Americans spend around 34 billion dollars from their own pockets on alternative medicine every year according to the National Institutes of Health. Almost all of these products are either supported by weak research, no research or directly contradicted by large-scale high-quality scientific studies. What is worse is that this kind of quack “treatments” have seeped into academia and created several centers for “integrative medicine”.
It has also invaded public perception, with alternative health stores popping up all across major cities around the world that sells all kinds of quackery, from colloidal silver to allegedly healing mushrooms. What is truly terrifying is their aggressive marketing of these products for medical conditions they certainly do not effectively treat, thereby conning innocent and sick people for money while giving very little, if anything in return in terms of health benefits. In particular, there seems to be a growing trend to sell alternative medicine products for psychiatric conditions and symptoms such as depression, anxiety and suicidality.
A local department of the Swedish public television (SVT) decided to make a critical investigation (webcite) into one of these alternative health stores called Clearlife and a product they sold called Reishi. What they found was that the company recommends powdered mushroom in hot water as treatment for recurring suicidal thoughts. Utterly unscientific, unethical and likely illegal.
What is Reishi mushroom?
Reishi mushroom (Ganoderma) is a brownish red mushroom that grows on trees (called bracket fungus) predominantly in Asia. It is commonly used within Traditional Chinese pseudomedicine and proponents allegedly claim that it has been used for thousands of years.
Reishi has in recent years become a hot product in the alternative health world, and can be bought from many health food stores on the net. The tried bracket fungus is often sold as a powder that can, much like instant coffee, be mixed into hot water.
How do alternative medicine quacks describe it?
The head of Swedish alternative health store ClearLife, Tom Lidström, is very found of the product and even attempt to hint at a therapeutic effect on the nervous system using common weasel words so common to alternative medicine snake oil salesmen:
– Traditionally, Reishi has been used a lot as an herb to help medication or inner calmness. And then one can imagine that in modern terms that it can be related to the nervous system, that it can have an effect nervous system in some way, he says.
In Sweden, quacks are not allowed to sell fake products together with health claims. So sellers of alternative medicine often try to stay away from making direct health claims about their product. Instead, they use vague phrases like “helps relaxation” or “may relate to the nervous system” to give potential customers and victims enough misinformation to convince them to buy their products, but not enough to get into trouble with regulatory agencies. This will become even more apparent later on in the journalistic exposé.
According to the investigation, there is no approved health claim for Reishi mushroom on the EU level. Not a single one. The only candidate (“contributes to physical well-being”) got rejected because the scientific evidence was not enough to support it. Despite this fact, the company in question markets their product by claiming that it (1) treats stress and insomnia and (2) vague claims about providing “physical, immunological, mental and spiritual protection” for the body. There is no credible scientific evidence for these claims at all, and it is unclear how mixing fungus powder into heated water and drinking it can provide any “spiritual protection” (whatever that means). Although obviously laughable in its absurdity, it foreshadows highly problematic health claims with regards to psychiatric conditions.
The company recommended dried mushroom for suicidal thoughts
An investigative journalist decided to sent an email to the company under a fictitious identity to see what kind of health claims they made about their products to potential customers. The journalist took a mental health perspective:
To test how Clearlife guides their customers, we from SVT Nyheter Väst [SVT News West – Emil’s note] sent a mail to the company’s consultation service. In the mail, we pose as a woman with recurring suicidal thoughts. We ask if Reishi can cure the psychological problems. This is an excerpt from the response we got:
“Yes, Reishi is a product that, according to the ancient wisdom of the Chinese, can help to stabilize senses and emotions.”
“I would recommend you test 1/2 to 1 table spoon, twice per day.”
At no point is the woman advised to get into contact with the health care system for her problems.
This is a clearly unscientific, unethical and likely illegal. It is unscientific because there is no scientific evidence that this mushroom has any beneficial medical effect for anything, let alone for suicidal thoughts. It is unethical because the company prefers to con customers with suicidal thoughts for their money instead of referring them to effective treatments. It is probably illegal since they are selling snake oil with health claims, which makes it medication according to the law and that cannot be sold with false claims or without approval. For more legal details, see the previous article on Swedish Health Store Sells Colloidal Silver Despite Ban.
This is also an example of what is known as “crank magnetism”, which occurs when people embrace several forms of pseudoscience at once. In this case, it combines alternative medicine and anti-psychiatry, because it trivializes psychiatric conditions because they claim drinking water with mushroom powder can help against serious issues like suicidal thoughts.
The journalists confront owner Tom Lidström about this response. Lidström attempts to wriggle himself out of this precarious situation:
When we confront Tom Lidström with the email, he says that he regularly gets email from this kind of mentally ill people, but he usually recommends that they contact the health care system. He claims that the fact that he did not do so this time was a mistake that he regrets.
The precise details about the confrontation is unclear. Swedish television, both public and private, have a history of making very powerful confrontation of politicians, business owners and others that have seriously misbehaved. When well-known journalists from shows like Uppdrag Granskning (“Mission: Scrutiny”) or Kalla Fakta (“Cold Facts”), people know they are in deep, deep trouble. However, these skills are difficult to learn and local journalists may not be aware of them. Typically, a useful method is called strategic disclosure of evidence, whereby you lure the person into denying what he or she has done and then confront them with the evidence, asking the rhetorical “well, how do you explain this?”
What did the expert say?
The journalist also interviewed an expert, psychiatry professor Mikael Landén, at some length, but the big picture message was this:
What Mikael Landén considers to be the biggest problem with the current legislation is that there are risks that mentally ill people are tempted to take supplements, such as Reishi, instead of seeking traditional health care. While the patient miss out on medication and therapy, the psychological problems can accelerate and in the end there is a risk that the patient then commits suicide.
In other words, it is one thing that their fake medical products lack efficacy and has potential side-effects, there is also an indirect side-effect of not seeking real medical care. For instance, homeopaths often miss this key issue when they claim that it has “no side-effects”. Of course they do, but they do not have to be direct side-effects.
What does Cochrane say about efficacy of Reishi mushroom?
So what does the scientific evidence say about the supposed efficacy of Reishi? To date, there have been two reviews published by Cochrane, one for cancer and one for cardiovascular risk factors. In both reviews, the evidence was either weak, inconsistent or non-existent. A number of the included trials suffered from considerable methodological issues.
There were no Pub Med hits for “Reishi mushroom suicide” and no relevant hits for “Reishi mushroom depression”. In the latter case, the only hit talked about “depression of splenic CD8+ cells”, which is clearly unrelated.
What can be done?
Right now, there are two basic ways to legally fight quacks in Sweden. The first is to catch them making unsupported health claims about their products. That automatically makes their product fall under the regulations for medications, and those ban false health claims and the selling or marketing of unapproved medications. The other is for it to fall under what was previously know as the “quack law”, which bans people who are not medical doctors to treat people with e. g. cancer or HIV or treat children under the age of 8.
It would be a very good idea to add severe mental health problems to this list, such as suicidality. People with psychiatric conditions deserve just as much legal protection against quacks as those with cancer and HIV.