Any Experience With Chelation or Fluid Therapy?

[Candido]

My point is that like everyone else, and probe all these 20 years with tinnitus, and the traditional or conventional medicine we know that does not give us the solution or cure for our tinnitus, then we have left? the other is the alternative medicine, and between urine therapy and fluid therapy or chelation, chelation chooses my question is someone on this board have any experience with this therapy?

 

[Dr. Nagler]

My point is that like everyone else, and probe all these 20 years with tinnitus, and the traditional or conventional medicine we know that does not give us the solution or cure for our tinnitus, then we have left? the other is the alternative medicine, and between urine therapy and fluid therapy or chelation, chelation chooses my question is someone on this board have any experience with this therapy?

So as I see it ...

We have conventional medicine that doesn't have a cure for tinnitus.

And we have alternative medicine that doesn't have a cure for tinnitus; they just say they do.

Help me here, folks. What exactly is the appeal of alternative medicine? The fact that they make false claims? Is that it?

Stephen Nagler

 

[Steve]

It depends what you put into alternative medicine. Is it everything that has not been subjected to a proper randomised, controlled, double blind, placebo study - including those that have and have been shown to perform no better than placebo?

If somebody says they can cure you then they are trying to con you, that's a fairly simple rule. They are preying on your desperation and selling you magic rather than medicine. Everyone here longs for the day when that isn't true, but unfortunately it's a fact.

The power of the mind, of placebo, is well documented. And as we are very much influenced by our perception of tinnitus you could argue that there is still value in some alternative approaches. Although I can only see any value in those that have other benefits too, homeopathy is pointless for example but massage will also help your muscles. Some of these so-called treatments can cause harm so you need to be very careful.

Chelation is completely pointless for tinnitus, there is no 'bad' molecule or substance in the body that causes it. There was a recent study on chelation for cardio vascular disease that showed it may help. But that's all.

If you google 'chelation therapy tinnitus' one of the first hits is an idiot telling you it will cure tinnitus. Unfounded, no research.

Steve

 

[Dr. Nagler]

It depends what you put into alternative medicine. Is it everything that has not been subjected to a proper randomised, controlled, double blind, placebo study - including those that have and have been shown to perform no better than placebo?

@Steve, I try to look at the big picture. However you define alternative medicine, it does not offer a cure for tinnitus. Neither does conventional medicine. So why split hairs on the definition?

When there is a predictable lasting cure for tinnitus, we'll all know about it quickly enough.

Until then I choose to focus on the achievement of meaningful relief in the absence of cure. And in that regard, I firmly believe that the habituation-based approaches are the best thing tinnitus sufferers have going for them.

Stephen Nagler

 

[jchinnis]

The power of the mind, of placebo, is well documented.
Steve

Most of the placebo "power" evidence is based on trials that lacked an appropriate control group. This is a serious flaw in the evidence.

If more tinnitus sufferers report improvement than worsening following a doctor-prescribed ginkgo pill, there's a question of how many would have reported improvement in the same (invariably short!) period if a doctor simply talked with them or if nothing was done at all. Maybe just meeting a doctor makes you feel better in a generalized way for a short time; maybe the fact that someone asked you if the pill helped (gosh, someone cares!) made you feel better. And, of course, someone has to ask in order to get the data.

I spent a while reading studies about the placebo effect as a treatment and came away a non-believer.

 

[Dr. Nagler]

@jchinnis, I understand what you are saying and agree with you.

But it got me thinking ...

How would one construct a randomized double-blind placebo-controlled study on the efficacy of placebo in the treatment of tinnitus? (Makes me dizzy just thinking about it!)

Stephen Nagler

 

[cullenbohannon]

Hey Dr.Nagler I don't really know much about medical studies. I was wondering if you could clarify what you mean. I might be involved in a trial so I'm interested to know. Thanks in advance.

@jchinnis, I understand what you are saying and agree with you.

But it got me thinking ...

How would one construct a randomized double-blind placebo-controlled study on the efficacy of placebo in the treatment of tinnitus? (Makes me dizzy just thinking about it!)

Stephen Nagler

 

[Dr. Nagler]

@cullenbohannon -

You want me to clarify what I mean? Hell, I don't even understand what I mean. But hopefully @jchinnis does.

smn

 

[Steve]

I spent a while reading studies about the placebo effect as a treatment and came away a non-believer.

I don't think it can be a viable treatment alone, although if we can convince somebody that their tinnitus is reduced then we are effectively reproducing a psychological intervention. Of course it could never be a treatment anyway, once you've told the patient that you aren't actually going to do anything the effect is gone.

If the patient tries something however that claims it can help tinnitus and will have another health benefit, where they feel a tangible difference in that area of health, that can produce a useful placebo effect. The problem arises when the claims to help tinnitus can not be grounded and we will naturally call the people who claim they can reduce tinnitus scammers.

 

[Dr. Nagler]

Very muddy, @Steve.

On the one hand you talk about putting together a first rate resource. And then it seems you want to consider including third rate (at best) treatments.

Stephen

 

[Steve]

Very muddy, @Steve.

On the one hand you talk about putting together a first rate resource. And then it seems you want to consider including third rate (at best) treatments.

Stephen

I'm not considering that at all, just discussing some issues around placebo.

It's an interesting problem that you can never actually treat with a placebo because you have to be honest with somebody who is paying for your service. Unless of course you are outside of any system and controls - though see below for the exceptions.

I agree with Jim that I don't believe in treatment by placebo, but it still interests me. If a person can convince themselves that they are no longer as bothered by their tinnitus by being open to the suggestion that an ineffective intervention works, I find that intriguing.

Intervention alone I consider a form of placebo, showing that you care and understand a patient, dependant on the condition of course. A quack that cares can make many people feel better without doing anything effective.

Placebo measured against no intervention by this meta-analysis showed no benefit overall, though for pain and nausea there were benefits. But the studies were not robust enough to confirm this.

http://www.ncbi.nlm.nih.gov/pubmed/20091554

This study of GP's in the UK shows a fairly widespread use of placebo in practice. At grass roots level they seem to think it works. It does include off-label use of medicine as an impure placebo so there could be a significant amount of big-pharma sales influence at work here.

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0058247

 

[jchinnis]

I'll try to respond to Stephen's randomized trial question, but it might be tomorrow. Busy, busy day today.

I don't believe the placebo effect has a treatment role in tinnitus or maybe anything unless it is purely or almost purely psychological. Yes, it is conceivable that some element of a placebo treatment in its entirety has a beneficial effect on the emotions and attitudes of the patient, and those effects might either help relieve a temporary psychological issue (need for caring or attention, for example) or might create a response bias when the patient is asked about his symptoms following treatment (unconscious desire to please the people who were trying to help, for example).

Jim Chinnis