Zeolicious Science Part II: Or, why I’d rather be attacked by hyenas than buried in bullshit
Simon’s mom has terminal cancer, and he wants to know if anyone out there has tried it, and does it work? Maina’s aunt was recently diagnosed with brain cancer, and she plans to take it along with chemo and radiation; does anyone know about the risks? Sara’s six-year old niece was just diagnosed with an aggressive melanoma; does anyone know about dosages in children? Messages like these litter cancer discussion boards; they’re written by desperate people who are looking for hope in tiny plastic bottles filled with earth and water: “Natural Cellular Defense Zeolite.”
A few days ago, I was watching a nature show on PBS. It was one of those heart-wrenching life-is-the-ultimate-reality-show moments – a baby zebra had strayed from the herd and was lost on the savannah. Night was falling, and the situation was getting dire; the little animal tottered through the brush looking for the rest of the herd. It called out, but only occasionally and tentatively – as if it was aware that not all the ears out there in the dark belonged to other zebras.
Those enterprising individuals that stray (or are forced) from the well-trod paths of mainstream medicine into the wilds of the Internet find themselves in a similar predicament; a cry for help from a desperate cancer patient is as likely to bring hyenas as it is healers. For example, in response to requests for information like the ones above, you often see answers that are sympathetic and encouraging … with a toll free “Waiora” number or web site at the bottom. Type “Natural Cellular Defense and cancer” into Google and you’ll find hundreds of different sites with positive testimonials, scientific references … and, inevitably, the Waiora insignia along with a price list. Four tiny bottles of Natural Cellular Defense (NCD) zeolite sent to your home will set you back anywhere from $150 to $200, VISA or MasterCard accepted.
Of course, in nature, it’s easy to tell the zebras from the hyenas, but in the world of alternative cancer therapies, unfortunately, things aren’t so simple. It’s not the hyenas – the shysters selling snake oil – that you really have to watch out for; it’s the sincere ones, the people who really believe they’re selling you a miracle cure. In the case of Natural Cellular Defense, the company capitalizes on the sincerity of its sales force; it’s marketed through a multi-level structure that allows any true believer to become a salesperson and recruiter. That doesn’t mean there aren’t probably some people selling the product who think they’re separating fools and their money, it just means that it’s not as clear-cut as a group of unscrupulous scam artists ripping off desperate patients.
The advertising for this product makes me nostalgic for the days when people selling miracle elixirs could just flat-out lie to you. Nowadays in the U.S., the FDA and FTC tightly regulate the claims you can make for alternative health products, so Waiora can’t actually say that NCD cures cancer, or autism, or any other disease. Even indirect claims like those made by Rik Deitsch in the “Scientific Research Monograph” that was the subject of last month’s article are regulated by the FTC. (We’ve since learned from Deitsch himself that the FTC has banned him from distributing the largely-plagiarized monograph.) This might seem like a pretty severe handicap for a company trying to market a product like Natural Cellular Defense, but there are a number of ways around it. There’s “structure/function” claims, there’s personal anecdotes and stories about ongoing scientific trials that may never be published, and there’s what I like to call “the secret weapon.”
NCD is primarily marketed as a “detox” product, which means basically that it removes the bad stuff from your body and leaves the good stuff free to work better:
“The zeolite in the Natural Cellular Defense attracts and traps small, highly-charged particles that fit into the pores and channels of the zeolite cage. This includes heavy metal toxins. The Natural Cellular Defense has been shown to remove mercury, lead, cadmium, arsenic and other heavy metals. Research has shown that it does help balance pH, which makes a more alkaline system. A slightly alkaline environment in the body helps to stabilize the immune system.”
Assertions like this one on the Waiora website about NCD’s “detox” properties fall under the FDA’s definition of a “structure/function” claim. Unlike “disease” claims, structure/function claims are allowed as long as they are restricted to “statements that describe the role of a nutrient or dietary ingredient intended to affect the structure or function in humans or that characterize the documented mechanism by which a nutrient or dietary ingredient acts to maintain such structure or function.”
In the case of NCD and cancer, the anecdotal evidence is probably much more motivating to consumers than the scientific evidence. Of course, in the anecdotal reports available on NCD sites, you don’t see any resembling the one below, which was sent to the Litmus e-mailbox after the first article we did on the topic:
“Good to see another article revealing the truth about Waiora, Rik D. and the liquid zeolite scam. My husband tried it after a relative signed up as a distributor. Within 6 months, he had a large portion of his right colon removed due to colon cancer. The strange thing is that he gave blood every month, only 32, in great health, but after using that stuff ...”
Quick quiz: What’s the right conclusion to draw about NCD zeolite and cancer from this email:
- I still think NCD zeolite cures cancer.
- Fuck! NCD zeolite causes cancer!
- Who the hell knows!
If you answered ‘c’, then you got it right, congratulations. There’s nothing wrong with considering anecdotes, but it pays to be especially cautious when it comes to a product like NCD. Why? Well, first of all, the positive NCD testimonials are collected in neat lists by people selling the stuff, while negative reports like this one (some of which are just as compelling), are scattered across blogs and discussion boards. Secondly, while the use of anecdotes and personal testimonials in advertising is regulated by the FTC, there may be more leeway in the use of anecdotes than in direct product claims. Third, most of these sites seem to share similar lists of testimonials. It only takes one sufficiently motivated and immoral salesperson to fabricate a testimonial; a hundred others are waiting to replicate it on their own web sites. Finally, anecdotes are inappropriately powerful in influencing people’s decisions, even when they are provided along with statistical evidence. With respect to NCD zeolite curing human cancer, there are no published clinical trials; there are only anecdotes. There’s a story circulating on a lot of the NCD web sites about an informal trial with 65 supposed late-stage cancer patients where 78% of them supposedly went into remission. It’s a powerful story – I even hesitate to mention it here for fear of contributing to it’s longevity – but despite having developed a life of it’s own, and despite claims that it was in the process of being written up as a “best case report” (without any statistics) more than a year ago, it’s still just an anecdote.
In fact, referring to ongoing or in some cases completed trials that often seem to be just weeks or months away from being written up is another favorite Waiora strategy: on Waiora websites and in discussion groups you'll frequently see references to unpublished studies on NCD and cancer, NCD and autism, NCD and toxic coal miners. The coal miners study is one of my favorites because of this quote from the transcript of an April 11, 2006 conference call with Rik Deitsch:
“It’s going to be a tier one study, and we’re in the last two weeks of that study. In fact we’ve already written up the study except for the data, statistics, and results.”
Sounds like a tier one study to me. You can find a list of “ongoing studies” on the Waiora web site. Whether or not these studies actually yield publishable results, it’s a way for the makers of the product to create an atmosphere of credibility and imply that there is research supporting their claims.
As it turns out, the non-anecdotal scientific evidence for NCD being an effective anti-cancer agent is weak but not non-existent, but none of the research has been performed in the states. Virtually all of the published scientific evidence supporting the notion that NCD might have an anti-cancer effect has come out of Zagreb...that’s right, in Croatia. Finely powdered1 clinoptilolite, the zeolite in NCD, was first marketed as a dietary supplement with the power to cure cancer (and hemorrhoids and Parkinson’s disease and sore throat…) in the late 1990s in Croatia. By the turn of the millennium, “Megamin,” as it was called, was being marketed throughout Eastern Europe to tens of thousands of customers. My Croatian translator tells me that according to this article, the Croatian government apparently refused to license the product as anything more than a “cooking additive,” but despite that limitation there appears to have been no small degree of national pride in Megamin’s success, at least in some circles. In 2000, for example, the Croatian newspaper Vjesnik ran a series of articles touting the miraculous properties of Megamin that included a series of interviews with doctors and patients.
The supplement continues to be extremely popular as far west as Germany and Austria, and it’s made enough of a splash throughout the EU that it was the focus of one of a series of “Alternative Medicine Assessments” carried out by the EU in 2005. The aim of that review was specifically to consider the evidence for the claimed anti-cancer properties of Megamin. The authors of the report conclude that: “at present there is no convincing evidence regarding the efficacy of TMAZ [Tribomechanically Activated Zeolite] supplementation against cancer, regarding the improvement of side effects of cancer therapy by TMAZ, or regarding its safety.”
In spite of the notable lack of clinical studies, there are a few in vitro (cell culture) and animal studies that are worth mentioning (see references). The in vitro studies suggest that the addition of clinoptilolite to culture media affects proteins involved in cell survival and proliferation, and that it may also inhibit cell growth in a number of cancer lines. A recent article attributes this latter effect to the ion-exchange and adsorbent (the ability to bind small molecules like growth factors) properties of zeolites. While these findings deserve further research, it’s worth pointing out that adsorption and ion exchange are very general properties – they’re the same properties that make zeolites useful for filtering aquarium water, for example – and it’s not at all clear from the absence of controls in this research that zeolites in any way “target” cancer cells. It’s like saying “I threw a bunch of sand on my cancer cells and they died – therefore sand is an anti-cancer agent.”
Two things emerge from the handful of in vivo studies on clinoptilolite and cancer. The first is that everyone agrees that for the most part ingested zeolites don’t break down in the gut (one study did find that small but detectable amounts of elemental silicon but not aluminum were transferred to solution when clinoptilolite was added to “simulated body fluid”.) The second thing these authors agree on is that even the finely ground “tribomechanically activated” clinoptilolite is not absorbed into the blood, but passes straight through you, all the way from your guggle to your zatch. The obvious question then is whether in vitro studies are relevant at all, since how the hell is the zeolite going to get to any cancer outside the GI tract? The consensus seems to be that it doesn’t; that any systemic (body-wide) effect of clinoptilolite on cancer is probably due to non-specific stimulation of the immune system. That’s right, the idea is that clinoptilolite actually triggers an inflammatory response; an army of macrophages are recruited to engulf the tiny grains of the mineral and they produce signaling molecules that rally the immune system and thus have an anti-cancer effect. Like the in vitro results, these in vivo studies warrant further work. However, it’s important to note that the leap from the results of these studies to the conclusion that clinoptilolite is an effective anti-cancer agent is a huge one. For example, one of the more credible studies found that tumor growth was reduced in mice taking micronized zeolite, but that even in these mice, the death rate remained unchanged. The same study found a reduction of tumor growth due to another variety of cancer in only 5 of 80 mice. The authors of a second study were willing to draw conclusions about the positive effects of supplementing cancerous mice with zeolite even though there were only three, four, and five mice in the three treatment groups. It’s hard to do statistics on three mice.
It’s easy enough to caution against anecdotal reasoning, or to point out that the scientific evidence for zeolites as anti-cancer agents is extremely weak; but extremely weak may still be strong enough for someone who is desperately seeking a cure. As Waiora scientific advisor Rik Deitsch put it with a chuckle in a April 11 2006 conference call, if he had terminal cancer and someone told him to stand on one foot and kill a chicken, he’d do it (scroll down to “Discussion of NCD with cancer” and press play). Not surprisingly, that somewhat insensitive comment was edited out of the subsequent transcript.
In case you’re still sitting on the fence about NCD and cancer, Waiora still has one giant trick up their sleeve, a colossal secret weapon to be deployed when neither the sincerity of their sales force nor the available scientific evidence can recommend the product very strongly:
To truly understand what is meant by bullshit, it’s necessary to consult the definitive reference, On Bullshit by former Princeton philosopher Harry G. Frankfurt. Bullshit, according to Frankfurt is primarily characterized by “a lack of connection to a concern for the truth…an indifference to how things really are” (p. 34). The bullshitter is distinguished from the liar, says Frankfurt, in that:
“It is impossible for someone to lie unless he thinks he knows the truth. Producing bullshit requires no such conviction. A person who lies is thereby responding to the truth, and he is to that extent respectful of it…[The eye of the bullshitter] is not on the facts at all, as the eyes of the honest man and the liar are, except insofar as they may be pertinent in his interest in getting away with what he says” (p. 56).
In that way, observes Frankfurt, the bullshitter is a greater enemy of the truth than the outright liar.
Consider the following two exchanges. Both are from conference calls with Waiora “chief scientific advisor” Rik Deitsch, the first is from April 11, 2006, the second is from June 21, 2006. Both serve to illustrate Frankfurt’s observation that “Bullshit is unavoidable whenever circumstances require someone to talk without knowing what he is talking about. The production of bullshit is stimulated whenever a person’s obligations or opportunities to speak about some topic exceed his knowledge of the facts that are relevant to that topic” (p. 63).
In this first exchange, Deitsch’s interlocutor, Deb, asks him about a 2003 study on the effect of clinoptilolite on serotonergic receptors in mice. This study is not that convincing to begin with – there were only five mice per treatment group and the statistics seem somewhat dodgy – but in any case it had NOTHING whatsoever to say about either serotonin levels or depression.
Deb: Can you comment on what dosage level would be useful for balancing the serotonin levels in depressed patients?
Rik: As I said, I think the study—and I’m not a specialist in this area—but the study showed an increase in serotonin receptors, not necessarily an increase in serotonin. So I don’t know about balancing serotonin, I don’t know what dosage would be necessary as a treatment of depression, I do know a lot of people using the product say that they feel better, and certainly mild to moderate depression seems to be benefited … [he searches for article …]
Deb: Could we assume then that they might want to take the same dosage that is recommended for people that have other serious illnesses?
Rik: Exactly, I’d say we’re actually recommending … Oh I found it! The Journal of Life Sciences, September 5, 2003 … one of their concepts for mechanism is regulation of immune system … In regulating the immune system all sorts of things balance, serotonin is released by platelets, so anytime you regulate the immune system, you regulate your ability to clot or not clot … and you wind up balancing serotonin levels. It’s funny how everything gets attached, but that’s even with people who take Prozac or Paxil, they increase serotonin levels and there is a biofeedback that actually down regulates platelet product so you have risk of bleeding when you take high doses of Prozac. Isn’t it amazing? You would think one would have nothing to do with the other.
Deb: When you found that article you were just about to comment on dosage.
Rik: Right. 10 or 15 drops three times a day …
If you’re hungry for more, you can see the full transcript here.
Somehow, following this exchange, one gets the distinct impression that not only is NCD efficacious in treating depression, not only is there a recommended dosage and a plausible (if complicated) mechanism of action, but also that there is a published scientific study to back these claims up. Despite the fact that he is clearly not concerned with the truth of the matter (that this study has no relevance to the question that was asked, nor is there any study that does), Deitsch never actually tells a lie, which, as Frankfurt reminds us “is an act with a sharp focus … designed to insert a particular falsehood at a specific point in a set or system of beliefs” (p. 51). Instead, he bullshits. In Frankfurt’s terms, “He does not limit himself to inserting a certain falsehood at a particular point, and thus he is not constrained by the truths surrounding that point or intersecting it. He is prepared, so far as it is required, to fake the context as well” (p. 52).
In this second example, Deitsch responds to a claim by University of Kentucky chemist Boyd Haley that NCD doesn’t bind mercury in solution. Here, Deitsch is responding specifically to Haley’s assertion that a water insoluble material like NCD zeolite would be very unlikely to have “any direct effect on removing mercury from cells.” Deitsch responds:
“First of all, it's not purely insoluble product, in fact zeolite absorbs water very, very well and goes into solution very, very well as a colloidal suspension, so it's not a wholly insoluble product.”
Amazing. He says it’s not purely insoluble – in fact it absorbs water and goes into colloidal suspension very, very well. Guess what; neither of those statements say anything about whether or not NCD is soluble, which it is not. Keep in mind, that this is a transcript of an interview; he’s responding to these questions in real time. To be able to twist a question around like that on the fly, and to give an answer that at first glance seems plausible, well that requires real skill, even craftsmanship. One might almost say it is the work … of an artist.
If you read my first article on this subject, you may remember the feeling I described of being bothered by the marketing for NCD. At the time I couldn’t figure out exactly what it was that was so distasteful to me, but now I recognize what it was: of course, it was the smell of bullshit. Frankfurt observes that in general, people tend to be more tolerant of bullshit than outright lies: “We may seek to distance ourselves from bullshit, but we are more likely to turn away from it with an impatient or irritated shrug than with the sense of violation or outrage that lies often inspire.” [p. 50] The reactions of friends who I told about this article were along these lines: “So what? It’s just bullshit.” This kind of indifference is hard to argue against.
Scientific bullshit, however, should have a particularly distasteful smell to individuals committed to some version of realism. For the scientist who has devoted him or herself to a communal effort that, in whatever flawed and incomplete way, seeks to produce shared truths about the world, Frankfurt’s observation that the bullshitter is a greater enemy of the truth than the liar rings quite true. Although the scientific community inevitably responds with shock and disgust on the occasion of a breathtaking lie by a respected scientist, there is something comforting about outright, clearly recognizable fraud. It’s much easier to recognize and less corrosive to the aims of science than bullshit. Like the hyena and the zebra, the liar and the truth-teller are both, as Frankfurt puts it, “playing on opposite sides, so to speak, in the same game.” The bullshitter, on the other hand, plays by rules all his own.
Ceyhan T, Tatlier M, Akcakaya H. 2007. In vitro evaluation of the use of zeolites as biomaterials: effects on simulated body fluid and two types of cells. J Mater Sci Mater Med. [Epub ahead of print, April 17, 2007].
Ivkovic S, Deutsch U, Silberbach A, Walraph E, Mannel M. 2004. Dietary supplementation with the tribomechanically activated zeolite clinoptilolite in immunodeficiency: effects on the immune system. Adv Ther. 21(2): 135-47.
Martin-Kleiner I, Flegar-Mestric Z, Zadro R, Breljak D, Stanovic Janda S, Stojkovic R, et al. 2001. The effect of the zeolite clinoptilolite on serum chemistry and hematopoiesis in mice. Food Chem Toxicol. 39(7): 717-27.
Pavelic K, Katic M, Sverko V, Marotti T, Bosnjak B, Balog T, et al. 2002. Immunostimulatory effect of natural clinoptilolite as a possible mechanism of its antimetastatic ability. J Cancer Res Clin Oncol. 128(1): 37-44.
Thanks to E. Covic and friends for translation help and J. Harmon for help with research.
Megamin is described as being “tribomechanically activated” zeolite, which basically involves grinding clinoptilolite to a very fine powder using a series of concentric disks that revolve in opposite directions.
Related “The Zeolistas” by Jake Reimer-