It’s Q&A time, holiday edition. You can ask your own question here for a chance to have it answered in the future, and become a paid subscriber to read the whole thing.
I have family members who swear by certain alternative treatments and sometimes push them on me. I’m skeptical at best, and sometimes I just think these things are outright BS…but occasionally there’s a small voice in my head wondering if maybe they’re worth a shot. Do you think it’s at all possible that there are treatments out there that just can’t be easily measured and/or studied, yet they really do work? How would you respond to someone you’re talking to who claims, “this really worked for me”?
FYI: my answers here are for educational and informational purposes only, aren’t a substitute for medical or mental-health advice, and don’t constitute a provider-patient relationship.
Thanks so much for these questions. The answers to each are related but distinct, and conflating them could lead to some trouble. So first, I’ll discuss whether it’s possible that some treatments really do work even if they haven’t been scientifically validated—and explore some other potential explanations for their seeming effectiveness. This is really just for your own edification, as someone trying to stay skeptical in the face of pressure from proponents of wellness culture. Then, I’ll discuss how to actually talk to people who proselytize about their favorite alt-med treatments—which is less about facts and more about strategies for communicating across divides. There will definitely be some things from the first answer that you won’t want to repeat to the wellness devotees in your life.
With that in mind, let’s talk about your first question.
When Alt-Med Treatments (Seem to) Work
I think it’s definitely possible there could be treatments that work and just haven’t been studied yet—that’s part of how medicine evolves. I DON’T think it’s very likely that these effective but as-yet-unproven treatments are currently being discussed on, say, Andrew Huberman’s podcast, because most of the small, early-stage studies wellness bros like him tout as “cutting-edge” just end up on the cutting-room floor once better evidence comes along. Still, there will undoubtedly be some small number of medical hypotheses that go on to be borne out in randomized controlled trials somewhere down the line.
It’s also possible that some treatments work for one person but not for people across the board, because just by chance the treatment happens to address a particular problem for a particular person. For example, say someone has an undiagnosed vitamin B12 deficiency that’s causing them to feel exhausted all the time. They go to a naturopath and get the dubious diagnosis of adrenal fatigue, for which the prescription is a restrictive diet and a cocktail of supplements. If one of those supplements is vitamin B12, the person may start to feel better—not because of the diet or any of the other supplements, but simply because the “adrenal fatigue protocol” happened to include the correct treatment for what was actually ailing them, totally by chance.
There are also many reasons why people may feel better after alternative treatments that have nothing to do with the treatment at all. I talk a lot about confounding variables in observational studies, but there are confounding variables at the individual level, too—and those may be the real reason for any improvement in symptoms, as we’ll discuss.
Of course, personal experience is an important source of information, and we don’t live our lives by science alone. I’m someone with personal experience of dealing with many different chronic health conditions, and I know that listening to my intuition and continuing to pursue diagnosis and treatment even in the face of dismissal has been incredibly important to my healing and well-being. So that’s where I’m coming from when I say that personal/lived experience is valuable, AND it’s not an accurate predictor of what works in all cases.
There are some significant confounders that can prevent us from making accurate judgments based on our own personal experience, including:
