Saturday, July 12, 2008

Amalgams…

By Edgar Kieu

With reference to an article on MyPaper on Friday:

Dear Mr. Nanayakara,

I object to your insinuations in your article dated July 11 2008, especially your paragraph, quoted below:

“Mercury, which by itself is a highly poisonous metal, makes up almost half of an amalgam filling, which also contains silver and a small amount of copper and tin. When introduced to the body via such amalgams, mercury can have neurotoxic effects on growing children and foetuses.”

This is a very damning and highly scientifically inaccurate statement to make.

Two very good studies published in the Journal of the American Medical Association have shown no neuropsychological, renal or neurobehavioural effects of dental amalgam in children. Moreover, elemental mercury itself has a different toxicity profile in the form of vapour, liquid or as part of a restoration.

Neuropsychological and Renal Effects of Dental Amalgam in Children, A Randomized Clinical Trial JAMA.2006;295:1775-1783. David C. Bellinger, PhD, MSc; Felicia Trachtenberg, PhD; Lars Barregard, MD, PhD;Mary Tavares, DMD, MPH; Elsa Cernichiari, MS; David Daniel, PhD; Sonja McKinlay, PhD

Neurobehavioral Effects of Dental Amalgam in Children, A Randomized Clinical Trial JAMA.2006;295:1784-1792. Timothy A. DeRouen, PhD; Michael D. Martin, DMD, PhD; Brian G. Leroux, PhD;Brenda D. Townes, PhD; James S. Woods, PhD, MPH; Jorge Leitão, MD, MS;Alexandre Castro-Caldas, MD, PhD; Henrique Luis, MS; Mario Bernardo, DMD, PhD; Gail Rosenbaum, MS;Isabel P. Martins, MD, PhD

Your article is unduly alarmist, badly researched, irresponsible and potentially misleading to dental patients.

There are many indications to use other types of restorative materials such as composites, glass ionomers or ceramics but there are still very good reasons to use dental amalgams.

It is indeed disappointing and sad that a newspaper such as yours with a broad public reach would have such poorly researched information thinly veiled as news.

I look forward to either an explaination, retraction or clarification of your article, preferably quoting good research to substantiate your claims.

Kind regards,

Edgar Kieu

26 comments:

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Some Notes on Dr. Batmanghelidj's Silly "Water Cure"
Stephen Barrett, M.D.

Fereydoon Batmanghelidj, who died of pneumonia in 2004 at the age of 73, claimed that dehydration is the underlying cause of many diseases, including some that the medical profession regards as incurable. He claimed that users of his "Natural Therapy Cure Program" could "cure virtually all pains at no cost—forever"; reduce blood pressure naturally; lower blood cholesterol without medication; lose unwanted pounds; regain youthful skin; increase mental power and alertness; become stress-free; prevent and cure migraine headaches; prevent Alzheimer's disease; prevent heart disease; permanently cure angina pain; regain sexual powers; cure asthma in a few day; and even cure multiple sclerosis [1]. His theories were embodied in 20 audiotapes, videotapes, books and other reports that he marketed. His best-known work, a book called Your Body's Many Cries for Water [2,3], had two paperback editions (1992, 1995) and one hard-cover edition (1997) with a total of more than 30 printings. Batmanghelidj did business as Global Health Solutions in Falls Church, Virginia, and operated the Foundation for the Simple in Medicine, a private nonprofit corporation located at the same address. According to a biographical sketch on his Web site:

Fereydoon Batmanghelidj, M.D. . . . received his medical education and training at St. Mary's Hospital Medical School of London University. He has spent most of his scientific life researching the link between pain and disease and chronic dehydration. Dr. Batmanghelidj discovered the healing powers of water 21 years ago when he was serving as a political prisoner in an Iranian jail. He successfully treated 3,000 fellow prisoners suffering from stress-induced peptic ulcer disease with the only medication he possessed -- water. This is when he understood for the first time in medical history that the body indicates its water shortage by producing pain. Since his prison experience, he has focused his full-time attention on dehydration-produced health problems in the body. His discovery has helped hundreds of thousands of people suffering from a variety of pains and degenerative diseases regain their health [4].

Batmanghelidj's book further states:

In June of 1982, he was released from prison. Several months later, he escaped from Iran and came to America to further research and eventually introduce his discovery in medicine to scientists and researchers in the United States.

In 1983, the Foundation for the Simple in Medicine was formed to foster research into this topic and become the vehicle for change in the present structure of medicine [3:180].

Batmanghelidj claimed that water is one of the main sources of energy for the brain and the entire body and that it produces "hydro-electric" energy by splitting into hydrogen and oxygen [5]. This claim is absolute nonsense. The only source of energy for humans are the calories in proteins, fats, carbohydrates, and alcohol.
"Full-time Research"

Batmanghelidj claimed that he did more than 20 years of full-time research and that his findings achieved worldwide acclaim. His Web site states that he "has presented his findings at several international and world conferences, and they have been published and peer-reviewed in a number of scientific journals." [4] However, the world's largest medical research database (Medline) lists only two entries for "Batmanghelidj." The first is a 3-page editorial, "A New and Natural Method of Treatment of Peptic Ulcer Disease," which was published in 1983 the Journal of Clinical Gastroenterology [6]. The other, titled "Pain: A Need for Paradigm Change, reflects a lecture he gave in Greece in 1987 that was published in Anticancer Research [7].

Neither of these documents would be appropriately described as a research report. The first one states that from November 1979 through May 1982, while imprisoned in Iran, he treated over 3,000 fellow prisoners with "ulcer symptoms" and was able to follow the progress of about 600 of them with information "from guards, physicians in charge of other sections, and chance meetings or messages received." The second paper presents no additional data but contains a "theoretical discussion" of why he believes "water deficiency" is a major cause of disease.

In an interview published on his Web site, Batmanghelidj stated that the British journal Lancet rejected a report he sent about treating ulcers with water, but the report was published in an Iranian medical journal. (This journal is not indexed in Medline.) No respectable journal would even consider publishing the type of data Batmanghelidj claimed to have accumulated. Although he claimed to have treated people with ulcers, he conducted no x-ray examinations or other tests to confirm any such diagnosis. Moreover, reliable conclusions about effectiveness cannot be drawn from a haphazard collection of tidbits from about 20% of one's former patients. Although heartburn can sometimes be relieved by drinking water, there is no logical reason to believe that water can heal ulcers or do various other things that Batmanghelidj claims to have observed during his prison stay. Nor is there any logical reason to conclude—as he does—that the stomach pain or any other problem reported by the prisoners was due to "water deficiency." [5]

Even if his prison experience were considered research, nothing I have seen indicated that he has done any research since his release from prison in 1982. The 1992 edition of Your Body's Many Cries for Water states that he had done "12 years of clinical and scientific research," and he updates this figure as the years go by. But as far as I can tell, he has not described any data acquired since he emigrated to the United States in 1982.

Curious about whether Batmanghelidj has ever practiced medicine in the United States, I searched several databases. The 1986 AMA Physicians' Directory and AMA's current "Doctor Finder," which list all physicians licensed in the United States, do not mention him. Nor do the states of Pennsylvania or Virginia list him as being licensed within the past ten years. I did learn that he was registered as a naturopath in the District of Columbia, but I do not know whether he has used this registration to see patients.

Batmanghelidj's states that his foundation's "researched views" were self-published an annual volume under the title "Science in Medicine Simplified" in 1989, 1990, and 1991. I have seen no mention of these reports in medical publication or on any science-based Web site. The foundation's 1999 tax return listed $1,930 in cash as its only asset.
Unanswered Questions

The above observations raise the following questions:

* Did Dr. Batmanghelidj do any patient-based research since 1982? If so, where are the data?
* Did he examine or treat any patients in the United States? If so, where are his findings?
* Did he practice medicine in the United States? If so, when and where was he licensed?
* Why didn't the biographical sketches in his books and Web site provide a clear description of how he spent his time since coming to the United States? Did his "research" since arriving here include anything more than reading journal articles, processing mail from readers of his books, and spinning fantasies about his biochemical theories?
* What was the basis of his claim that "his discovery has helped hundreds of thousands of people suffering from a variety of pains and degenerative diseases regain their health"? (Over a 20-year period, that would be nearly 200 per week. How could he receive such reports? How could he check whether they were credible?
* If his research claims were exaggerated, should anyone trust anything else that he said?

References

1. Batmanghelidj F. Medical report. A new medical discovery: It is chronic unintentional dehydration that causes pain and disease, including cancer in the body. Global Health Solutions Web site, accessed Jan 2, 2003.
2. Batmanghelidj F. Your Body's Many Cries for Water: Don't Treat Thirst with Medications. Falls Church, VA: Global Health Solutions, 1992.
3. Batmanghelidj F. Your Body's Many Cries for Water: You Are Not Sick, You Are Thirsty! Don't Treat Thirst with Medications. Falls Church, VA: Global Health Solutions, 1995.
4. F. Batmanghelidj. ©2002. Global Health Solutions Web site, accessed Nov 5, 2002.
5. Biser S. The greatest discovery in the world: An exclusive interview with F. Batmanghelidj, M.D. Global Health Solutions Web site, accessed Oct 19, 2002.
6. Batmanghelidj F. Pain: A need for paradigm change. Anticancer Research 7(5B):971-989, 1987.
7. Batmanghelidj F. A new and natural method of treatment of peptic ulcer disease. Journal of Clinical Gastroenterology 5:203-205, 1983.

This article was revised on November 20, 2004.

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