Dear Misha Cohen and Chinese Herb Academy moderators,
I’m quite willing to have an open, active discussion of these issues. I request that my following letter be posted on Chinese Herb Academy, as that is where Misha responded. The moderator, Doug, has refused to publish this. I fail to see the benefit to this discussion or our profession in disallowing me to defend myself or explain my claims and criticisms. Certainly a one-sided attack of my tone, intent, and scholarship while avoiding direct discussion of the issues I’ve raised doesn’t put the Chinese Herb Academy in a higher moral or academic position.
Misha Cohen has written a preliminary response which she posted on the Chinese Herb Academy. Without her “express written permission” I can’t directly reproduce it. I can, however, discuss it.
Misha begins by being perplexed at my criticism. She states that it does not work towards scholarly discussion. However, my posts clearly and directly reference her published abstracts and research data. In Health Concerns’ large Handbook and collection of promotional material they never have directly referenced, quoted, or linked to the abstracts or studies. My posts provide those direct references. I analyze quotes and data. My censored post directly requested criticism and corrections on the actual abstracts and studies I reference.
Misha states that she has not reviewed the studies in question, was not the author of the journal articles, and would need several hours to do a full literature review to remember the details. I found these via searching for her name as a co-author on Pubmed. She has had 3 published studies on HIV. Here is the Pubmed.com link which pulls up studies for “Cohen MR HIV Chinese”: http://www.ncbi.nlm.nih.gov/pubmed?term=Cohen%20MR%20HIV%20chinese
She says they never studied the anti-viral effects of the formulas, just general effects for symptomatic management. Both the abstract and the research data include HIV load counts and CD4 levels.
I very directly address the differing statements about HIV count data in my (censored) summary about this issue. So far, no one has discussed it directly. Here it is again, from my list of 8 points:
4. The abstracts of their own research conclude:
“Patients taking Chinese herbs reported significantly more gastrointestinal disturbances (79% versus 38%; p = .003) than those receiving placebo… At completion of the study, no significant differences between the intervention and placebo groups were found regarding plasma viral loads, CD4 cell counts, symptoms, and psychometric parameters. HIV-1 RNA level was unchanged at study end…This standardized formulation of Chinese herbs for HIV-infected individuals did not improve quality of life, clinical manifestations, plasma virus loads, or CD4 cell counts. The data suggest that this formulation of Chinese herbs is not effective when administered in a Western medicine setting.”
5. If the abstract was correct, the situation would be bad enough, as it seems unethical to sell a formula to acupuncturists to recommend to AIDS patients if the only documented effect is gastrointestinal disturbance (both the herb and placebo group had worse CD4 counts, so it’s not like they both improved).
6. Unfortunately, the abstract is not correct, specifically when it says the “HIV-1 RNA level was unchanged at the end of the study.” Their own data (which they left out of their discussion) shows for all patients in the study, the Chinese herbs group’s HIV-1 RNA level went from 35,612 to 53,371 (149.86% of starting) and the placebo group’s HIV level went from 52,027 to 33,254 (63.9% of starting). That difference is 85.96% between herbs and placebo, in opposite directions! This opposite effect was magnified in the subgroup taking antiretrovirals.
Misha also states that Enhance and Clear heat were “never designed as anti-viral for HIV or any other disease.” Here is a brief direct quote from the current Handbook for Enhance:
“A concentrated isatis (da qing ye and ban lan fen) extract is used in high doses for its strong antiviral activity, particularly in hepatitis, herpes simplex, herpes zoster, and viral warts. It has a broad range of safety. Additionally a high proportion of clear heat clean toxin herbs are used for the underlying heat inflammation/viral infection present in persons with HIV infection, Cytomegalovirus (CMV), and other chronic viral syndromes.”
Following that is one of the references to her double-blind research accompanied by the direct claim of antiviral effects:
“Clear Heat was designed to be used as the primary adjunct formula to Enhance. Enhance, along with Clear Heat, has been the subject of two double blind studies (see Professional Health Concerns Newsletter, Vol. 5, #3). Clear Heat is specifically used for its antiviral and antibacterial activities and is helpful for swollen lymph nodes.”
The subset of patients in the Switzerland study who took both the herbs and the antiretrovirals were not analyzed as their own group. After crunching the numbers to extract that data, the results were stunning. I’ve reported it clearly in my longer post, including the math I used to get to my results. While the number of patients was small, it is the best published data I found. It shows that Enhance and Clear Heat completely counteract the antiretrovirals. I have asked for more recent research data if it is available, but so far no one has even commented directly on the abstract, much less my data analysis.
Also in the Health Concerns description for Enhance is the statement: ”Similarly, it appears to be helpful to people with HIV for the side effects of drug therapy such as AZT anemia.” This is just three short paragraphs after “designed by Misha Cohen, OMD, L.Ac.” The general reader would take this as a recommendation and stamp of approval, though what little research there is shows the herbs to be far worse than placebo in combination with antiretrovirals.
The most basic premise of the scientific method is that when you test your hypothesis and don’t get the predicted results, you must modify your theory and try again.
The second premise of responsible scientific discourse is to encourage your peers to analyze and criticize your methods and data to look for weak holes so you may improve and refine your theories. I would still like to be convinced that my findings are incorrect and that my concerns for AIDS patients taking these formulas can be laid to rest by better, more current research.
Ancient Way Acupuncture & Herbs, Inc.
Kevin O’Neil, Licensed Acupuncturist