Since 2012, The Skeptic has had the pleasure of awarding the Ockham Awards – our annual awards celebrating the very best work from within the skeptical community. The awards were founded because we wanted to draw attention to those people who work hard to get a great message out. The Ockhams recognise the effort and time that have gone into the community’s favourite campaigns, activism, blogs, podcasts, and outstanding contributors to the skeptical cause.
Last year’s Ockham winner was Knowledge Fight, the long-running podcast that dissects right-wing propagandist Alex Jones, and through that lens attempts to shine light on the larger community of extremists he exists within. Created in January 2017 by Dan Friesen and Jordan Holmes, it has amassed a sizeable fanbase, and has become an essential repository for understanding the conspiracy theory ecosystem of Alex Jones and Infowars.
While we recognise the best in skepticism, our awards are also an opportunity to highlight the danger posed by promoters of pseudoscience with our Rusty Razor award. The Rusty Razor is designed to spotlight individuals or organisations who have been prominent promoters of unscientific ideas within the last year.
Last year’s Rusty Razor went to Dr Aseem Malhotra, a cardiologist who advocates against the use of statins, promotes a fad diet he claimed could prevent 20 million deaths per year from cardiovascular disease, and has been a prolific and highly influential voice scaremongering about the alleged dangers of the COVID-19 vaccine.
Previous Rusty Razor winners have included the Global Warming Policy Foundation for their promotion of climate change denialism, Dr Mike Yeadon for his anti-vaccination scaremongering, Dr Didier Raoult for his promotion of hydroxychloroquine as a treatment for COVID-19, Andrew Wakefield for his ongoing promotion of anti-vaxx misinformation, and Gwyneth Paltrow for her pseudoscience-peddling wellness empire, Goop.
One of the most important elements of our awards are that the nominations come from you – the skeptical community. It is that time again, we ask you to tell us who you think deserves to receive the Skeptic of the Year award, and who deserves to receive the Rusty Razor.
I’m in pain. I’m always in pain. Listeners my podcast, Skeptics with a K, will know that. I feel it in lots of different parts of my body. A dull ache in the front of my ribs and my lower back. Something sharper around the back of my neck and into my upper back. My ankles hurt when I walk. My hips, shoulders, even one of my fingers at the time of writing.
My thighs and knees don’t hurt right now, but they feel weird. I think most people would describe it as pain but I have a weird pain threshold that doesn’t always register painful stimuli.
I know the cause of it. I have a health condition that causes chronic pain and acute injuries. But I also work full time. Sitting in an office chair for hours at a time is good for no one. It’s especially bad for me.
I have plenty of modifications to help. I use an ergonomic office chair at home – padded with memory foam and with a heating element I can turn on when needed. I use a sit-stand desk riser so I can stand up when sitting hurts too much. I have an external screen and a laptop riser to bring up my laptop screen – it’s portable so I can use it from my work office as well. I have an ergonomic keyboard and a trackerball mouse.
I remind myself to walk around every 50 minutes or so. Even if it’s just to the kitchen and back to make a cup of coffee. I try not to slouch. I sit back in my chair so I have back support. When I worked in a lab, I cleared out a space under my bench so I could sit with my knees straight instead of skewed to one side. I go for a walk as many days as possible.
It all takes a lot of conscious thought. It also takes a lot of self-advocacy – to insist on a break in longer meetings so I can walk around, or to explain why I can’t just “take the stairs” to that meeting, because my version of “healthy” is different to yours.
It also takes a lot of unconscious thought – thought I forget to explain, so when I refuse to embark on that walk up the stairs in order to go to the bar, and instead give someone else my money to go get my round, people forget that that is an access thing. Or when I leave things piled up at the bottom of the stairs waiting for the next I need to go up, instead of nipping them up now. Or when I don’t put away the clean dishes that live in bottom drawers, because bending can be hard. Sometimes, assumptions are made.
Similarly, there are unconscious habits that aren’t so good for me. As an autistic person, I stim. As an autistic person with poor proprioception and bad joints, sometimes my stims cause my pain. My ankles are bad right now because I go through phases of twisting and turning them to create a particular sensation. Without realising. Until it hurts to walk.
Like many people with chronic pain and mobility issues, I am extremely aware of how I use my body. And how easy it is to use it in a way that causes pain. Which can be useful for others – when a friend writing a thesis complained their back was hurting, I could point out to them that using a laptop might be the culprit, and they found that stacking their laptop on some books solved the issue.
It also means that I frequently come across a particular treatment that is offered to people with conditions like mine: the Alexander Technique.
The Alexander Technique was invented by F Matthias Alexander, an actor from Australia who lived from 1869 to 1955. He developed the process when recurrent laryngitis was affecting his voice.
The Alexander Technique is a training method that supports patients in being aware of the way they use and hold their body. From that perspective, it can be valuable. My proprioception – that is the sense of where my body is in space – isn’t great. That’s common both for people with my joint condition and for autistic people. It means I walk into things quite a bit. I’m constantly covered in scuffs and bruises from some innocuous interaction with a door frame or banister. But it also means I can be prone to overextending a joint without realising it. Taking a moment to recognise how I’m sitting or standing is an important part of managing my condition.
There is some evidence that postural and proprioception training can help manage pain in certain conditions – particularly low back pain. It might also be part of the reason some people find benefit in yoga or pilates exercises. We also know physiotherapy helps with some pain conditions – not least because stretching out tension or building strength in weaker muscles can be very beneficial. Any exercise that helps us move our muscles a little more consciously can be helpful for that.
There is some evidence that the Alexander Technique might help with the motor effects of Parkinson’s disease for some patients. But there’s evidence that exercise in general can help with Parkinson’s disease, so using the Alexander Technique as a guided exercise method makes sense if that’s the thing that helps patients maintain an exercise regimen.
However, that is not the full extent of claims made by some Alexander Technique practitioners. Some make claims around breathing. It’s easy to see why, given Alexander himself was struggling with his voice and projection when he developed the technique – it’s why he came up with the idea to change how he held his head and neck.
But chronic laryngitis – inflammation of the voice box – is a condition that can actually be helped by changes in behaviour. If you’re distressed enough to invent an entirely new therapy, maybe you’re also trying other things which might cause changes in the inflammation of the voicebox. Maybe you stop acting for a while, to focus on developing your new technique… and therefore you rest your voice and allow the inflammation to come down a little. Maybe you stop smoking, or spend more time outdoors away from the dusts which might be irritating the voice box. Maybe the posture changes help manage the acid reflux you didn’t realise was exacerbating things.
Despite the possible other reasons for Alexander’s apparent recover, many practitioners today still attribute it to the Alexander Technique, and believe it can help with breathing. One practitioner writes:
“Next time you have a cold you too can breathe freely through your nose as normal. All you have to do is to stop sniffing and uselessly blowing your nose to get rid of the blockage! Don’t open your mouth either. Just ignore the feeling that you’re in dire danger of asphyxiation! Can you do that? I doubt it, but if you do, you will find that you are breathing freely through what was a completely blocked nose. Even if you do succeed for a time, I guarantee that the blockage will be back again shortly after. You see, it is no easy matter to disregard that feeling of asphyxiation. The fact that that feeling is utterly mistaken makes no odds.”
The issue, here, is this is an excerpt from an article about treating asthma. He begins the article:
“Asthma is essentially a breathing problem. No, I lie: asthma is not a breathing problem. Asthma is one’s own inappropriate reaction to feeling unable to breathe.”
This isn’t true. Or at the very least it’s a complete misinterpretation. Asthma is a chronic inflammatory condition which causes difficulty breathing. One characteristic part of it is that the muscles of the lungs react inappropriately to some stimuli. Since Alexander Technique aims to relax certain muscles, you can see how someone might think that it’s an inappropriate reaction that a person can control. But we know that key to the asthma response is smooth muscle. You cannot physically control your smooth muscle. Smooth muscles are those that make up the walls of organs like the stomach and bladder and also the walls of your blood vessels. You can’t consciously relax these muscles. You have no voluntary control over them.
It is true that when you’re struggling to breathe during an asthma attack, panic can exacerbate the symptoms and therefore advice is to try to keep calm. But that advice is for while you are taking your inhaler medication and if there is no improvement – calling for emergency support (in the UK, by calling 999 for an ambulance).
A Cochrane review found no good evidence supporting the use of Alexander Technique for asthma.
Ultimately I think the Alexander Technique is no different to any other exercise program that supports an awareness of your own body in space. The big difference is that it’s much more expensive – classes can cos £35-50 for an hour session. Whereas a yoga or pilates class can be much cheaper, and physiotherapy is available freely on the NHS.
The prices are more comparable to private physiotherapy… but for something that is not grounded in any medical basis. It was just invented one day, by some guy who looked in a mirror at his own body, and then taught some other people to do the same.
I don’t necessarily think the Alexander Technique is a complete waste of time for some people, in some very specific circumstances. But then again, I don’t think it has any real value, either – certainly not more so than many other forms of exercise, forms that don’t also then inappropriately claim to treat or cure serious conditions.
When I was younger, my Asian grandmother used to tell me that bigger busts signify youth and fertility, which men in today’s society select for. If we don’t have them, then it is as if we are deemed less worthy, desirable and attractive in this world.
The global market for breast implants was valued at a staggering $1.8 billion in 2021, and this figure is projected to skyrocket to $4.5 billion by 2031 (Allied Market Research, 2022). As women worldwide invest significant sums in enhancing their bust, it begs the question: to what extent have societal expectations moulded unrealistic beauty standards, especially concerning women’s breasts?
The pursuit of an idealised feminine figure has led many women to seek breast augmentation. However, the psychological impact of feeling inadequate about our body image and femininity is profound, impacting our self-esteem, body confidence, and overall mental wellbeing. This emphasises the complex interplay between cultural norms, societal pressures, and individual perceptions of beauty, raising important questions about the broader implications of conforming to today’s ever changing societal beauty standards.
The Papaya and Milk Concoction
Contrary to the prevalence of breast augmentation surgeries in other parts of the world, Asia takes a unique approach. Over here, the search for larger busts is not commonly met with surgical procedures. Instead, it is intertwined with age-old remedies and cultural practices. In the realm of beauty myths and wellness fads, especially in Asia, there is a persistent myth that seems to resurface time and time again – consuming papaya and milk can significantly enhance our bust size.
Rooted in cultural traditions and traditional medicine systems such as Ayurveda and Traditional Chinese Medicine (TCM), this belief reflects a broader cultural preference for natural and holistic approaches to health and beauty. Papaya and milk, being readily available and nutritious ingredients, are often associated with promoting overall health and vitality, and are believed to indirectly contribute to hormonal balance and nourishment (Sharma, 2023), which could potentially enhance our bust size.
Moreover, within Asian societies, there exists a cultural ideal of feminine beauty that emphasises natural attributes, and the belief in the effectiveness of papaya and milk aligns with this preference for non-invasive methods of physical enhancement.
Sarah, a dear friend of mine, relates her experience to me over dinner. Sarah identifies as transgender, and in her journey to feel more like a ‘woman’, she brews and drinks papaya and milk every morning and night like a ritual, in hopes to enhance her bust size and shape.
“I first heard about the benefits of having papaya and milk from friends who are in the LGBTQIA+ community here in Singapore. And in fact, the myth is so popular that friends who are in a similar situation as me are also brewing and drinking this every day and night.” Sarah said. “I identify as transgender after all, and I did it all because I wanted to look and feel more like a ‘woman’, that is, with a bigger and fuller bust.”
I asked Sarah how she has been taking this concoction, and whether she has seen any changes to her body. “I have been doing it since I started transitioning, so about 4 years now. It didn’t work, even though I was spending so much money, time and effort purchasing and brewing the ingredients every day and night. It came to a point where I broke down so badly because I still had not seen any results despite the effort and time spent on doing so.” Sarah said. “I went into depression, and even went to the extent of questioning my own body and attributing the lack of my bust growth to my own flaws. I really hated myself for not being able to grow my bust.”
What shocked me was the fact that she blamed herself for not being able to grow her bust, instead of attributing the failure of her bust growth to the fact that papaya and milk might just not enhance her bust at all. I asked her whether the failure might be in the treatment, not the patient. “I actually did not look at this from that perspective at all…”
The dinner I had with Sarah made me realise that self-love and acceptance are paramount, especially in a world where societal expectations can be suffocating. I learned about the immense pressure Sarah felt to conform to traditional notions of femininity, which often prioritise physical attributes over individual identity and self-expression.
At first glance, the idea of papaya and milk as a bust enhancer seems rooted in ancient wisdom, perhaps reminiscent of Asian herbal remedies passed down through generations. However, skepticism demands scrutiny, and when we examine through a scientific lens, the claim quickly loses its allure.
Lack of scientific evidence
Proponents of the papaya and milk theory often highlight the presence of certain compounds in these ingredients, suggesting they play a role in stimulating breast tissue growth. Phytoestrogens, naturally occurring plant compounds with oestrogen-like effects (Chaudhary, 2023), are frequently cited as key components. Papaya is believed to contain phytoestrogens, which some claim can mimic the activity of oestrogen in the body and thereby promote breast enlargement (Chaudhary, 2023). Additionally, milk is rich in proteins and other nutrients essential for tissue repair and growth, leading some to believe that consuming milk can lead to noticeable bust enhancement (Whelan, 2020).
In reality, the science behind bust size primarily revolves around genetics, hormonal balance, and overall body composition (Flanagan, 2020). While phytoestrogens may indeed interact with oestrogen receptors in the body (Burgess, 2018), the effect on breast size remains inconclusive and the interaction is unlikely to produce significant changes, especially when phytoestrogens are consumed in relatively small quantities.
Similarly, while milk contains essential nutrients for tissue growth, there is no scientific evidence to support the idea that drinking milk alone can lead to noticeable bust enhancement (Macpherson, 2023). Bust size and shape are primarily determined by factors such as the amount of fibrous tissue and fats present, which are influenced by genetics and hormonal fluctuations (American Cancer Society, 2023). Dietary intake alone is unlikely to have a substantial impact on these factors.
While papaya and milk may contain certain compounds that help to enhance the bust size and shape, the scientific evidence supporting these claims is lacking. Bust size and shape are complex traits influenced by multiple factors, and relying solely on dietary interventions like consuming papaya and milk is unlikely to produce significant changes.
Health and Ethical Issues
Beyond the lack of scientific evidence, the promotion of such myths like papaya and milk as a bust enhancer raises ethical concerns. Promoting unrealistic beauty standards through unfounded myths perpetuates body image dissatisfaction. People like Sarah who believe in such myths may develop unrealistic expectations regarding their own bodies, leading to feelings of inadequacy, low self-esteem, and even the development of body dysmorphic disorder.
The constant pursuit of unrealistic beauty ideals can also have significant psychological consequences on us, such as anxiety, depression and disordered eating behaviours. Furthermore, individuals believing in such myths that promise dramatic transformations can exacerbate these mental health issues, causing a cycle of dissatisfaction and despair about oneself that would never end.
However, we should not overlook the root cause of the issue as well. In many societies, there exists a strong emphasis on physical appearance, particularly concerning aspects of femininity such as bust shape and size. The media and advertising often promote unrealistic beauty standards that equate larger bust size with attractiveness, femininity and desirability – which was exactly what my Asian grandmother used to always say.
This is further testified by Sarah: “I think society has already determined how a ‘woman’ should look to be seen and recognised as a ‘woman’ – bigger bust, curvy body and wider hips… and because of all these expectations placed on us women, I feel compelled to live up to that expectation. I just wanted society to recognise and accept me as a ‘woman’.”
I asked if Sarah was still taking the papaya and milk, even though it hasn’t produced any results yet.
“Yeah, I’m still having them twice a day. I am still holding onto the faith that the concoction will work, and I am going to choose to believe that my body just needs more time to grow.” Sarah told me.
Sarah’s experience shed light on the pervasive influence of societal beauty standards, not only on cisgender women but also on transgender individuals like herself. The relentless pursuit of an idealised feminine figure, perpetuated by media, culture, and social norms, made her feel inadequate and doubtful about herself.
Her persistence to continue the papaya and milk regimen highlights the deeply ingrained societal pressures and the psychological toll they can take on individuals striving to conform to the unrealistic beauty standards.
The importance of self-love and acceptance
I asked Sarah if she was happy with who she is today. “The honest truth, no. I don’t feel good enough about myself. I often catch weird glances at me while walking along the streets, and it feels as if I have done something wrong.” Sarah said. “I wished I had the confidence and courage to accept who I am wholeheartedly.”
It is essential to explore alternative ways that prioritise self-love, acceptance, and holistic well-being. Rather than relying on external remedies or conforming to societal expectations, embracing individual authenticity and celebrating diverse forms of beauty can lead to a more fulfilling and empowered sense of self.
Self-love and acceptance transcend physical appearance and encompass a deeper appreciation for one’s unique qualities, strengths, and experiences. It involves cultivating a positive relationship with ourselves, free from judgement, comparison, and unrealistic standards. While societal pressures may tempt people like Sarah to seek validation through external means, true fulfilment comes from within, rooted in self-awareness, compassion, and inner peace.
Embracing self-love and acceptance requires a shift in your mindset and values. It involves challenging the influence of media, culture, and social norms that perpetuate unrealistic beauty standards. By rejecting narrow definitions of femininity and beauty, we can reclaim autonomy and redefine success on our own terms.
Furthermore, fostering self-love and acceptance within ourselves is not a solitary journey but a collective endeavour. It involves creating supportive communities and spaces where individuals feel safe to express themselves authentically, free from judgement or prejudice. By building networks of solidarity and mutual respect, we can collectively challenge oppressive beauty standards and advocate for inclusivity, diversity, and equity.
While myths and/or health misinformation like the papaya and milk concoction may persist, the real magic lies in cultivating self-love, acceptance, and holistic well-being. By looking inward and embracing our authentic selves, we can set ourselves free from the unrealistic beauty standards, live fully and unapologetically as we are.
The expression “p-hacking” is relatively new to the science lexicon, but has caught on quickly. It is a label for various manipulations of data or analysis to achieve statistical significance when statistical significance was not truly earned. The term p-hacking ingeniously expresses the essence of these activities and provides a convenient shorthand for the growing discourse on the subject.
Producing novel, impactful research is how investigators get published, funded and promoted. It is also how medical entrepreneurs gather evidence and gain regulatory approval for their products. For better or worse, one of the factors that makes research more impactful is attaining findings that are “statistically significant.”
Statistical significance is considered a proxy for scientific validity or, in medicine, clinical significance. Studies with statistically significant results are more likely to published. When conducting research for regulatory approval (such as for the Food and Drug Administration), achieving statistically significant results can be essential for success.
The yardstick on which statistical significance is measured is known as a “p-value.” P-values has a very specific meaning:
The P value is defined as the probability under the assumption of no effect or no difference (null hypothesis), of obtaining a result equal to or more extreme than what was actually observed.
The pressure to create statistically significant research motivates some investigators to engage in p-hacking. They gently “massage” their data or tweak their analyses to transform a statistically insignificant result into a statistically significant one. These practices violate sound statistical principles, increase false positive results, and exaggerate real positive results.
P-hacking techniques may be employed naively by well-meaning investigators who believe they are polishing and presenting data in the best light. The motives may be innocent, but the consequence is the proliferation of false and exaggerated conclusions.
To understand p-hacking one needs a basic understanding of the null hypothesis, statistical testing, and p-values.
The null hypothesis
Medical research often looks for differences between variables or changes in variables over time. Do smokers have a greater risk of lung cancer than nonsmokers? Do diabetics treated with Drug A have lower blood sugars than those treated with Drug B? Do children raised in Springfield have higher IQs than children raised in Shelbyville?
Under most circumstances the statistical tests exploring these differences compare the measured results to a hypothetical assumption that there is no difference between the variables of interest. This assumption of no difference is known as “the null hypothesis.” The objective of research is then to collect data and run appropriate statistical analysis. If the results demonstrate a persuasive deviation from the null hypothesis the difference is declared to be “statistically significant.” If the measured difference between the test scores of Springfield and Shelbyville students is unlikely to occur under the null assumption, the difference is declared statistically significant.
Statistical testing and p-values
What differences are “persuasive enough” to reject the null hypothesis? This question is the essence of statistical testing. If we set the bar for persuasiveness too low, we risk rejecting the null hypothesis too easily, resulting in unjustified conclusions. We might incorrectly conclude that Springfield High students are smarter than Shelbyville students, when they are truly the same. This is known as a false positive (or Type 1) statistical error. If we set the bar for persuasiveness exceedingly high, we make it difficult to reject the null hypothesis even when real differences exist (a false negative, or Type II error).
P-values are expressed as decimals on a scale from 0 to 1. The p-value is the likelihood that a particular or a more extreme result would be obtained IF the null hypothesis is true. The smaller the p-value, the greater the inconsistency with the null hypothesis. Let’s pretend we run an experiment and measure slightly higher IQ for Springfield High students compared to Shebyville High. We run an appropriate statistical test and find a p-value of 0.45. This means that IF students in Springfield and Shelbyville have equal IQs, we would expect to find this particular result or a more extreme difference 45% of the time. For most purposes this would be insufficient evidence for rejecting the null hypothesis and we would not be confident declaring students in Springfield smarter than those in Shelbyville.
There are many reasons that a study might fail to reject the null hypothesis. It could be the null hypothesis is true, but it could also be a poorly designed study, or insufficient sample size, or a very small but real difference, or just bad luck. The p-value does NOT tell you how likely it is that the null hypothesis is really false or that the alternative hypothesis is really true. In most cases, it means there is insufficient information to make a reliable calculation of those propositions.
It is worth mentioning that failing to obtain a p-value low enough to reject the null hypothesis does not allow us to conclude that the null hypothesis is true. In other words, despite a high p-value, Springfield seniors might actually be smarter than their Shelbyville counterparts, but for whatever reason our experiment did not confirm this.
Before performing an experiment, researchers are obligated to define a threshold p-value. If the results of the experiment yields results that differ sufficiently from the null hypothesis to generate a p-value at or below the preselected threshold, the null hypothesis is “rejected” and the deviation from the null is declared statistically significant.
The p≤.05 standard
The selection of a threshold p-value is based on a variety of philosophical and practical considerations. Philosophically, we want to avoid false positive results – but there is a tradeoff. A very stringent threshold p-value decreases the chances of false positive findings, but effectively raises the hurdle to validate a truly positive finding. In other words, it also decreases true positive results and increases false negative results.
This can be overcome by designing larger, more powerful studies. Unfortunately, there are practical limitations to the funding and other resources for biomedical research, so larger studies are not always possible or practical. For better or for worse, a threshold p-value of .05 has become the de-facto standard for much of medical research. The consequence of a threshold p-value of .05 is that in situations where the null hypothesis is true, the research will erroneously reject the null hypothesis in 5% (1 in 20) of studies.
A dicey metaphor
Let us explore the implications of a threshold p-value of .05. P-values can range from 0 to 1. we can divide this range into 20 increments like this:
Let’s then assign the upper limit of each of these increments to one side of a 20-sided die, like this one.
A 20-sided die, modified to show incremental p-values on each face (source: author’s own)
If we are comparing 2 groups that are, in fact, equal (the null hypothesis is true), utilising a threshold p-value of .05, every study is like a roll of that 20-sided die. One out of every 20 rolls of the die will land on the ≤.05 side. We will reject the null hypothesis and erroneously declare the two groups to be different.
Flexible sample size
When doing research, it is traditional to pre-specify the sample size (number of patients, specimens, test runs) for the study. Under ideal settings, this would be done based on existing clues about the behaviour of the groups being compared, and through the use of power calculations to ensure that the planned study has a reasonable chance of finding a real positive, if one exists. Often sample sizes are based on more practical considerations, such as the number of subjects available for study, funding, and other such limitations.
The p-hacker’s way to do it is to enrol a few patients, analyse the results, enrol a few more and repeat the analysis. This cycle is repeated until a statistically significant result is achieved. Then enrolment is halted. At first glance this seems like a very efficient way to do a study. Only the minimum number of patients needed to achieve statistical significance are needed.
Here’s the problem: if you want to minimise false positives, you have to roll die and accept the final lie. During the course of the roll, the die will inevitably roll over multiple sides before it ultimately comes to rest. By repeated enrolling and re-analysing, it is as if we take intermittent snapshots of the die in motion. If they happen to catch the die with the <.05 side face up, the die is stopped mid-roll, and victory is declared. In order to avoid excess false positives you have to set the parameters in advance and accept the outcome of the roll.
Slicing and dicing (also known as multiple comparisons and data dredging)
I can think of no better example of so-called data dredging than this gem from Randall Monroe’s xkcd cartoon. In his Great Jelly Bean study, authors report the shocking result that green jelly beans are linked to acne, complete with a statistically significant p-value. What they failed to disclose in their press release is that they ran analyses on 20 colours of jelly beans and obtained a “significant” p-value once.
If one has a large enough database, and runs enough analyses, one is almost certain to stumble on a relationship that is statistically significant. It is just a matter of numbers. Rolling the 20-sided die over and over is bound to produce “statistically significant’ results by chance alone. There are legitimate ways to test multiple hypotheses, but they require more stringent p-values to declare statistical significance. Had the jelly bean authors disclosed the multitude of analyses they performed, their results would have earned a yawn, not a headline.
This is closely related to the practice known as HARKing (hypothesising after results are known). In HARKing, investigators look at the data, run multiple analyses until they find something interesting (and probably statistically significant), then pretend that the results they found were what they had been looking for in the first place. If the Jelly Bean Study authors constructed a rationale that green jelly beans were uniquely suspected to cause acne, and reported their results as a confirmation of this hypothesis they would be guilty of HARKing.
Other researcher degrees of freedom
Researchers make many decisions when they perform a study. What kind of patients? What age range? How many? How long they will be followed? What parameters will be measured? At what points in time? If some patients miss exams or doses of medicine, how that be handled during data analysis? What statistical tests will be used? And on, and on. Collectively these are called researcher degrees of freedom. Ideally, these parameters will be defined before the study is begun. There can be a temptation to play with these parameters post hoc to create statistically significant outcomes.
An amusing but cautionary paper demonstrated that motivated manipulation of researcher degrees of freedom can dramatically alter research conclusions to such a degree that even absurd conclusions can be “proven” with statistical significance. In their example, they p-hacked data to prove that listening to certain music decreased the subjects age. These investigators also deserve credit for coining the term “p-hacking.”
P-hacking in action
Let’s say I run a startup company and have a promising vaccine to protect those bitten by the living dead from being transformed to zombies. I design a clinical trial comparing Zombivax vs placebo. The results of this study will determine the success or demise of my company. In the case of our study, the null hypothesis is that Zombivax and placebo are equally effective (or ineffective) in preventing zombie transformation. If our study shows Zombivax results superior to placebo with a P≤.05 we can then reject the null hypothesis and declare Zombivax effective. At the end of the study 43% of the Zombivax group became zombies compared to 68% of the Placebo group. How confident can I be that the difference between the treatments is real?
We analyse our results and achieve a p-value of 0.09. This means that IF Zombivax and placebo are equal (the null hypothesis) and we were able to run our clinical trial over and over again, we could expect, by chance alone, our results (43% for Zombivaz vs 68% for placebo) or a more extreme result 9% of the time. This result does not meet the prespecified threshold of P≤.05, so we would not be able to declare the effectiveness of Zombivax.
As CEO of the company, I am very disappointed that the clinical trial did not achieve statistical significance. I instruct my statisticians to go back and review the study design and analysis to see if any details were done improperly. They notice that some of the subjects in the Zomivax group missed one of 3 doses of the vaccine. If they omit those subjects from the analysis, the Zombivax group does a little better, now achieving a p-value of .07.
Next, they detect that the vaccine doesn’t seem to work as well in older subjects. If they limit the analysis to subjects 65 or younger, the results look much better, yielding a p-value of .04! As CEO I give my statisticians a bonus and issue a press-release declaring Zombivax a medical breakthrough.
What is wrong with exploring changes in the data and analyses to optimise the results? Once the data are known, there are many ways things can be adjusted and manipulated that will change the p-value. If one is so motivated it is possible to explore alternatives, accept those that move the results in a desirable direction and reject those that do not. This enables investigators to transform negative or borderline results into positive ones. This is the essence of p-hacking.
Using the 20-sided die as a metaphor, the clinical trial of Zombivax rolled the die. Unfortunately for our company, the die did not land on the ≤.05 side. It landed on the adjacent side for p-values between .05 and .10. What I instructed my statisticians to do is to kick, nudge, and tilt the table until the die rolls over to the desired result. If the die rolls in the wrong direction, they can just reset the die to the original roll and try something else. With enough motivation and creativity, it is likely that they can get the die to fall on the desired side and declare statistical significance.
If Zombivax was truly worthless, our clinical trial and subsequent p-hacking would be an example of a pure false positive result. If Zombivax was slightly effective, our p-hacking would be an example of “truth inflation,” transforming a small, statistically insignificant result into a larger, statistically significant one.
Conclusion: The significance of promoting the insignificant
The extent to which p-hacking can manufacture false positive results or exaggerate otherwise insignificant results is limited only by the p-hacker’s imagination and persistence. The results of p-hacking are much more consequential than simply padding an investigator’s resume or accelerating an academic promotion. Research resources are limited. There is not enough funding, laboratory space, investigator time, or patients to participate in clinical trials to investigate every hypothesis. P-hacked data leads to the misappropriation of resources to follow leads that appear promising, but ultimately cannot be replicated by investigators doing responsible research and appropriate analysis.
Provocative, p-hacked data can be the “shiny thing” that gets undeserved attention from the marketing teams, the press, and Wall Street. In medicine, compelling but dubiously-obtained results may be prematurely accepted into clinical practice. And within the CAM world, charlatans may can use sloppy research to promote worthless and irrational treatments.
There is no clear solution to solve the problem of p-hacking. Better education of investigators could reduce some of the more innocent instances. Greater transparency in reporting research results would disclose potential p-hacking. Deviations from planned data gathering and analysis plans should be disclosed and justified. For clinical trials, registries such as clinicaltrials.gov are intended to provide transparency in the conduct and reporting of clinical trials. Investigators are expected to “register” their studies in advance, including critical features of study design and data analysis. If used as intended, deviations from the registered and reported study details would be evident, and a red-flag for potential p-hacking.
Greater understanding of p-hacking among investigators, journals, peer-reviewers, and consumers of scientific literature will promote more responsible research methodologies and analyses.
This article originally appeared in The Skeptic, Volume 4, Issue 1, from 1990.
You might be forgiven for thinking that alchemy had been consigned to the dustbin of history. If the Times Higher Education Supplement [1] is to be believed, it is currently undergoing a resurgence of interest, albeit for its role in the growth of modern-day chemistry rather than any intrinsic merits in its methodology. At the recent annual meeting of the British Association for the Advancement’s of Science, its History of Science section held a session on gunpowder. It emerged that alchemy has a respectable pedigree.
There are two variants, stemming from Egypt and China. The former propounded the familiar Aristotelian notion of the elements of earth, air, fire and water, and the possibility of combining them in such a way as to produce gold. The latter, together with Greek ideas, formed a synthesis which was imported into Europe by Arab migrants and gave rise to such words as alkali, alcohol and naphtha. Ironically the Chinese interest in gunpowder originated in alchemical research into immortality. Richard Gregory of Bristol University is quoted as saying that Newton ‘probably spent more time on his alchemical and biblical studies than on his laws of motion, gravity, optics and colour, and mathematics’, although whether he is being admiring or quizzical is not made clear.
The answer may be given in another reference to Professor Gregory, printed in the Daily Telegraph, in an article which also concerns the British Association [2]. It states that CSICOP speakers at the annual meeting would be demonstrating how ‘stories about spoon-benders, ghosts, UFOs and communication with the dead can be exposed. In this context, Professor Richard Gregory, of Bristol University, will describe how, in the light of 17th century science, people stopped believing in alchemy and witchcraft. Superstition faded, and the modern scientific method was born.’ Alas Gregory’s pronouncement seems to be a non sequitur, else CSICOP would not feel compelled to expose cases which flagrantly have not been subjected to current scientific methods.
It does seem that there is a belief in certain religious quarters that alchemical processes can occur, though in this context it can hardly be said that these are precursors to modern science. Two recent news items give details of supposed miraculous transformations in Texas [3] , California and Medjugorje in Yugoslavia [4]. The Californians had been on a pilgrimage to Medjugorje, where miracles linked to sightings of the Virgin Mary had allegedly occurred. The description of the Texas incident does only state that ‘dozens reported that the silver beads on their rosaries turned to a gold colour’. The participants in the Californian and Yugoslav events appear to have been more specific, and asserted that the metal had changed from silver to gold (or copper). Happily for the the owners, who might have had their faith tested by the power of Mammon, a jeweller who examined one such rosary said that the colour change was due to tarnishing.
Perhaps here the matter would rest, except for an odd story which appeared in the Guardian earlier this year [5], concerning a bizarre little organism called Thiobacillus ferro-oxidans. It would seem that it lives, by some unspecified means, on inorganic matter, and can liberate precious metals (including gold) as a by-product of eating spoil heaps containing such small quantities of the desired materials that it would not be economically viable to recover them mechanically. This may not be exactly what ancient alchemists had in mind, but I am sure that it can be seen as the transmutation of something worthless into something valuable. It so happens that the philosopher’s stone turns out to be organic.
There has to be a catch, and not just the possibility that the main beneficiary would be South Africa, the largest gold supplier and therefore the possessor of the biggest spoil heaps. It transpires that T. ferrooxidans has a very low tolerance of temperature variations, making industrial applications too expensive and complicated. The article largely concerns the efforts of a team at King’s College London to improve the organism so that it will flourish in a much wider temperature range. Unfortunately, it claims, commercial exploitation of the new version had been slow due possibly to an unconscious aversion to the prospect of using organisms in an industrial process (presumably brewing does not count?) .
By definition, of course, this loose usage of the term ‘transmutation of elements’ is about the closest one can come to the alteration of one element into another by chemical means. An element is defined as a substance which cannot be changed into or from simpler forms, except by a change in its atomic nucleus. In theory it would be possible to produce gold from cheaper elements, but the energy required to do so would be so expensive that the technique would not be viable whilst substantial stocks could be dug out of the ground.
However, I came across a reference to an alleged Russian process [6] which claimed to be able to turn lead into gold in an atom smasher at a very cheap rate (about $600 per oz) as opposed to previous processes which produced gold at a cost of between $3,000 and $3 million per oz, a considerable reduction and one which would have significant consequences for the world market. However, this item appeared in 1980, and nothing seems to have been heard of the process since. Fool’s Gold perhaps?
References
Martin Ince, ‘Rich seam of explosive ideas amid the mumbo-jumbo’, Times Higher Education Supplement, 15 September 1989.
Roger Highfield and Adrian Berry, ‘Britain needs major initiative on science’, Daily Telegraph, 11 September 1989.
‘Hundreds of people stay in St John Neumann Roman Catholic church, Texas to talk about alleged miracle’, Associated Press, 17 August 1988.
Robert Sheaffer, Psychic vibrations, The Skeptical Inquirer, Vol 14, No 1, 1989, pp. 23-24.
Dan Van Der Vat , ‘Answers lie in the soil – How science is harnessing the microbe to turn base metal into gold’, The Guardian, 28 February 1989.
‘The escalating price of gold could make nuclear transmutation economically sensible, and the Soviets may have a method’, Cleveland Plain Dealer, 27 January 1980.
On March 11th, I participated in the Roda Viva program on TV Cultura, as a member of the panel invited to interview physicist Marcelo Gleiser, on account of the launch of the book “O Despertar do Universo Consciente”. The program can be watched in full online (note, it is in Portuguese). I will share my impressions and considerations about the book and the interview, since the format of the program is not suitable for a direct debate between interviewers and interviewees.
The book’s goal is to provoke a change in worldview in order to recover a “sacred” feeling for the biosphere, so that it can be preserved. One of the first problems that jumps out at us, however, is that history shows, since the beginning of Homo sapiens, that there is no possible consensus on what is “sacred”: people are crucified, women are burned and buildings are destroyed with airplanes, all in service to sacred ideas.
Even though the author does not want to give a religious or confessional meaning to the term “sacred”, using it to refer to a “secular sacredness”, the proposal seems, at the very least, naïve. It is like saying that to end wars all people need to do is love each other – it may be nice, but it is completely disconnected from reality.
Associating the veneration of the sacred with something necessarily good is not only a fallacy – just see that people are capable of identifying absurd passages in the Bible, showing that the sense of sacredness is socially constructed, and not imposed by a supernatural authority or the fruit of a superior feeling or intuition – but religious fervour is normally linked to something bad: when attachment to the “sacred” is placed above all else, buildings are knocked down by airplanes.
This does not mean that we should abandon responsible behaviour regarding food consumption, waste production, and respect for the environment, but society should be convinced through well-founded public policies supported by objective data – this is where scientists can act in a very positive way. Public policy cannot be made based on good feelings (“good” in what frame of reference?) or personal impressions.
In addition to being unnecessary, the introduction of the sacred for the salvation of the planet does not follow from the factual exposition made by Gleiser in the first part of the book. The scientific facts presented there are correct, but the general conclusion of the work does not follow from this first part – accepting the statement that the beauty of scientific discoveries is enough to support the sentimental manifesto that comes later will be a gesture of eventual goodwill on the part of the reader, not a logical conclusion constructed by the force of facts and arguments. The conclusion and the central thesis do not derive from the premises – “The Awakening of the Conscious Universe” is a sophisticated non sequitur : the scientific validity of the factual part does not pass, by osmosis, to the rest of the book.
The practice of using correct premises to create the impression that questionable speculations are well-founded is something that is commonly seen in pseudoscientific texts. The texts begin with something sophisticated, citing philosophers and scientists. The reader does not fully understand what the author wrote, but is left with the feeling that it is his own fault for not knowing complex concepts. Once dressed in scientific garb, the path is clear to say anything at all. This does not exactly apply to Gleiser’s book, but throughout his career the author has not stopped instigating an intersection between science and spirituality, which resulted in him winning the Templeton Prize.
Climatologist Michael Mann accuses Big Oil of pushing the responsibility for stopping global warming onto individuals and their “personal carbon footprints” while they continue to extract oil from the planet. This shift in focus is essentially what Gleiser’s book proposes: let’s foster good feelings among the people, and then the big structural problems that threaten the biosphere will go away on their own. In Mann’s words,
“If people start to think that stopping flying and eating meat is a more efficient way to combat climate change than pressuring governments to limit CO2 emissions from important sectors of the economy and invest in clean energy sources, that’s the shift strategy at work.”
It certainly won’t hurt to read “The Awakening of the Conscious Universe” in Tuscany, “drinking Brunello and eating wonderful prosciuttos“, but the manifesto is more like a magic solution, à la hippies trying to levitate the Pentagon to stop the Vietnam War, than a real proposal to be taken seriously.
This month has seen an election in the UK, and a change in government. And while it’s true that skepticism as a toolset should remain politically neutral, that isn’t to say there is no role for a skeptical view of politics, or that politics is wholly separate from skepticism. Politics is relevant to everything, because everything is influenced by – and can influence in return – the political landscape. Where policies mis-cite evidence, or cite misleading evidence, or tell outright falsehoods, skeptics should take keen interest.
With that, I’d like to first of all congratulate Dr Danny Chambers, who, on top of being a practicing vet and a writer for this magazine, has now been elected as the Liberal Democrat MP for Winchester. I’d also like to congratulate the new Labour MP for Morecambe and Lunesdale, Lizzi Collinge, who is a long-time skeptic and regular attendee of skeptical events like the QED conference. I’m certain both will take a strong skeptical attitude and appreciation for the value of good evidence into their constituency work, and that both will be assets to parliament.
In further good news, the election saw a change of representative in Leicestershire North West. Its incumbent MP – former Tory-turned-independent-turned-Reclaim Party MP-turned-independent-again, Andrew Bridgen – lost his seat to Labour’s Amanda Hack. Parliament will be a better place without Bridgen, not least because he used his time there to push for multiple debates about the supposed harms of Covid-19 vaccines, wasting parliamentary time with misleading statistics and misinterpreted studies in the process, following his very public radicalisation.
Andrew Bridgen tweeted dramatic and unfounded accusations about Covid vaccines
Bridgen continues to enjoy great support within the conspiracy theory circles – most recently, when an interview he gave to a conspiracy theory channel back in April resurfaced in which he claimed that Joe Biden and “his controllers” were so desperate to stop Donald Trump from getting winning the election that they’d be willing to start WWIII… or even, Bridgen feared, actively try to assassinate Trump.
This is now being claimed as cause for a victory lap by Bridgen and his supporters, though it remains… let’s charitably say “unconfirmed” that Thomas Matthew Crooks’ assassination attempt was ordered by “Joe Biden and his controllers”.
Despite being the incumbent MP, and despite having such ardent support among frequenters of conspiracy Telegram and parts of the right-wing press, Bridgen amassed just 1,568 votes, or 3.2% of his constituency. The result was, suffice to say, disappointing to him and his supporters, including among readers of the conspiracy-tinged blog “Conservative Woman”, where they published the following letter:
Dear Editor
Andrew Bridgen has achieved heroic status for his statements on vaccine injuries from those knowledgeable of the injuries suffered from the covid intervention. He has received various abuses on the parliamentary estate and declined offers to benefit his circumstances to remain silent in his criticism of the vaccines.
After 14 years as the efficient and successful MP for his North West Leicestershire constituency, increasing his majority at each election, he received a miserly 1,568 votes as an independent in the recent general election.
Something does not add up.
Conspiracies upon conspiracies, clearly.
Save Us Now
Bridgen is not the only fan of conspiracy theories to have been running in the election. In Gateshead Central & Whickham, voters had the chance to put their cross in the box for Graham Steele of the Save Us Now party – a prospect I found particularly interesting, as I have twice interviewed the leader of the party.
Mark Steele, brother of Graham Steele and founder of Save Us Now, first made his name when he tried to take Gateshead council to court, accusing them of installing 5G transmitters in their street lights, which were “causing cancer and microwaving babies in their beds”. Gateshead council, for their part, denied being part of the New World Order, and pointed out that their street lights do not contain 5G transmitters.
Some 5G fears on public display
I first spoke to him about this in April 2018, where he claimed his background as a weapons engineer for the Ministry of Defence gave him the technological insights to understand how dangerous the (non) 5G streetlights could be. It is worth pointing out that there is no evidence for Mark having a background in weaponry, aside from a 1993 conviction for shooting a teenage girl outside a pub, for which he served eight years.
Three years later, I requested an interview with the leaders of the new Save Us Now campaign group, unaware of who those leaders were, only to be somewhat surprised when my Zoom call was answered by Mark Steele. That was July 2021, and the 5G fears had merged with anti-vaccination scaremongering. During the call, Mark told me that 5G, Covid, and the vaccine were all created by Satan himself, with the aim of planetary depopulation – in fact, by the end of 2021, the death toll in the UK would have reached 55 million. 82% of the population. Suffice to say, he was wrong.
Save Us Now received 170 votes in Gateshead Central & Whickham, with at least some of those people knowing what Graham and Mark Steele stood for. Thankfully, those votes represented just 0.4% of the constituency.
The Freedom Alliance
While Save Us Now stood in just one seat, the same can’t be said for anti-vaccination party, The Freedom Alliance. An informal collection of candidates, the Freedom Alliance has prolific support among conspiracy groups on Telegram, or at least the ones I regularly follow. They were founded during the pandemic as a way of protesting and defying measures to control the virus, and from there they rolled into anti-vaccine misinformation, and onward through a variety of conspiracy theory panics.
The Freedom Alliance says it stands for “individuals, families and communities to be freed from state and global corporate control”, but mostly their output suggests their priorities are opposing 15-minute cities, central bank digital currencies, the great reset, net zero, and social credit scores.
The party ran five candidates, none of whom secured a seat, all of whom lost their deposit:
Catherine Evans in Birkenhead – 324 votes, 0.8% of the vote share
Ian Pugh in Wallasey – 197 votes, 0.5% of the vote share
Earl Jesse in Newbury – 131 votes, 0.3% of the vote share
Mark Turnbull in Paisley & Renfrewshire South – 113 votes, 0.3% of the vote share
And Wesley Massumbukoly in Derbyshire North East – 108 votes, 0.2% of the vote share
The English Constitution Party
Elsewhere on the fringes of politics is the English Constitution Party, a nationalist outfit whose political platform was “MEGA – Make England Great Again”. The use of “England” in the acronym is not merely for convenience; the party argues we need to void the Act of Union and disband the United Kingdom, so that England can stand alone, run under a system of common law. They argue that parliament contains Scottish MPs, Welsh MPs, Irish MPs, but “not a single English MP”… because they’re British, not English.
The desire of the party is to make England self-determined and Independent, with:
Separation of powers restored in favour of the people, in whom sovereignty lies in perpetuity, not the state. Individual rights respected again in law.
Understandably, such a change could result in some legal challenges, but the party has a proposal for how a self-determined and independent England should handle those challenges:
Common law and Constitutional Rights final appeal heard in USA not Continental Europe. America did not Americanise the English, the English anglicised America, America as a Protégé of England became the master of the common law and the protector of the Christian faith, God’s Law. The English common law.
In short, if we have any legal issues, we take them to a court in America, and only then will England be truly independent.
The English Constitution Party are run by Graham Moore, who goes by the pseudonym “Daddy Dragon”. He is a former QAnon promoter, and vocal supporter of Donald Trump, who called for supporters to protest the coronation of King Charles in 2023 by bringing rape alarms and throwing eggs. His website also currently includes a page selling the benefits of Ivermectin, and a recipe for a fruit smoothie that will treat cancer.
The English Constitution Party ran four candidates:
Joe Greenhalgh in St Helen’s – 274 votes, 0.7% of the vote share
Colin Birch in Romford – 195 votes, 0.4% of the vote share
Brett Frewin in Broxbourne – 87 votes, 0.2% of the vote share
Their final candidate was Daddy Dragon himself, Graham Moore, who ran in Chorley gaining 1007 votes, or 3% of the vote share. This might seem unusually high, but Chorley is the constituency of the House speaker, Lindsay Hoyle, and it’s conventional for none of the big parties to campaign against the speaker, allowing them to get back in unopposed. So the higher vote share to the English Constitution Party might reflect that.
According to campaigners DeSmog, there were more than 30 MPs with links to the Global Warming Policy Foundation prior to this election – of those, 28 have now left office, including prominent and influential figures like Philip Davies, Jacob Rees-Mogg, Miriam Cates, Andrea Jenkyns, Jonathan Gullis, Craig Mackinlay, Julian Knight, and Damien Moore, as well as Net Zero Scrutiny Group founder and Global Warming Policy Foundation trustee, Steve Baker.
Of those 36 MPs who are supporters of – and are in turn supported by – a climate change denialist group, the only ones who still have a seat are Esther McVey, Sammy Wilson, Mark Francois, Lee Anderson, Greg Smith, John Whittigdale, Bob Blackman and Iain Duncan Smith.
It is not ideal that there are twice as many still associated with the GWPF as there are Green MPs, but for now at least, their influence will be greatly reduced, and the GWPF will need to start over in wooing sitting politicians. Hopefully there will be fewer from this intake willing to take those meetings than there were from the last government.
I do too much. I run a skeptics in the pub group with events and socials, a magazine, a podcast, a conference, I give talks at skeptics in the pub groups all over the country, I do undercover investigations that I sometimes travel to. I have a job that involves the peaks and troughs in workload that are common when you’re wrangling academics, and it is seriously under-resourced, so I pick up lots of various odd jobs and side projects – often travelling to engage with events and meetings, requiring lots of task or role switching, which is often extra challenging for us neurospicy folks. I work on an entirely separate side project with some academics in Scotland, again requiring travel.
All of those plates are challenging to spin at the best of times, but on top of that I have ongoing health issues that come with a whole chunk of admin and emotion. I actually wrote this piece from my bed while dealing with neck pain.
As much as this sounds like me complaining – it really isn’t. I love that I get to do a bunch of exciting, varied, important and interesting things with my job, with the various other projects I work on and all the skeptical activity. I feel incredibly lucky to be able to do stuff I love doing.
In a way, I thrive on stress – it helps me get things done. And I also know that everyone on the planet is stressed in one way or another. Whether it’s financial, parental, or disability… or more likely a combination of different stresses all layered on top of each other until it feels like we can’t cope. Humans are a stressed bunch, and these are particularly stressful times.
The list of symptoms associated with chronic stress is long and can include anxiety, depression, headaches or dizziness, muscle tension or pain, heart disease, high blood pressure, strokes, and problems with digestion, sleep, sex, weight, memory and focus. Stress can cause us to be irritable and snappy, to sleep too much or too little, to eat too much or too little, to avoid certain places or people, and to turn more to habits like drinking or smoking.
That’s why I find how we talk about the consequences of stress particularly problematic. We see news articles all the time with headlines like “Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression”. Meanwhile, there are constant news articles telling us that study X showed that chronic stress will reduce your life expectancy. Or give you a heart attack. Or make your hair fall out, or your toes fall off.
On top of all that, according to a whole range of ‘wellness’ people, chronic stress can exhaust your adrenal glands. This is rooted in the false notion that the body is such a finely-tuned machine that we can overwhelm it with toxins or chemicals, and it simply won’t know what to do with those things.
Adrenal fatigue has become the popular explanation for burnout. It’s not that we’re exhausted from doing too much, or that our mental health is suffering and can cause physical symptoms, or even that we have another underlying health problem that we should get investigated – no, apparently, it’s adrenal fatigue. According to an article in Goop:
Common symptoms of adrenal exhaustion are a general lack of energy, difficulty sleeping, clouded mind, depression, weak immunity with frequent colds or other infections, and difficulty digesting. But pretty much anything else can go wrong when our adrenals are exhausted, such as infertility, low blood pressure, and anemia.
Many of those are actually symptoms that we know chronic stress can cause – but they’re not due to an entire organ in our body collapsing.
The adrenal glands
The adrenal glands sit on the top of each kidney. Their job is to produce a variety of hormones that the body needs to function, some of which are an important part of our stress response.
Position of the adrenal glands on the kidneys, above the bladder. By Cancer Research UK, via Wikimedia Commons
When humans encounter stress there are two main pathways that help regulate our response. The autonomic nervous system – that’s your flight or fight/rest and digest system – and the hypothalamic-pituitary-adrenal (HPA) axis. Both of these systems can stimulate the adrenal glands to do their thing and start producing relevant hormones to help us handle the stressful situation.
These two pathways stimulate a range of different responses and feedback loops. It’s a finely tuned and complicated system that can affect basically the entire body.
Hormones are important signalling molecules in the human body because they can act at long distances. Many others only interact with nearby cells, but hormones spread great distances through our blood supply and cause changes all over the body. Hormones produced by the adrenal glands at the top of the kidney can therefore trigger a response in our brain.
There are lots of hormones and other signalling molecules that are triggered by stress pathways. One is adrenaline, a hormone that increases blood flow to muscles and triggers the release of glucose so there’s more energy available for those muscles. It also dilates our pupils and airways and increases our heart output, allowing us to get ready to fight or to run away from danger.
The other hormone we hear a lot about is cortisol. Cortisol is also involved in the fight or flight response, but it’s also important for generally managing our stress response. It essentially tells the body, “Look, we’ve got some sort of imminent danger so let’s turn down some of our longer-term survival processes to focus on the immediate threat”. Cortisol reduces our immune function, alters our digestion, increases our glucose metabolism and it can even decrease bone repair and increase muscle breakdown with long-term exposure. It’s also important for day-to-day regulation in the body, and follows a circadian rhythm – meaning we have more or less of it depending on the time of day.
These systems are indeed incredibly finely balanced – our bodies are constantly adjusting and tweaking things according to a range of different stimuli, including the presence of these hormones in the first place. Too much of a hormone for too long, and the body will try to bring the levels down; too little, and it’ll bring the levels back up. Homeostasis is what our bodies do.
Inappropriately high cortisol levels can, for example, have long-term effects on the whole stress system. Studies have even shown that after periods of high stress – like famines – the offspring of people who experienced that stress have genetic changes that impact their stress response. It’s these sorts of long-term changes that wellness people cling to when they discuss things like adrenal fatigue.
Adrenal fatigue is a deficiency in adrenal gland functioning that can result in debilitating symptoms ranging from lethargy to lowered sex drive to weight gain. James Wilson draws on 24 years of clinical experience [that’s clinical experience as a chiropractor] and research to help readers determine if they have adrenal fatigue and learn how to treat it. Beginning with a diagnostic questionnaire, he moves through the causes, symptoms, and treatment of the condition through lifestyle and dietary modification.
Except, adrenal fatigue doesn’t actually exist. There is absolutely no evidence to support this theory. It has been examined, and debunked or disputed, by experts in the field. Adrenal insufficiency does exist, but those who have experience it suffer serious health consequences far beyond those we attribute to stress.
Addison’s Disease is a condition usually caused by an autoimmune response, where the body’s immune system attacks the adrenal glands. It comes with a huge range of symptoms including: fatigue, malaise, muscle and joint pain, reduced appetite, weight loss, increased sensitivity to cold, nausea, abdominal pain, vomiting, craving salty foods, low blood pressure that leads to dizziness upon standing, and hyperpigmentation in the skin. In women it can cause dry and itchy skin, loss of armpit and pubic hair, and reduced sexual drive. Left untreated, Addison’s Disease can cause severe, penetrating pain, bouts of vomiting, loss of consciousness, slurred speech, and convulsions; it can lead to adrenal crisis, which is life threatening.
Addison’s Disease is a specific, defined condition we can identify and treat, whereas adrenal fatigue is just not supported by evidence. That doesn’t mean that people who believe they have adrenal fatigue aren’t experiencing symptoms of fatigue, or burnout, or another health condition – but, by focusing on a debunked condition, we lead people away from getting a diagnosis of something they might actually have and towards a treatment plan that is useless to them.
How not to treat ‘adrenal fatigue’
If you scroll through TikTok and hear mention of adrenal fatigue, cortisol cocktails are probably not far behind. Proponents claim that you can boost your cortisol levels with supplementation. They claim it will help you lose weight, boost your energy, help with carb ‘craving’, reduce panic attacks.
Adrenal cocktail – AKA “Orange Creamsicle” – is a magical elixir that supports hormone balance, HPA axis health, and blood sugar regulation… The central theme here is balance. We want to make sure that we are supporting our body’s natural ability to regulate blood sugar, increase insulin sensitivity, and improve metabolic flexibility.
Her recipe includes four to six ounces of freshly squeezed orange juice, two tablespoons of coconut milk or cream, one scoop of collagen, and a generous pinch of sea salt. Most recipes include coconut water and cream of tartar, orange juice and salt. These are claimed to increase your levels potassium, vitamin C and sodium. Others involve a complicated series of powders and elixirs to boost the power of the drinks. And, of course, those powders and potions cost a lot of money and are sold by a wide range of wellness companies.
These cocktails, potions and elixirs are nonsense. They’re probably not going to cause too much direct harm – they’re pretty safe ingredients – but the reasons people turn to these solutions are indicative of a wider problem.
As I mentioned earlier, we experience significant stressors on a daily basis, and things only feel like they are getting worse. Many of those stressors are caused by things outside of our control like stressful jobs, or financial difficulties when welfare support has been significantly reduced. But, if we go to our employers to help with stress at work, we end up on courses that tell us to manage our own stress by writing lists or practising good work life balance – but without any meaningful support in encouraging our employers to reduce our workloads.
We are constantly told that stress will kill us early, but if we’re too stressed it’s apparently our own fault. We need to work harder at “relaxing” – an oxymoron if ever there was one. We need to prioritise our sleep – some employers will even pay more if we sleep more – but “trying” to sleep better is a sure-fire way to make sleep impossible if you’re someone who already struggles with it. The guilt and responsibility is piled on to us as we’re told to not feel stressed or anxious about it. Mental health waiting lists are growing, and private therapy is an expensive minefield.
There are no readily available solutions, there is inadequate support.
So if someone on TikTok tells you this one simple trick to help you make it through the day with a little more energy, with fewer panic attacks, and without the stress you have little control over harming your body – who wouldn’t want to try that? Plus, you say, it’ll help me lose weight and feel a bit better about my body, too? Great. Sign me up.
Of course people are turning to woo. Our stress systems are broken. But the cause absolutely is not what’s happening in our adrenal glands, it’s what’s happening out there in the world around us.
