There are certain words that should always set off your bullshit detector. These terms are unfortunately not only used to sell products; they are also used by the media to make their news stories sound exciting. Consider how often have you heard a story headline like “scientists at the University of Smartsville discovered cancer cure”? (hint – a lot) vs. how often has a cure for all cancer been discovered (hint – never)? Granted, some therapies are truly revolutionary. Some examples include penicillin, anesthesia and handwashing. But, as you might expect, truly revolutionary ideas do not come along every day.

A general rule of thumb that applies to both people and medical BS: when you have a lack of substance it helps to dress fancy and surround yourself with famous people. When it comes to putting things in your body, it really doesn’t matter who the marketing team can get to endorse their product. In science, the value of a famous person’s opinion is the same as any other piece of data from a single source—nearly worthless. In fact, an excess of famous people should clue you in to see if there is a scarcity of data.

Excessive promotion often indicates low confidence that a product can sell itself. Often this advertising focuses on images unrelated to the product (relaxing on a beach, parties with beautiful friends). This is true for both alternative and prescription medications. Pharmaceutical companies have huge advertising budgets targeting both consumers and physicians. For products that clearly work, they may not need to spend much money. But for products where there is a need to manufacture demand there is high motivation to advertise. In fact, several heavily promoted products later turned out to have serious safety issues that were possibly known but suppressed by the company.

Take the following made-up example of a Parkinson’s disease (PD) cure:  “We know the Pharaoh’s diet works because over thousands of years no pharaoh was reported to have PD.” Appealing to ancient wisdom is common, but does it really prove anything? Is it possible that none of the Pharaoh’s had PD because Pharaohs died before most people get PD, because they hid illness to maintain power, or because PD wouldn’t be a recognized disease for a few thousand years?  This example seems silly, until you stop to think about claims for other products. As in this example, they often make bold statements that don’t prove anything. 

Bullshit experts hope to lure you in by sounding scientific, using “sciency” words that superficially make sense but are really meant to distract you. My current favorite is “clearing toxins on a cellular level.” This sounds sciencey but what does it really mean? What “toxins” are they talking about?  And since your body is made of cells, where else would toxins be? The history of bullshit parallels science. The same snake oil might be called hormonal balancing, detox, or a genetic enhancer… but the seller behind it has the same goal – to confuse you into thinking their product works.

A testimonial is the story of a single satisfied customer in a quote: “I tried the Pharaoh brain diet and within minutes I was remembering more than I had in years!” Anecdotes are similar, one or more stories used to illustrate a point. Anecdotes have no control group and should not be considered strong evidence. Anecdotes are very prone to many types of bias. Most notably, the person choosing the anecdotes is very likely to choose only those stories that confirm their beliefs or desires. When anecdotes are the only evidence presented sound the bullshit alarm. 

If something seems too good to be true, it probably is. As one example, curing Alzheimer’s disease would be a significant medical advance that would land one or more people a Nobel Prize. To cure Alzheimer’s, one would have to: a) find a therapy that cures the disease; and b) test it to make sure that it is safe and reliably works. It would also help to understand what causes Alzheimer’s (although it’s possible one might find a cure through sheer blind luck). Given the vast amounts of research done by teams around the world, it seems highly unlikely that a lone individual would stumble upon it by chance or genius.

Another very important question: are there any independent sources also promoting this product? If not, you should probably move on. One of the principles of science is that facts can and should be independently verified. People who care about truth want to see verification. People who want to sell you bullshit or have something to hide don’t want their claims tested.

I have seen some of the world’s greatest researchers speak, including several Nobel Prize winners. Many of these individuals truly needed no introduction. However, when they were introduced, the introducer listed their impressive accomplishments, things like their major discoveries, illnesses they cured, people they trained, important institutions they have worked at. None of them called themselves a ‘health expert’, nor did they list a bunch of best-selling diet books, Oprah appearances, or namedrop celebrities they are friends with. Pay attention to how experts sell themselves, and ask, “does this really matter?”

The idea that there is a monolithic entity, “the medical establishment”, is appealing to conspiracists but what does it really mean? If one is talking about the culture of medicine there may be some interesting things to say about how healthcare professionals act. However, if one is claiming that all doctors, researchers, hospitals, insurance companies… get together to make collective decisions, particularly against a specific individual, don’t be fooled. It is next to impossible to get healthcare professionals to agree on almost anything. Granted, there have been major discoveries that were not immediately welcomed by mainstream medicine, but the primary difference involves tireless research and attempts to get other scientists to replicate their results instead of condemnation of everyone else in science.

Many professions, like medicine, counseling or acupuncture, have state boards that regulate the profession and handle licensing and testing. It is never a good sign when an expert dismisses these regulations. Sometimes the person behind the product introduces himself as doctor, which in the healthcare setting implies a medical doctor, but they really hold a doctorate in another field. A somewhat newer phenomenon is a medical doctor embracing a new branch of medicine (e.g. Functional Medicine, Alternative Neurologist) that does not have established training requirements or licensing.

Getting a second opinion is never a bad thing. If patients ask me about getting a second opinion I encourage it. Maybe I’ll be proven correct. Maybe I’ll learn something. But most important is that you can move forward knowing you have the correct diagnosis and plan. When someone warns you against getting a second opinion, they are doing you and themselves a disservice. They are also providing a clue that what they are selling may be more about them than you. No matter how confident or important the doctor, treating their ego should never take precedence over your health.

People who don’t know your medical situation should not make recommendations about how you take care of yourself. I am not just talking about situations where an abrupt end to medication may cause significant side effects. I am also referring to situations where treatments that are working are stopped. As an example, patients with Parkinson’s disease told to stop taking levodopa, the single most effective medication for this condition, in favor of acupuncture, herbal treatments, dietary changes or cannabis may lose the progress they have made in their symptoms and, in rare cases, can develop life-threatening complications.

Fear sells. Richard Leask, a representative of the California Chamber of Commerce said, “if you can’t convince ‘em, confuse ‘em: if you can’t confuse ‘em, scare ‘em.” The best healthcare providers do their best to balance being realistic with compassion. Even if they have bad news,  they do their best to balance this news with emotional support and highlight any opportunities for hope. In contrast, the bullshit artist will focus on the worst, will fan the flames of your fear (often while pretending to offer understanding), and will lead you towards the one best choice for someone in your situation which, coincidentally, happens to be what they are selling.

If you can’t convince ‘em, confuse ‘em.  When someone doesn’t have evidence to support their claims, they often present vague and fancy-sounding ideas and then add that the details are too complicated for any but the most brilliant experts to understand. They hope that people will “just take their word for it” rather than press for details. This goes with the notion that experts know things, not just that most people don’t know, but that most people CAN'T know. This attitude supports a claim to unjustified power for those in the Expertocracy that reinforces a message of helplessness for everyone else.  

Medical bullshit experts prominently flaunt any credentials they have – diplomas, certificates, awards, publications. In fact, having too many credentials may even be a clue to something amiss. Often a careful look reveals that the credentials on display are not the credentials needed, for example: having training as a surgeon and claiming expertise in nutrition; highlighting the fancy school one went to but not what was studied (e.g. a Harvard graduate writing about Lyme disease who neglects to mention that they majored in English); or having a degree in a field you’ve never heard of or from a school you’ve never heard of.

This comes up in two contexts. In the first, someone with the goal of selling you a product lets you talk, but only up to the point where they feel they have the information they need to move forward with their sale. The expert pretends to listen to you, to “understand exactly what you are going through” and then, once they have your confidence, they begin to talk more than listen.

In the second, a practitioner, often a doctor or nurse, sees you in a hurried manner. Perhaps they are busy, poorly trained, or burnt out. In any case, you get the distinct feeling that you’re not being seen or heard. Listen to this feeling. Recommending therapies without knowing your full story can lead to dangerous situations and regrets.

Many websites, videos and books appear to offer information about a disease or health topic that is important to you. However, once you get past the headline, you find yourself immersed in an infomercial for a particular product, diet or “expert” advice. When evaluating healthcare products, you should always ask yourself: what does the person recommending it have to gain by me doing this therapy? A common goal of bullshit is not to cure your illness but to get your money. This may occur by selling you books, supplements, tests, procedures, medications, stem cells, news, or an expert who wants to launch their medical celebrity career.

People love “ancient” wisdom and “natural” products almost as much as they love puppies. When it comes to healthcare it is worthwhile to test ancient findings before you accept them as true. Many ancient treatments were bizarre, such as using crocodile dung as birth control, and others harmful, such as smoking to cure asthma. Regarding the term natural, I would simply state that arsenic, earthquakes and sharks are all natural. Moreover, there are numerous occasions where unregulated “natural” products have been found to contain everything from lead to Viagra.

This is an easy tip-off. Given the many different things that cause disease, ranging from bacteria to cholesterol, it is extremely unlikely that any “cure-all” could actually cure numerous illnesses. Cure-alls tend to arise in the context of new medical discoveries before they are fully or widely understood. Currently, stem cells fall into this category. Vitamins, hormones and electromagnetic energy previously filled this role. Outside of staying hydrated, fresh air, eating a healthy diet, managing stress and moving your body, there are few things that are broadly essential to health.

For a while, this was a fairly safe clue that a product might not be legitimate, as being outside the US was an easy way to sidestep the tougher regulations inside the US. Unfortunately, loopholes, poor regulation and brave bullshit sellers have established many of these therapies now within the US as well. There was a time where the only places you could get unregulated stem cell treatments were outside of the US. Now, billboards advertise some of these untested treatments in the US and even through some hospitals. There are even fake “research trials” that require participants to pay to gain access to untested products, as a way to profit and avoid regulations.

Would you buy brakes for your car if you knew they were untested? What if you knew that other people using these brakes had serious accidents? Why should our standards be any lower for things that we put into or onto our body than things we put into our car? There is a good reason that the US government formed the Food and Drug Administration (FDA); the public expects that food, medications, and medical devices meant to be put into people are safe. Unfortunately, many products either fall outside of these regulations (e.g. supplements, cannabis) or have slipped through FDA loopholes (e.g. stem cells, some medical devices).

A trick used by deceptive mechanics to sell you a new air filter is to pretend to give your car a check-up; meanwhile they have a horribly filthy air filter on hand that they show you when you come back as evidence that your car needs a new filter and other services. The medical equivalent happens when an alternative doctor orders a large panel of nonstandard tests from an unregulated laboratory. Invariably, these test results show many concerning values or evidence of infections that do not show up on standard testing. These abnormalities, of course, “need” treatments ranging from supplements and dietary changes to intravenous medications or stem cells.

This happens most often with news stories. The headline reads “Researchers at the Genius College Discover Cure for Parkinson’s Disease.” When you read the full story (or go beyond the story to find the original sources) you are very likely to find: 1) The research was performed in animals; 2) The research is based on an observational study that found a correlation; or 3) The research is a preliminary and small trial with no control group. The bottom line is that this evidence is not enough to conclude that something is safe and effective in people.

Sometimes experts reference studies hoping to convince you that there is solid research behind their claims (and also hoping that you won’t look at them too carefully). However, if all of the studies were done by them and their group, be skeptical. SImilarly, just a quick glance at the titles or place of publication can tell you a lot. If the title of the study doesn’t clearly indicate a high-quality study in humans or if the publication is hard to find (or your doctor has never heard of the study or the journal), it likely indicates low quality and dubious research.

Like tip #1 this is an easy tip off. Nothing in life, short of death is 100% certain. When Products or promotions say that something works 100% of the time in ALL people, you should anticipate that they are, at best, exaggerating, and at worst, ying or fabricating data. Similarly, if something has an effect there must be a side effect. If a product claims to be 100% safe, you can assume that either there is a lack of safety data or that the product itself is a placebo that has no real effects, good or bad.