Wednesday, September 28, 2016

Ultraviolet Blood Treatment Revisited

A man undergoing blood irradiation therapy.

A man undergoing blood irradiation therapy.

If there is one thing this election cycle has demonstrated it’s that, when ideology or emotions are involved, people can be entirely immune to facts. The narrative takes control, reinforced by motivated reasoning and confirmation bias.

Even worse, people tend to think they are actually informed, and are confident in their opinions, even when they are grossly misinformed. Regular contributors here frequently receive e-mails from people who truly believe they have it all figured out – modern medicine is a con and we are all shills, while alternative gurus speak the Truth. The confident reality distortion is amazing to behold.

A total lack of ethics and regulation

Let’s take one stunning example from the world of alternative medicine – ultraviolet blood treatment. Britt Hermes, who has contributed to SBM before, is an ex-naturopath who wrote recently about a medical device called the UVLrx. This is a device that is inserted into a vein like a catheter, and then emits UV light directly to the blood.

As she nicely documents, the device is being used by alternative practitioners, mostly naturopaths and chiropractors, without supporting scientific evidence or rationale. There isn’t even sufficient reassurance of safety. How to they do this?

The pattern is one we are now very familiar with here. The company makes a long list of (sort of) clinical claims for the treatment. There are many ways to imply clinical claims without directly making them, or they may just boldly make unfounded claims.

These are supported by a combination of hand waving BS pseudoscientific technobabble, and basic science papers which sound impressive but don’t really directly relate to the claims being made.

You then have a choice of other support – you can always resort to just posting anecdotes. You can even make them up, no one will check. Or you can claim to be studying the clinical claims. You can do in-house pilot studies, without controls, without blinding, and without any chance of getting an inconvenient negative result.

Savvy snake oil providers are now also just constantly doing clinical trials as a back door way of selling treatment with an investigational drug or device.

As Hermes reports – naturopaths are using the UVLrx device, which has not been proven to do anything, and charging thousands of dollars for treatments. The company is being very coy with their claims, with the website referring to basic science that does not support their claims, and pilot studies which are essentially useless. They talk a good game for those who don’t know the difference, doing just enough to create the false impression that their company is interested in science.

The evidence for UV treatment

Marc Crislip discussed the dubious history of UV treatments a few years ago, and not much has changed. The idea of using UV light to treat infections started with a Nobel Prize – using UV light to treat tuberculosis infection of the skin. This, of course, is an external use. Using UV light to treat the blood had its heyday in the 1950s, but fell out of favor without leaving much of a paper trail behind. This often happens with treatments that don’t work. The few practitioners using the treatment fail to convince the scientific community of their claims, which then fade when they die. Sometimes other pick up the claims and carry it on, sometimes not.

UV light is seeing a resurgence recently, because pseudoscience in medicine is now hugely profitable. Many people have observed that we seem to be living in a post-fact world, where you can make up your own reality and spread it across the internet. It’s a golden age of quackery.

But the plausibility of this treatment has not changed. Treating infections by treating the blood with UV light is not likely to have any significant impact, as most of the viruses or bacteria will not be in the blood. Further, you would need to give an adequate dose to a significant portion of the blood, and many treatments only affect a small percentage, like 5%.

The UVLrx claims to fix that problem by placing a laser inside a vein and then all the blood as it flows by. This doesn’t really fix the problem, however, as the dose will be small to any part of the blood as it quickly flows by the light. There is no evidence that this treatment does what it is supposed to do.

And of course charlatans are quick to add all the usual evidence-free claims that are frequently made for alternative treatments: it boosts the immune system, while also decreasing inflammation, and increases oxygenation in the blood (so that you can later take antioxidants) while detoxifying it. This is cut-and-paste pseudoscience. These are not even plausible, or really even coherent, medical claims.

Further, in this case there isn’t evidence to show that the treatment is safe. UV light can cause tissue damage, as anyone who has suffered a sunburn can attest. What damage is being done with the UV light from this device, and can it have any clinically significant effect on infections at a dose that is safe for the tissue? These are unanswered questions.

Conclusion: A dubious device and a double standard

This is just one dubious medical device out of the countless that are out there. What it shows is that the rules change based upon whatever narrative you wish to operate under.

Here we have practitioners who are charging thousands of dollars for a treatment without evidence that it is safe or effective, making claims not backed by evidence, and conducting worthless research without proper oversight or transparency, but this is all somehow alright because they are “alternative” or “natural.”

It just shows the power of an effective marketing narrative. Now believers who seem intent on being taken advantage of will accuse me of being a paid shill for raising these obvious questions.



Ultraviolet Blood Treatment Revisited Steven Novella

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