, such as kiwi and papaya, and seeds, such as sesame, poppy, mustard, and rape (canola).

Traditional or class 1 food allergens induce allergic sensitization by way of the gastrointestinal tract and are responsible for systemic reactions (traditional or class 1 food allergy). Type 1 food allergens are typically heat- and low pH–stable, water-soluble glycoproteins ranging in size from 10 to 70 kD. Type 2 food allergens are heat-labile and susceptible to digestion. Type 2 food allergens are highly homologous with proteins in pollens, and sensitization occurs in the respiratory tract as a consequence of sensitization to the cross-reactive pollen allergens (oral allergy syndrome or class 2 food allergy). Cooking can reduce the allergenicity of fruits and vegetables responsible for the oral allergy syndrome, or that of raw or undercooked egg and fish, by destroying heat-labile conformational allergenic epitopes. In contrast, high temperatures (eg, roasting) may increase allergenicity of certain allergens, such as peanut, through the induction of covalent binding that leads to new antigens or improved stability.

[EntropyModel]

I'm just tossing this one out there to see if anyone has similar experiences and to get some general feedback.

Six years ago I suddenly developed an alergy for beans. Lentils, to be exact. While making a lovely hamhock and lentil soup, I noted that my throat was closing up, my breathing was shallow, my skin began itching. It was what I'll now call a mild reaction.

Fast forward three years.

At the local outdoor grocery market, I sampled an almond. Then I rubbed my eye. It started with the throat closing up and inability to breathe, but now add non-stop sneezing, sinuses running, and the best of all.... my face began to swell. And I don't mean, "Gee, that's swell, Mr. Cleaver." I mean, "Who did you lose the boxing match to? Mike Tyson?" kind of swelling.

So here I am, six years later, allergic to nuts and beans and now I'm noticing the allergy food plague spreading... kids and adults allergic to peanuts in particular, but also other nuts and beans. I never heard about this when I was younger, the adult onset of allergies. I mainly heard that kids were allergic to strawberries or shellfish, and often lost those allergies as adults (although some not).

Is the adult onset of allergies increasing in adults, or am I just noticing it more in the media and conversation because it relates directly to me? (Like getting a new car and then suddenly getting the impression that everyone seems to be driving the same model because you're more aware of it.)

Just curious what some other opinions are.

BTW: My father-in-law just developed an allergic reaction to peanuts.

He's in his 70's.

TTHQ Staff ...I found this article which has some statistics on the rise, and throws out some theories, but the bottom line there is no scientific explaination for it currently.

http://www.straight.com/node/12914

Putting a scientific hat on I have to say the 'hygiene hypothesis' is poor scientific 'arm waving' in an attempt to pretend medicine has a clue whats going on, it doesn't, and its what gets medicine a bad scientific name in my book as a good scientistics says when they don't know something.

Before you can propose a theory to explain this, you first have to understand what is happening! and as the article states, no one knows why the immune system 'all of a sudden' changes, its poor science to make unprovable wild cliaims like 'its caused by not eating dirt in childhood' or similar.

What we do know scientifically speaking, is it means a persons immune system has gone wrong. The immune systems has a list of known 'invaders' whom it want to defend you from. These invaders have a 'known shape', and the immune system has a list of these shapes and sends out guards who check for them. When a person in adulthood suddenly becomes 'allergic' to say cats or peanuts, it means those shapes have been suddenty identified as an 'invader', and so an immune response triggered.

The key question is why would that happen?
As I understand it, the list of 'invaders' we inherit i.e. babies get the list two sources: inherited and from breast milk( collustum I think).

However, there is another complex system for dealing with Viruses. We don't have a list for virus shapes, they constantly mutate. So the immune system generates millions of 'random shapes' based off of known shapes in an attempt to identify the mutant - the longer it takes, the sicker who get i.e. a virus that is hard to identify can kill you if it acts fast enough.

Since others are wildly guessing at cause, we might as well, here some theories, either -
1. Our immune systems are suddenly being exposed to a far greater number of stimultant that cause the immune system to generate vast numbers of random 'shapes', and by random bad luck, some of these end of identifying things like peanuts, cats and carrots.

2. Chemicals in our environment can damage our immune system such that its randomly creating shapes.

3. There is another as yet unknown mechanism by which shapes can be created. Just for wild Speculation for example say if the gut lining is broken, then material from the stomach can get into the blood where an immune response could trigger.
The stomach lining is damaged by many factors of a modern western lifestyle.

Anecdotally as I posed elsewhere, I started becomming allergic to just about everything in my 20's and its progressed over several years to the point I could barely function and doctors had no clue to help me on this. I did tons of research on the immune system, and to cut a long story short I reversed all my allergies by avoiding the allegens completely for 12months which is very hard to do, then gradually reintroducing.

The other approach is to desensitize, expose the immune system to the smallest amount that triggers a minimal response,then very gradually increase exposure in the 'hope' that the response is reduced - I've found that works well with pollens/dust etc but not with food type allergy. The one thing I'm still hyper allergic too is mold, and certain perfume(maybe due to mold carry in it?), nothing works for that so far and I tried everything including homeopathy I was so desperate but no use, but they are largely avoidable.


Mark

[maineman]

The article you posted, Entropy, quotes from the same researchers at Mount Sinai. So you agree, right? Anway, true "allergy" is an IgE mediated event that is well studied. There are several different types of immunoglobulins we produce, labeled IgA (for Immunoglobulin A), IgG, IgM, and IgE. IgG and IgM are the primary immunoglobulins. Their production is stimulated in response to exposure to various stimulants, or "antigens" and that is what enables our bodies to fight disease. We take advantage of this knowledge by vaccinating ourselves, like for Polio. We can trigger very specific Anti-Polio immunoglobulins, which are stored in our immune memory banks. Then, in the future, if we come in contact with real polio our bodies can replicate a clone-army of anti-polio antibodies to protect us. Likewise if we are naturally exposed to various unwanted virus or bacteria. (interestingly, we can build specific immunity to some, but not all, antigens). IgE, or immunoglobulin E, is produced in response to non-living antigens, such as pollen, mold, bee stings, shellfish, peanuts, etc. What is not known is why we do this, as the bodies natural immune response in this situation seems to be more destructive than helpful. The result is an "inappropriate" "clone-army" of anti-peanut, anti-pollen, etc. which results in the stimulation of the histamine pathway in eosinophils and basophils in the blood stream and mast cells in the skin. The result of overproduction of histamine is the release of mucous, swelling of blood vessels with leakage of serum (runny nose, blood-shot eyes, etc), itching, heat. or hives. But, the same is true for IgE as is true for IgG and IgM, i.e. prior exposure leads to a "memory" which leads to a more vibrant response in the future. Again, for polio, mumps, etc. this is good. For bee stings, peanuts, pollen, etc. this is bad. This explains why it takes many years to develop allergies in some people. Repeated or intermittent exposure over time leads to an increase in "IgE memory" and then one day it reaches critical mass and you have hives, wheezing, swelling, or whatever. It is well known that someone can move somewhere and feel fine, but after several seasons "develop" an allergy to the spring plants. Or someone can take penicillin a few times as a child, but many years later have a horrible reaction when taking the same drug as an adult. This is very common in bee sting allergy, too. The first stings may be painful or annoying but the third or 4th sting can lead to sudden death. As for the "rise" in environmental allergy, you are right, "the" answer, if it exists, is not fully understood, but the research is excellent. As with all environmental data analysis, the research is painstakingly slow. To statistically ferret out cause and effect from the vastness of the world around us takes an enormous amount of data, time and statistical power. But that is what science is all about, including the putting forth of a hypothesis and the rigorous testing that follows. mm

[EntropyModel]

The article you posted, Entropy, quotes from the same researchers at Mount Sinai. So you agree, right?

Right. I don't think I disagreed with anything, I just added my 2cents about throwing casual theories around with little evidence.

Anway, true "allergy" is an IgE mediated event that is well studied. There are several different types of immunoglobulins we produce, labeled IgA (for Immunoglobulin A), IgG, IgM, and IgE.

IgG and IgM are the primary immunoglobulins. Their production is stimulated in response to exposure to various stimulants, or "antigens" and that is what enables our bodies to fight disease. We take advantage of this knowledge by vaccinating ourselves, like for Polio. We can trigger very specific Anti-Polio immunoglobulins, which are stored in our immune memory banks. Then, in the future, if we come in contact with real polio our bodies can replicate a clone-army of anti-polio antibodies to protect us. Likewise if we are naturally exposed to various unwanted virus or bacteria. (interestingly, we can build specific immunity to some, but not all, antigens).

All true and this is what I tried to simply above.

IgE, or immunoglobulin E, is produced in response to non-living antigens, such as pollen, mold, bee stings, shellfish, peanuts, etc. What is not known is why we do this, as the bodies natural immune response in this situation seems to be more destructive than helpful. The result is an "inappropriate" "clone-army" of anti-peanut, anti-pollen, etc. which results in the stimulation of the histamine pathway in eosinophils and basophils in the blood stream and mast cells in the skin. The result of overproduction of histamine is the release of mucous, swelling of blood vessels with leakage of serum (runny nose, blood-shot eyes, etc), itching, heat. or hives.

But, the same is true for IgE as is true for IgG and IgM, i.e. prior exposure leads to a "memory" which leads to a more vibrant response in the future. Again, for polio, mumps, etc. this is good. For bee stings, peanuts, pollen, etc. this is bad.

This is another good theory. There are a number of problems with it, like all good theories -

1. Why has there been such a rapid rise in these allergies, its not like people are suddenly eat more peanuts?

2. If the IgE response occur to all 'non living things' - and memory leads increasingly vibrant responses to them -
Then why aren't we ALL allergic to everything?

It appears only a few people are allergic and only to a few non-living substances.

The obvious explaination is a genetic one, have any studies been done on this? would be an interesting avenue of investigation. Likely as usual, humans shows a normally distributed diversity in response.

3. The 'memory' you describe here is a mechanism for gradual increase in allergic reaction, but not exponential type increase people are getting that means one day they eat a peanut just fine ( with minor symtoms ) and the next they end up in the emergency room.

This explains why it takes many years to develop allergies in some people. Repeated or intermittent exposure over time leads to an increase in "IgE memory" and then one day it reaches critical mass and you have hives, wheezing, swelling, or whatever.

Not really, because that would be a linear type response, gradual, but the response discussed in the article is 3. an sudden onset of severe symptoms.

It is well known that someone can move somewhere and feel fine, but after several seasons "develop" an allergy to the spring plants. Or someone can take penicillin a few times as a child, but many years later have a horrible reaction when taking the same drug as an adult. This is very common in bee sting allergy, too. The first stings may be painful or annoying but the third or 4th sting can lead to sudden death.

Agreed, we just don't know exactly why its happening.

As for the "rise" in environmental allergy, you are right, "the" answer, if it exists, is not fully understood, but the research is excellent. As with all environmental data analysis, the research is painstakingly slow. To statistically ferret out cause and effect from the vastness of the world around us takes an enormous amount of data, time and statistical power.But that is what science is all about,

Agree 100%.

including the putting forth of a hypothesis and the rigorous testing that follows.
mm

It is, but the hypothesis is proposed to explain the known data, must be falsifiable and explain the causality. The reason I criticize the hygiene hypothesis is -
1. Data - the article makes clear there is no consensus of peer reviewed studies showing this.
2. Its not readily falsifiable - you would need a very long term study, and have great trouble finding control subjects i.e non exposed children to monitor over decades. Very likely you couldn't control other variables.
This is just the 'nature of the beast', its really hard science, anyone doing this study has my sympathy.

3. It doesn't provide any casual explaination, thats what I call 'arm waving', imagine an empty black box with the caption 'something happens in here'. i.e. eating dirt and being dirtier in childhood 'somehow' makes this happen.

Actually though, I was being very tongue in cheek, poking a little fun at the medical professions exagerated use of science, and jargon ( I notice economists have goten' this religion too). The medical profession always leap on any non-scientific statements made by others( as they should), so what's good for goose etc.

But I do believe medicine over relies on (1)&(2) based on dubious statistical practices, and fails (3) i.e. to provide causal explaination with supporting reproducible data. Thats because the body is so complex.


So medicine is a 'pragmatic science' which focussed largely on statistical correlations at only 5% signficance which is a low threshold indeed for 'hard science'. It amounts to 'it it appears to work, so lets try it and see' - which results in the high incidence of 'changed minds' as more evidence arrives.

Correlation is not confirmation - and hard sciences requires the casual proof. My degree is in physics, and sorry but you can't get away with 'there a strong correlation between buffalo herd movements and cold winters', therefore lets kill the buffalo to warm us up. You need to show how thats happening.

For example, most drugs used for depression, mental illness, ADHD etc lack casual proof, and just have alot of arm waving. The standard strategy to avoid difficult questions on that, is to dress up everything with very complex jargon.
I hear this strategy is taught so as to maintain authority, fair enough, I woudln't want to be questioned by scientifically illiterate people all day either ! message boards have taught me how frustrating that can be :-)

But I guess this is partly what gets lot of people backs up( you asked about this on another thread), this pretence of omnipotence, doesn't get my back up, I just think its funny.

Mark

Edited by entropy, 24 January 2007 - 02:55 PM.

[stocks]

For example, most drugs used for depression, mental illness, ADHD etc lack casual proof, and just have alot of arm waving.

We're slowly getting there:

http://www.psycheduc...1Reversible.htm

[maineman]

Entropy, Quite the critical analysis of immunology and physiology. You must really like this stuff. A couple of points, for what its worth. I did not say that the IgE response is to "all" non living items. The IgE system is involved with immunity to items that are, for the most part, "non-living" like dust, pollen, etc, as opposed to "living" items. like Polio virus, or the pneumococcus bacteria (to name 2 that induce immunity through the IgG/IgM system). If we had the capacity to become allergic to everything we'd probably die off as a species. Who knows? Maybe genetic selection has only preserved those of us who were able to survive exposures? Not sure what you are talking about with exponential and linear exposure. What we know is that those who are susceptible build up immunity over time. In the case of polio, for instance, it only takes a couple of exposures (vaccines) and we have appropriate immunity for life. For bees, or peanuts or penicllin, for example, it takes a few exposures, each time a few more "anti-Bee" copies are stored and when you reach a certain level you manifest the allergic response. We know an enormous amount about immunology (one of your answers implied that we do not). Of course genetics play and huge part. Some are allergic to bees, others aren't, in spite of both being stung by bees.... Environmental Data collection studies are NOT the same as controlled research studies (hence we don't go looking for non-exposed kids, but rather collect data). This is how we discovered things like cigarettes cause lung cancer, or cholesterol causes blocked arteries. By poring over huge population data and crunching the numbers and looking for statistical relevance. Your Buffalo example is not in any way shape or form remotely like anything we do in medical research. You state our data for the efficacy of "drugs" for depression, ADHD, etc is non-existent. Just not true. We have excellent data, which is the result of planned studies (unlike Environmental Data collection). I wouldn't get too bent out of shape worrying about the "rise" in allergy. We'll figure it out, quantify it, and, if possible, come up with a way to help kids (and adults) who might be at risk. I have no doubt. Thanks again for the lively discussion. Science and medicine are really cool, I think. I love it. All of it. mm

[EntropyModel]

Entropy,

Quite the critical analysis of immunology and physiology. You must really like this stuff.

I like to make people think outside their box.

A couple of points, for what its worth.
I did not say that the IgE response is to "all" non living items.

Reread my reply, it only refers to non-living items, of which there are
an almost infinite amount of course which is what i meant by 'everything'.

Not sure what you are talking about with exponential and linear exposure.

See point 3.

We know an enormous amount about immunology (one of your answers implied that we do not).

Do we? Maybe, maybe not, not sure what I said as you don't say. I will agree we know alot more than when we knew less, but its just humanistic egotistical relativism to define that as 'an enormous amount' . Only a God with absolute knowledge can quanitify what we know, relative to the totality of 'what can be known'.

This raises another point about good science I will summerize as 'We don't know, what we don't know, so be humble'.
The majority of human minds always believe they know 'alot' about whatever it is, until it is revealed by new knowledge they didn't.

Environmental Data collection studies are NOT the same as controlled research studies (hence we don't go looking for non-exposed kids, but rather collect data). This is how we discovered things like cigarettes cause lung cancer, or cholesterol causes blocked arteries. By poring over huge population data and crunching the numbers and looking for statistical relevance.

Right, its much easier to statistical analysis as proxy science than actual science. Most of the statistical 'finds' turn out to be false. I linked two articles previously on this fact.

Your Buffalo example is not in any way shape or form remotely like anything we do in medical research.

Medicine is largely based as you just said mainly on stastical correlations, and not casual science investigation, that was my point.

You state our data for the efficacy of "drugs" for depression, ADHD, etc is non-existent. Just not true. We have excellent data, which is the result of planned studies (unlike Environmental Data collection).

Of course there are studies on the 'efficacy' of drugs. You must be careful to read what I said, I was questioning the scientific validity of those studies, as do many scientists and statisticians including some of the worlds best statisticians as per article I linked.

-introduction to problems with relying on statistical methods - http://chetday.com/healthhoax.html
-problems of contant failure of peer reviewed studies -
http://www.boston.co...edical_studies/


To explain further, what I said was there is little casual science investigation, and unless you do that, the 'efficacy' is questionable because of stastistical problems that are well known. This is why so many treatments that appear to 'work', then appear to 'stop working' - as per article.

Again, correlation is not confirmation - statistical methods in scientific method are not the 'end product', you must then find out WHY that linkage exists or risk it being a temporary random artifact.

Perhaps another example weall know here would be better. The stock market is a great example. It like the body is so complex its 'causes' for price movement, that we cannot know 'why' it does what it does.

Instead, we look for 'patterns', that is, statistical correlations - these correlations are labelled things like 'technical analysis, sentiment analysis, elliot wave' etc. Each method represents an observed correlation, for which people produce statistical study showing how likely a certain market outcome is. - we often see the seasonal patterns, special days before holidays etc as well.

So purely on a statistical basis, there are correlations that appear to predict price movements with stastically significant amount of data. But what happens when people try to use these? people lose amlot of money. why?
Because most, maybe all of these correlations do not have 'physical causality', that is, they are just random patterns, random correlations. They might work for a while, just long enough to get you convinced and 'betting large', then wham they disappear.

Hence - correlation is not confirmation i.e. a correlation is not proof of a casual relationship, just because fridays before thnaks giving have say a 90% up probability, doesn't mean its anything but a fluke.

How can you know which ones are random, and which one's aren't?
You need to apply scientific method and look for CAUSALITY. You need to ask 'how/why would this pattern work'.

*** This is the hard part of science, statistical methods are 'black box' guesswork, you observe inputs and output and a 'correlation', causality means going inside the black box. ***

This is very had to do for the stock market, sentiment is the nearest thing to causality, well emotions are, and obviously liquidity.

In the case of medicine, most of what is done is black box -
1. You look are input e.g. drugs, food etc
2. You look at outputs, often subjective judgement of study participants about whether their symptoms improved. Better studies measure some metric e.g. hormone in the blood etc
*Yes, you can also do other stastical types of study, but they are still black boxes.

To not be a 'black box', you have to show the cause-effect, not imply it from statistics, actually show it. Let me give an example in the easy science of physics. All my data and maths might show a certain particle 'must exist', but I have to come up with a experiment in a particle acceleration to physical show its existance.

Science is about PHYSICAL OBERVATION - stastical correlations strongly suggest physical causality, but they are not 'observation' in themselves, they are not physical evidence. Any 'science' require physical proof, Darwin required the finding of a complete fossil record for example.

The problem for medicine is it cannot readily do casual experiments because -
1. People don't want to be experiment on.
2. The body is so complex experiment are very expensive and hard to create.
3. We cannot easily account for genetics and evironment.

As a result, medicine relies heavily on statistical method. Unfortunately, many studies are very poor in their methods, and their use of statitistics. OF course, there are many example of things like anitbiotics which do have casuality shown.

Studies are also very poor at identifying 'side effects', because you don't have the casuality. Instead its only after long term use of a drugs, or nutrition idea etc that 'side effects' show up.

As for brain drugs, forget it, there is not causality even remotely shown yet, of course EVENTUALLY there will be after the fct, and we've had is decades of experimentation on people without their consent. I feel the use of ADHD drugs is a particular scandle, but that's a whole other topic.

Thanks again for the lively discussion. Science and medicine are really cool, I think. I love it. All of it.
mm

Your welcome.

Mark

Edited by entropy, 29 January 2007 - 01:43 PM.

[maineman]

Your points are interesting, albeit flawed. Medicine is filled with superb science. Amazing science. Breathtaking research and commitment. It is not by accident or chance that we routinely save lives, improve health, heal children, and improve the quality of life for millions. Our power and knowledge go far beyond "just antibiotics". Don't be so naive. mm