Magnet Therapy On The NHS

February 26th, 2006 by Ben Goldacre in alternative medicine, bad science, magnets, placebo | 85 Comments »

Amusing to see that the NHS Prescription Pricing Authority have apparently put Magnet Bandages on the formulary:,,2087-2058902,00.html

(Even more amusing to see the Times mentioning that old “iron in blood is magnetic” chestnut again).

What’s interesting to me about this is that it may be the first time the PPA have put something on the NHS formulary on cost effectiveness grounds, but in the full knowledge that it very demonstrably, in well conducted trials, only works as a placebo, as the recent BMJ paper (amongst others) showed.

I ought to say I have no problem with placebos, I think they’re very effective, and it’s very much a contemporary cultural peculiarity that means medics don’t make use of the effect any more: click “placebo” on the right and see lots of articles on the subject.

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85 Responses

  1. Frank said,

    February 26, 2006 at 5:15 pm

    What baffles me is why journalists always include a list of famous people that use the latest miracle cure. Am I supposed to be swayed because a famous actor uses these bandages?

  2. JohnD said,

    February 26, 2006 at 7:05 pm


    Be honest. If a friend you trust recommends something, you are going to be well disposed towards it.
    The whole PA business promotes celebrities as ‘friends’, who you call by a personal or nickname, whose slightest personal detail and life history you know, or at least you know one that they want you to know. How many people do you work with who you ‘know’ that well?


  3. Kess said,

    February 26, 2006 at 8:36 pm

    Sarah-Kate Templeton, the journalist behind the piece, has won awards for her work but this article doesn’t impress. She happily states “It is not known exactly how magnets work”, and then regurgitates the usual mumbo-jumbo explanations concerning “circulation” and “negative energy”.

    Shouldn’t she engage her brain and actually be asking “Do magnets work”?

  4. David Colquhoun said,

    February 26, 2006 at 8:48 pm

    Oh heavens, bad to worse. Perhaps Ben knows why magnets don’t have to be approved by NICE?

    I poked around a bit to find more information about Dr Nyjen Eccles, and the unpublished trial that seems to underlie this bizarre decision. There seems to be more to him than was unearthed by the Sunday Times (see ).

    By the way I just discovered (at last) how to use RSS feeds, and put hints for the uninitiated at .Now I see most of what I’m interested in all on one netvibes page. Realy useful, so I made feeds for some of my pages.

    David Colquhoun

  5. Wongle said,

    February 26, 2006 at 9:44 pm

    Just in case they take the article down, as newspapers now often seem to do after debunking:

    The Sunday Times – Britain

    The Sunday Times February 26, 2006

    NHS takes up Cherie’s magic magnets cure
    Sarah-Kate Templeton, Medical Correspondent
    IT COULD be called the Cleopatra Effect. Magnetic therapy, which has held the rich and powerful in thrall from ancient Egypt to modern Downing Street, is about to be made available on the National Health Service.

    NHS accountants are so impressed by the cost-effectiveness of a “magnetic leg wrap” called 4UlcerCare that from Wednesday doctors will be allowed to prescribe it to patients.

    Magnetic therapy, which was pioneered in ancient Egypt, has become one of the pillars of modern alternative medicine. Its adherents include Cherie Blair, Bill Clinton and Sir Anthony Hopkins, the actor.

    Although its merits are challenged by traditional medics, it is used to treat joint pains, sports injuries, backache, muscle soreness and period pain.

    It is also used on animals — 4UlcerCare was inspired by a dog named Kiri, which developed severe arthritis. Conventional treatments did not help and, after researching the use of magnets, Kiri’s owner, Derek Price, made a magnetic collar.

    The dog made a remarkable recovery, which led Price to start manufacturing magnetic treatments for animals and people. Magnopulse, of which he is managing director, has sold more than 1m therapeutic magnets since 1997 to treat arthritis, swollen ankles, period pains and varicose veins.

    The NHS Prescription Pricing Authority has ruled that 4UlcerCare is not just good for patients but also a good use of NHS cash. It believes the magnets will save money on bandages and nurses’ time by healing the wounds.

    It has included magnets on the official list of items that can be prescribed on the NHS. The NHS has even done a cut-price deal with the manufacturers, buying treatments at £13.80 instead of the normal price of £29.

    Critics of magnetic therapy say it is no more effective than a placebo, however. Only last month a paper in the British Medical Journal by Professor Leonard Finegold, from Drexel University in Philadelphia, and Professor Bruce Flamm, from Kaiser Permanente Medical Center in Riverside, California, cast doubt on the treatment.

    “Patients should be advised that magnet therapy has no proven benefits. If they insist on using a magnetic device, they could be advised to buy the cheapest — this will alleviate the pain in their wallet,” they wrote.

    It is not known exactly how magnets work. Adherents believe they improve circulation because they attract the iron in blood towards them and, in doing so, increase the supply of oxygen to the wound. They may also reduce painful acidity in tissue.

    Some holistic therapists say magnets reduce “negative energy” in the body. They also believe magnets may encourage healthy tissue to generate its own electrical currents to stimulate wound repair.

    A study demonstrating the benefits of static magnets was published in the Journal of Wound Care last year.

    Dr Nyjon Eccles, an NHS GP in north London who carried out the trials, said: “I am not surprised that 4UlcerCare has been accepted since the clinical evidence is very convincing.”

  6. Baby A&E Doctor/Monkey said,

    February 27, 2006 at 12:11 am

    Maybe Dr Eccles just hadn’t kept up to date with reading his BMJ when he said that the clinical evidence was convincing? I know I struggle to interpret such pieces when I am eating my breakfast toast. However, I did and am having ongoing arguments with my girlfriend about them.

  7. Michael King said,

    February 27, 2006 at 9:04 am

    You will not be surprised to find out that the Prescription Pricing Authority’s role does not extend to the conclusions Ms Templeton draws on its behalf. Inclusion in the Drug Tariff means that products, which are already licensed become reimbursable in primary care. 4ulcercare, will be listed in Part IX of the Drug Tariff from 1 March 2006. From this date GPs and nurse prescribers will be able to prescribe this product on NHS prescriptions. The PPA approved the application for the listing of the medical device as the manufacturer’s submission met the inclusion criteria. There is no judgement offered about whether a product in the Drug Tariff is more (or less) efficacious than any other, or the placebo effect.

  8. David Colquhoun said,

    February 27, 2006 at 12:27 pm

    Thanks to Michael King for explaing the rules a bit further. But who authorised the inclusion of 4ulcercare in “Part IX of the Drug Tariff “?

    Who judged that the “manufacturer’s submission met the inclusion criteria”, and what exactly are the “inclusion criteria”

    As far as I can discover, the manufacturer supplies no satisfactory data about whether or not this gadget actually works. All the available data places it firmly in the quack/fraud category, so I think more explanations are needed from the PPA

  9. Ray Girvan said,

    February 27, 2006 at 3:51 pm

    Here at the PPA site are the inclusion criteria for Part IX of the Drug Tariff.

  10. Ben Goldacre said,

    February 27, 2006 at 4:18 pm

    i call them up to find out about it, ray just knows about it already, as usual.

  11. Ray Girvan said,

    February 27, 2006 at 5:38 pm

    While it’s nice to be thought omniscient, all I did was point Google at “Prescription Pricing Authority” “Part IX of the Drug Tariff”.

  12. BobP said,

    February 27, 2006 at 6:00 pm

    The RCT by Eccles at contains some nice cartoons. There’s probably a million things wrong with the study, but at least it’s well wrapped.
    It’s many years since I did statistics, but I don’t think the group was big enough to achive the probabilites quoted.
    I question the efficacy of “blinding” – wouldn’t a powerful magnet make your leg stick to the freezer? Then again, maybe the effort of constantly detaching yourself from metallic objects improves the circulation etc thus indirectly benefitting ………..

  13. Ellen Raphael said,

    February 27, 2006 at 7:04 pm

    We are planning to ask the PPA why it’s ok, even under their own selection criteria, to pay £13.80 for these bandages, which are much more expensive than other bandages for ulcer treatments – the most expensive bandage I found on the drug tarriff list was £12.40.

    Also, Magnopulse has put an entry on its own website ‘NHS medical study results now in’ – which makes it sound like there has been some sort of evaluation by the NHS, which I understand from Michael isn’t correct. The link goes to Magnopulse’s study. I will contact Magnopulse and ask.

    (Sense About Science)

  14. pv said,

    February 27, 2006 at 8:34 pm

    Wouldn’t it just be cheaper, and more fun, to sit on the vacuum cleaner or stand next to the telly (get some extra use out of that old CRT). And why aren’t scrap yards branching out (or diversifying as we say in busines speak) into magnet therapy?
    MRI departments could get in on the act too by announcing a radical new cure for headaches. It not only gets rid of the current headache but also completely eliminates the cause of all future headaches. No doubt cynics will label it as “brainless” medicine.

  15. David Colquhoun said,

    February 27, 2006 at 8:41 pm

    I presume Michael King is (Michael King is Director of Planning and Corporate Affairs at the PPA (, though he does not say so.

    Michael King says “There is no judgement offered about whether a product in the Drug Tariff is more (or less) efficacious than any other, or the placebo effect.”.

    The criteria for inclusion in Part IX of the Drug Tariff ( include, in sectiom 10 iii,
    “They are cost effective”

    Will Michael King please explain how a devise can be cost-effective, if it is ineffective realtive to placebo (he says “There is no judgement offered about whether a product in the Drug Tariff is more (or less) efficacious than any other, or the placebo effect.”)

  16. oharar said,

    February 27, 2006 at 8:49 pm

    BobP writted
    “It’s many years since I did statistics, but I don’t think the group was big enough to achive the probabilites quoted.”

    I think it is big enough, but I haven’t checked the maths. However, the study is so small that couple of lurking variables could cause problems, and invalidate the study. I’m not a medical statistician, but it looks to me like there would be enough in the data to suggest doing a “proper” study.

    If this was a drug, the trial wouldn’t be enough to get it approved for use: it’s about the size of a phase I clinical trial, which (roughly) is done to see if the drug is lethal. There are 2 more phases a drug would have to go through before licensing: why should devices get off more easily?


  17. Delster said,

    February 28, 2006 at 8:50 am

    everybody knows that audio speakers contain magnets, so the best treatment for leg ulcers is actually to convert your speakers into footstools. This will enhance circulation and raise the leg to help facilitate drainage.

    A little know side effect of this is that it will actually improve the depth and texture of the sound along with the width of the suffers thoughts at the same time!

    As this is the case do you think i can get a nice set of Lynn speakers on the NHS? :-)

  18. Paul said,

    February 28, 2006 at 9:31 am

    One thing I note about this study is that there doesn’t appear to have been any correction for multiple comparisons – a fair few comparisions have been made, inflating the likelihood of a false positives.
    As noted above, these results suggest that it is worth a follow-up study, but they are far from conclusive

  19. Chris L said,

    February 28, 2006 at 2:06 pm

    FYI…. there’s a JREF thread going on this topic now…

  20. Huwmanerror said,

    February 28, 2006 at 2:32 pm

    (17. Delster) – I think that would only work if the speakers were connected to a hi-fi that used a very expensive power cable (


  21. Ayupmeduck said,

    February 28, 2006 at 5:22 pm

    Ben says that he has not problem with this nonsense being paid for by the NHS, but I do. The main reason is that this is diverting funds that would otherwise go to company that would likely invest their profits in products that have demonstrated value. I also suspect, but to be honest do not know for sure, that a placebo could be purchased less than these magnetic bandages. Finally, by prescribing these magnetic bandages, there will be a lot of people, possibly including nurses and doctors, that will then be led to believe that there is real merit in this treatment beyond the placebo effect. Are we trying to miss-educate our professionals?

  22. Gareth said,

    February 28, 2006 at 10:54 pm

    So, um, if these magnetic treatments are so effective, how do their supports explain the complete lack of effect the massive magnets in MRI machines have on people? Hell, if blood is magnetic, why don’t people explode when they go new MRI machines? Like that unfortunate guard in the X-men film.

    Placebo’s like this are not a good thing, they just foster mistrust in conventional medicine because it can’t explain how they work (usually because they don’t).

  23. Andy said,

    March 1, 2006 at 1:00 am

    The job of the NHS is to make people better as cost effectivly as possible. People don’t expect their speakers or an MRI to make them better but they expect these magnetic bandages to work. True this is purely a placebo effect but it works and it’s cheap.
    The argument that this encoruages people to use medical treatments that aren’t understood is fairly pointless, you could have 50 studies proving the efectivness of a drug and hundreds of papers on the effects of that specific mixture of chemicals and the vast majority of people will still not understand any of the explanation on why it works. People just know that taking the pill will make them better.

    The only people who need to know why something works are the people producing the treatment and the ones who approve it for use, in this case they know exactly why it works.

    If anything the effectiveness of magnetic treatments will go up because of this giving more cost savings which can be spent on the expensive drugs that some people need.

  24. Rab Morton said,

    March 1, 2006 at 9:04 am

    Robert Park in “Voodoo Science” explains that field strength is measured at the surface and that the magnets he checked out were alternating north/south strips like a fridge magnet. To check the field drop-off he placed them against a steel cabinet and stuck paper sheets in until the magnets couldn’t grip. He found 1mm – in this case less than the thickness of the straps holding them against the skin and even without the straps wouldn’t extend much into the skin.

  25. coracle said,

    March 1, 2006 at 9:15 am


    I think, unfortunately, healthcare goes wider than just making people better in a cost-effective manner. Healthcare needs to be governed on a rational and evidence based principle. Giving such products and ‘homeopathic’ hospitals a veneer of credibility as such approvals do, works against a rational approach.

  26. pv said,

    March 1, 2006 at 10:02 am

    The argument for prescribing magnetic bandages on the NHS seems to be that they will work on the gullible – people who believe the things actually work. It follows that if you understand magnetic bandages don’t work then they won’t work. In which case it would be a waste of NHS time and money to prescribe them – since you would be soon return for something more effective. The procedure for prescribing therefore should include a question to the patient enquiring as to whether he/she believes in the efficacy of magnetic bandages. Perhaps there should also be a caveat, in the event of failure of said bandages, disallowing the patient from pursuing any other treatment or intervention through the NHS for that particular ailment. This might make it cost effective and have the additional effect of making people responsible for their choices.
    The same goes for those who opt for homeopathic treatment. Maybe they too should be barred from seeking further NHS support in the event that their chosen placebo fails them.

  27. Anne the mad scientist said,

    March 1, 2006 at 10:16 am

    I’m having problems with this. There is no doubt that people who debunk proven treatments like vaccinations are dangerous, but so many scientific theories of the past were riciculed before becoming accepted. I bet Newton got a hard time when he said that bloody apple etc, etc. Seeing as there appear to have been no real scientific research into these bandages maybe we should keep an open mind and say innocent until proved guilty???

    Maybe I should just shut up now…

  28. Delster said,

    March 1, 2006 at 10:48 am

    Andy in post 23 say’s

    “The only people who need to know why something works are the people producing the treatment and the ones who approve it for use, in this case they know exactly why it works.”

    I have to say that the people who are administering the treatment also need to know how & why a treatment works to ensure it’s used in the correct way, for the correct symptoms and won’t conflict with other treatments that are being administered.

    And also

    “If anything the effectiveness of magnetic treatments will go up because of this giving more cost savings which can be spent on the expensive drugs that some people need.”

    There is no way that the effectivness will increase for this reason. If it’s saving money to spend on other things, why not place an ordinary bandage (possibly dyed a particular colour) on the patient while explaining it contains very small magnetic particles which will (insert bad science here) to enhance healing. This should “invoke” the placebo effect and be very cheap to boot.

  29. Stever said,

    March 1, 2006 at 12:34 pm

    If its all placebo effect then why not just use normal cheapo bandages and tell people they are magnetic. just change the packaging or something. placebos all about fibbing anyway. save a few bob and get all the benfits.

  30. Mongrel said,

    March 1, 2006 at 12:44 pm

    Anne – Magnets have been tested enough for people to confidently state “Magnet Therapy in any form is a steaming pile of BS”.

    And yes, many scientists with revolutionary theories get laughed at, to be a proper scientist you’ve also got to be right. It’s probably worth Googling “The Galileo Gambit” for that particular fallacy

  31. Ben Goldacre said,

    March 1, 2006 at 12:45 pm

    anne: there is a lot research into them, showing they do not work better than placebo.

  32. potsy700 said,

    March 1, 2006 at 1:30 pm

    As has been mentioned, get the district nurses going out doing the dressings to ask their patients if they’ve heard of magnet therapy and if they’d like to try it – if they say yes, just use the same old cheapo bandages, but tell the patirent that they’re impegnated with tiny iron filings, magnetised to produced maximal bloodflow, and see what happens.

    The only problem with this is that someone will raise ethical objections re: informed consent if you are effectively lying to your patient.

    I remember when I was a pre-reg house officer. One of our surgical patients was several days post-op and was getting a bit too attached to her pethidine injections – and was asking for them more and more. My SHO disappeared off to theatre with the consultant, but instructed me not to give Mrs X any more pethidine as we wanted to wean her off. Mrs X subsequently asked for some pethidine. Being a new house officer, and not very confident, I didn’t really know how to say ‘no’ to Mrs X who told me she was in pain ( although observing her whenh she thought I couldn’t see her, she was laughing and joking with her husband ). I didn’t know how to say ‘no’ without accusing her of being a liar / addict etc. So I told her I’d go and get the nurse to give her an injection. I subsequently prescribed tramadol, not pethidine, and asked a junior nurse to administer it, making sure that she didn’t say what it was unless the patient specifically asked if it was pethidine. When the Sister found out, there was a right stink because she said I’d lied to my patient. At no point had I actually said to the patient that it was pethidine, I just said we’d give her an injection and she assumed it was pethidine, so I got away with it, and I justified it by saying that the placebo effect is a recognised clinical therapeutic effect, and was legitimate. The patient never knew, and indeed thanked me a few minutes later for the ‘wonderful’ injection.

    The problem with placebos is that these days the patients have a right to informed consent – so you really should tell them that you’re giving a placebo.

    Are there any studies that show the efficacy of placebo on a patient if the patient knows it’s a placebo?


  33. Ben Goldacre said,

    March 1, 2006 at 1:42 pm

    thats a great idea, because it illustrates the ethical convolutions you get caught in with placebos.

    so we can permit ourselves to give magnetic bandages, knowing they are no better than placebo, and that is considered acceptable deception…

    then, taking it one step further, we could just *tell* people we’re giving them magnet bandages, but give them normal ones, and employ the placebo effect that way…

    but that would be considered more ethically unacceptable, as the lie is bigger and more concrete.

    too weird.

  34. j said,

    March 1, 2006 at 1:55 pm

    In the US, homeopathic medicines in drug stores often sell with a disclaimer basically saying that they won’t treat anything. People still buy them and use them, so it seems likely that the placebo effect still works to an extent. It’d be interesting to try magnet bandages, giving the patient full information about them – that they’ve been shown to be a cost effective treatment, but scientific trials have shown them to be no more effective than placebo. Placebo effect might still work to an extent – even if this might be, for example, because the patient distrusts ‘western science’ – and would seem to avoid a lot of the ethical issues…

  35. Sockatume said,

    March 1, 2006 at 2:43 pm

    Sounds about right. Label says remedy does nothing, patient doesn’t believe label, voila, placebo effect.

    If only they’d word it more bluntly:


  36. le canard noir said,

    March 1, 2006 at 3:51 pm

    I’ve just got out of Stoke Mandeville after four days on the plastics ward after breaking some bones. Not once was I offered a magnetic bandage. Bastards. It really hurt and I needed a placebo.

  37. j said,

    March 1, 2006 at 5:35 pm

    I’ve just remembered a Simpsons episode, with a flu epidemic. The Dr says that there’s no point prescribing antibiotics, as they’d just be a placebo. The crowd’s response – where can we get this placebo! Give us some!

  38. Fi said,

    March 1, 2006 at 5:37 pm

    By the very act of actually spending money on homeopathic medicine the patient has pretty much already proved they rate the theory over the actual science and “believe” in the medicine.

    Most likely they think warning messages such as those are part of the pro-corporate-science-government-conspiracy-wotssit and they’re really clever for not falling for it.

  39. Andy said,

    March 1, 2006 at 5:59 pm

    With reguard to your comment here, on your first point you seem to have misunderstood me. I expect the GP or whoever writes a prescription to know a little about the drugs involved. I just don’t expect them to know the mechanism for every single chemical reaction that takes place with every possible drug they could prescribe. That would be impossible.

    On the second point, the effectiveness will improve. This works purely on the placebo effect. Which means the more that people believe it will work the more effect it will have. If something is offered by the NHS more people will think that maybe this magnetic stuff works (or at least have their belief in it strengthened), which will increase the strength of the effect.
    You’ve got to give someone a reason to believe the treatment will work, the more reason the better. Yes you would get the same effect if you gave out normal bandages but only as long as people think they are magnetic, as soon as they know they are normal bandages the effect will vanish.
    So the most cost effective solution would be to announce loudly that the NHS will be prescribing magnetic bandages and then quietly hand out normal ones telling people that they are magnetic.

  40. Melissa G said,

    March 1, 2006 at 6:04 pm

    “So the most cost effective solution would be to announce loudly that the NHS will be prescribing magnetic bandages and then quietly hand out normal ones telling people that they are magnetic.”

    Again you run into the ethics problem, though, yes?

  41. Andy said,

    March 1, 2006 at 6:40 pm

    True, don’t you hate it when ethics get in the way of a good idea. So many of my plans to take over the world have run into exactly the same problem.
    But then if people think that magnets will make them healthier then they obviously enjoy being lied to.

  42. potsy700 said,

    March 1, 2006 at 7:01 pm

    Just a thought – perhaps the NHS ARE giving out fake magnetic bandages???? Perhaps this ‘announcement’ is just to fool everyone and take full advantage of the placebo effect?

    I guess it comes down to the simple question:

    Is the NHS stupid enough to prescribe magents?
    Is the NHS clever enough to take full advantage of placebo and get the media onside by pretending to prescribe magnets?

    Which is more likely? Sadly, having worked in the NHS I know it is the former.

    This brings us to an interesting social dilemma. In the past, there was an attitude of “doctor knows best” and you didn’t question the doctor’s judgement. These days the public are encouraged (rightly) to ask about their condition / treatment etc., and we doctors are encouraged to develop communication skills, and the ability to translate complex concepts into everyday language. We also have to have informed consent, which means we have to tell our patients what we are doing, how any intervention works, and give them an idea of the risk / benefit balance.

    This is all very well, but sometimes you have to be deceitful in the best interests of your patient.
    One sunday morning I was in A&E and walked into a cubicle to see a patient. Straight away alarm bells were ringing: the chap was elderly, bright yellow and his clothes were several sizes too big for him, although he denied any weight loss. He had a massive liver and I basically suspected he had a primary cancer somewhere, with liver secondaries. But, the guy was anxious to go home. I got the impression that his wife was at her wits end trying to get him to go to the doctor, and basically his entire family had abducted him and carted him down to A&E that morning out of desperation because he refused to go to his doctor. I said I wanted to admit him for investigations. He tried to tell me he’d see his GP in the morning – I didn’t believe him. He was very scared and in denial because he knew that he had something seriously wrong with him. I think if I’d actually stated my suspicions he’d have run a mile. So I basically had to conive with his daughter to tell him that I wanted to bring him in overnight only, for some ‘routine’ tests and that I didn’t really know what was going on, but it was better to be safe than sorry.

    Technically, I lied to my patient. Technically I broke confidentiality by plotting with his daughter behind his back. Technically I should have said “I want to admit you to hospital because I think you have a terminal disease” and watched him run. But my conscience is clear because I think I did the right thing in deceiving him for his own good.

    The question is, could a doctor’s intention to make use of the placebo effect in the best interests of the patient justify a doctor lieing to their patient in this day and age??

  43. David Colquhoun said,

    March 1, 2006 at 7:58 pm

    I’m glad to see that some of the recent posts have been concentrating on the real dilemmas raised by CAM. I’ve tried to summarise these at

    They need as much publicity as possible. because they are rarely discussed (especially the ‘training dilemma’).

  44. pv said,

    March 2, 2006 at 12:16 am

    Actually I don’t think it very cleverof the NHS to do this. For a start, even though taking a positive attitude toward a treatment might help (not sure about this), it can’t always work out that way. When people find out they are being deceived, and they will, it will surely harm NHS credibility and drive people even further into the arms of the waiting legions of quacks and crackpots. Unless the objective is actually to get people out of the NHS system and to hell with anyone’s health, I’m sure this will be counterproductive in the long run.

  45. Paul said,

    March 2, 2006 at 7:47 am

    “When people find out they are being deceived, and they will, it will surely harm NHS credibility ”

    Well said pv – once distrust has been established, it generalises. People are incredibly tolerant of what doctors do to them but if you remove the trust you may as well be hawking your wares with all the other charlatans and mountebanks

  46. Ayupmeduck said,

    March 2, 2006 at 8:46 am

    In addition to the issues of ethics and credibility, I would add another issue: the business case from the supliers side. Development of new medical treatments is a relatively high risk and high investment business. Years of research and clinical trials are requred. However, development of magnetic bandages or any other such “placebo” requires only a marketing program, and moreover, a marketing program that must contain an element of missinformation. In this case, the logical extension of this is that by supporting magnetic bandages and the like, the health services are sending a worrying message the private sector – that it would possibly be just as profitable, possibly more profitable, to invest in a marketing program that is based on quackery rather than research and development into proven medical products.

  47. three tigers said,

    March 2, 2006 at 6:48 pm

    If static magnets are supposed to have an effect on blood circulation (e.g. increasing flow to promote healing) why do they not cause reddening of the skin? This is surely the minimum which would be expected to demonstrate their “efficacy”. I’m a pharmacologist and have enough trouble showing true efficacy with new drug candidates, this placebo effect argument doesn’t wash with our management or regulatory authorities. Perhaps I should move closer to the MRI lab?

  48. Janet W said,

    March 2, 2006 at 7:15 pm

    The article attributes the healing to tiny electric currents in the flesh around the wound (“ion fluxes across the cell membrane”), influenced by the magnetic field, rather than to magnetic blood (it seem to be a case of “magnets are good for you… insert latest explanation here…”, and the explanations do appear to be evolving; the magnets are no longer emitting either energy or positive ions, for example, though they are apparently still responsible for “changes in electrical potential” (between what and what?)).
    As I’ve already demonstrated the extent of my medical knowledge on previous threads, could someone tell me… Do these currents exist? Are they important in healing? Could they be enhanced by a static magnet on the surface of the leg? If so, could this be dangerous? Did I just misread this, or is the magnet “just below the knee” actually nowhere near the wound? And is the fact that (according to the graphs) the initial size of the ulcers in the magnet group is on average smaller than the initial size of the placebo group, likely to affect the rate of reduction?

  49. Janet W said,

    March 2, 2006 at 7:26 pm

    Paul, what did you mean about “multiple comparisons”? Did you mean looking at different effects (size reduction, pain relief etc) or did you mean something different from this?

    Can someone explain the p thing to me? Is p the probability of this overall test result or better occurring by chance, or is it something more complicated?

  50. Paul said,

    March 2, 2006 at 7:48 pm

    The issue of multiple comparisons is directly related to the p value.

    As you say p = likelihood that the observed difference occurred by chance. The traditional p

  51. three tigers said,

    March 2, 2006 at 8:34 pm

    Have a look at my favourite guide to statistics ( and go to ‘View the InStat guide to choosing and interpreting statistical tests’ on the left hand-side. Everything you would ever need to know is explained very well and in simple language, e.g. page 12 p values, page 13 null hypothesis, page 15 multiple comparisons, etc.

  52. Paul said,

    March 2, 2006 at 9:14 pm

    I’ve just read my previous post which seems, inexplicably, to have been cut off early on. Presumably my fault, but not sure why it happened.

    All I was going to say was that, if you set a p value threhold at, say, 0.05 then you are allowing yourself to refute the null hypothesis (that there is no “significant” result/difference) with a 1 in 20 chance that you might be wrong. So if you do 20 different comparisons you give yourself 20 chances of being wrong (i.e. of having a false positive result). So a 1 in 20 threshold set across 20 comparisons means that you’ve guaranteed yourself a false positive somewhere in the 20 comparisons. So if you want a spurious result that nevertheless manages to jump through the statistical hoop, just take loads of measures and do loads of comparisons.

  53. Alastair said,

    March 2, 2006 at 11:33 pm

    Sorry to burst anyone’s bubble over the “iron in blood is magnetic” chestnut, but iron in blood IS magnetic. I am a Chemistry Masters student and have recently done a course in macromolecules which include metalloporphrines like oxyhaemoglobin and deoxyhaemoglobin.

    Deoxyhaemoglobin has a property which is known as paramagnetism. This means that if placed in a magnetic field it will reinforce that field. This does make it, albeit weakly, magnetic. This property is actually exploited in fMRI scans. However, how much the individual molecules of deoxyhaemoglobin would move under the influence of a small magnet such as those mentioned in this article is negligable.

    However, for a practical demonstration that paramagnetism is *real* magnetism get yourself some liquid oxygen (perhaps easier said than done) , which is also paramagnetic, place it in a test tube on the end of a piece of string and hold a decent sized magnet to it: the tube swings towards the magnet.

    Apologies for being such an unashamed gimp, but thought you’d all like to know this useless crap!

  54. Ray Girvan said,

    March 3, 2006 at 12:29 am

    Yeah, we do know this. But general readers don’t know about paramagnetism (or diamagnetism for that matter): any product marketing that plays the “magnetism” card is going to make people think of ferromagnetism, which is outright wrong.

  55. David Colquhoun said,

    March 3, 2006 at 7:37 am

    The whole magnet saga is as good an eaxmple as any of double standards in the NHS.

    No form of CAM has ever been referred to NICE, they tell me. The best chance of getting something done might be a NICE assessment. The decision of whether or not to recommend anything to NICE rests, unfortunately, with the Department of Health, BUT anyone can suggest a topic.

    I have just suggested that homeopathy as a whole be referred to NICE. The objection is likely to be that there is not a suffciently good evidence base for NICE to deal with it. That, of course, is exactly why NICE should deliver a verdict. To say otherwise is to perpetuate the existing double-standard. I tried to counter this argument in the comment section.

    The best chance of success is probably for them to get a flood of requests. I suggest you all go to and suggest homeopathy, and get all you friends to do the same.

  56. potsy700 said,

    March 3, 2006 at 10:09 am

    How bizarre! You can ‘pick’ a topic you’d like to be investigated. Is that what NICE is for? Shouldn’t all new forms of treatment go through NICE, not just the ones they pick and choose from a suggestion box?

    I wonder if they would take on homeopathy, given that there is no evidence base and the NHS is spending money on it these days. I’ll certainly fill in a form.

  57. Stephen said,

    March 3, 2006 at 10:40 am

    So a 1 in 20 threshold set across 20 comparisons means that you’ve guaranteed yourself a false positive somewhere in the 20 comparisons

    Sorry to be pedantic but no you haven’t.

  58. Paul said,

    March 3, 2006 at 11:10 am

    Sorry – just re-read this myself – can’t think why I put it this way – of course you haven’t “guaranteed” yourself a false positive (Is that the term you’re objecting to? If not, perhaps you could enlarge). Perhaps it should be put the following way – for every 20 comparisons that you do with a threshold set at p=0.05 then you will, on average, get one false positive.

    Please don’t apologies for pedantry – I see it as vigilance.

  59. Janet W said,

    March 3, 2006 at 12:42 pm

    Thanks Paul, I get it. Thanks to all the tigers too.. will print off pdf and plough thru it sometime. Wouldn’t it be great if someone used this approach to generate a spoof study showing a non-existent relationship between 2 variables? I rather like the FSM pirates vs global warming, but would be nice to have a medical version.
    Can we be pedantic about spelling too?

  60. aspiring pedant said,

    March 3, 2006 at 12:50 pm

    Janet W. – Yes we can be pedantic about spelling – you mean “through”.

  61. Janet W said,

    March 3, 2006 at 3:56 pm

    accepted abbreviation in informal writing?

  62. RS said,

    March 3, 2006 at 4:23 pm

    Have submitted my NICE application for homeopathy. A pity they’d never consider it really.

  63. Steffan said,

    March 3, 2006 at 4:57 pm

    So what’s the consensus here? Should medical professionals pander/lie to their patient’s anti-scientific beliefs, if it helps them and saves money for the NHS, or should medical professionals tell the truth – thereby contributing to scientific rigour, but at the cost of removing the placebo effect and raising costs for the NHS?

    A medical professional lying to their patients is wrong. Diverting money away from treatments that are proven to work, towards treatments that are proven not to work is also wrong.

    On the other hand, a medical professional’s primary duty is to the patient – not necessarily to the truth. Spending more money on treatments that the patient doesn’t want, instead of cheaper treatment’s that patients DO want (and believe to be as effective, if not more so) is also wrong.

    Which is the right policy to adopt?

  64. NeilMac said,

    March 3, 2006 at 5:23 pm

    Perhaps we should only give people treatments that they believe will work for them. Over time Darwinian selection would then take care of the homeopaths etc.

  65. potsy700 said,

    March 3, 2006 at 5:58 pm

    I think NeilMac has the solution. Offer patients the choice. Advise them of the risks and benefits of the conventional treatment, and let them sign a disclaimer if they opt for alternatives.

    The problem is that you get a lot of people who have both, and then claim that the alternative therapy made all the difference. There was a girl in the Mail a few weeks ago who had cancer. She was treated with chemotherapy and also changed her diet and took vitamin supplements. She was quoted “I believe my vitamins and healthy diet made all the difference.” Never even mentioned the bloody chemo! A few people dropping dead because they had ONLY alternative treatments might make a difference to attitudes in future.

    But then medicine is the art of applying the science to people, I suppose, so you have to take account of the individual psyche. Some of my patients have waffled about alternative medicine, and will say that they’ve read that there are ‘studies’ showing the effectiveness of homeopathy etc. Unless I give them all a lecture in basic medical statistics and the concept of peer review I’m not sure what I can do. If I just say I don’t believe in it, it plays into their hands.

    At the end of the day, they tend to come running back when something gets serious.

  66. Stephen said,

    March 3, 2006 at 7:10 pm

    yes an average frequency of 1 false discovery is correct. Sorry again to be pedantic but it is a common slip.

    Do you think it would be right to lie to a patient about the efficacy of chemotherapy? Even if it makes them feel better? No thought not– why does it suddenly become OK with homeopathy?

    Firstly I think it is perfectly OK for a patient to go and have reflexology or acupuncture or massage. This will relax them and make them feel better while they have treatment. You can tell them that a spot of relaxation will help them cope or fell better with the stressful treatment. Tell them the truth though that the chemotherapy is the treatment and the reflexology is just a spot of fun like having a facial or getting your nails done.

    Secondly doctors or other medical staff should not be doing this. If you remove the lie that these are treatments then it is certainly cheaper to get medically unqualified staff to carry them out. Frankly I resent the doctors at the London Homeopathy Hospital being paid for stuff that a well trained beautician might do.

  67. potsy700 said,

    March 3, 2006 at 9:00 pm

    I would agree with that – I think there is a place for therapy that is relaxing, enjoyable, stress-relieveing, especially if you’ve got a potentially terminal illness. A bit of pampering is certainly acceptable. But that’s all. Why the NHS pays for homeopathy I don’t know.

    In one hospital in which I work, the post-graduate education centre had a poster up for a homeopathy course….gggrrrrrrr

  68. David Colquhoun said,

    March 4, 2006 at 11:00 pm

    It occurs to me that I should have added the following bit to the NICE recommendation

    It is now over 5 years since the House of Lords Select Committee ( said

    “We recommend that the Medicines Control Agency (MCA) help the public identify regulated products more clearly. We also recommend that the law against illegal or misleading labelling be rigorously enforced.”

    The giovernment accepted this report, but so far nothing has been done. NICE is clearly now the appropriate body to do the recommended assessment.

  69. Ben Goldacre said,

    March 4, 2006 at 11:13 pm

    i think this is an excellent idea, perhaps we should find a big homeopathy media event, like “homeopathy week”, when they are celebrating, and use that time to suggest it to a wider audience?

  70. Delster said,

    March 7, 2006 at 11:45 am

    Potsy700 in post 65

    You mentioned people only having “alternative” treatments dropping dead. Well that happened in a cancer case over here in Dublin area. The homeo treating them magaged to convince them to give up conventional treatments. After the guy dropped dead an inquest was held and the homeopath was called to give evidence. When she failed to show up they slapped her with a fine….. all of 5 euro’s (thats about £3 from those still in UK)

    As for alternative treatments such as massage…. i can recommend that for physical injuries. it’s amazing how much pain relief a good massuse can provide. I admit it’s only temporary but combined with physiotherapy it’s quite valuable.

  71. Roger Macy said,

    March 7, 2006 at 1:20 pm

    The Independent carries a full page piece on the subject today in their ‘Helath’ pages.

    I’ll post it in full below for the record. You’ll see from the lead-in that Jeremy seems to have kept more control of the presentation than on another piece, discussed elsewhere (‘Miracle Cures’).
    The last section ‘Magnets do they work?’ is more prominent on the printed page. But I don’t suppose that Ben would have minded if Jeremy had lifted from this site some of the discussion about getting a ‘sham device’ to be a convincing control.

    The main heading on the printed version (but not online) is ‘The big attraction’ with an illustration of a standard ferromagnet and attracted iron filings.

    Magnets: How effective is the latest NHS treatment?
    Cherie Blair is a fan – and now they’re available on the NHS. But Jeremy Laurance wonders whether magnets really can treat everything from period pains to backache and insomnia
    Published: 07 March 2006 The Independent
    Professional sceptics of alternative medicine got their comeuppance last week with the disclosure that magnet therapy, said to be favoured by Cherie Blair, was to be made available on the NHS. Magnets have been used as a remedy for centuries, and widely marketed in Britain for over a decade, but this was a seal of scientific approval.
    You can buy a magnetic hairbrush said to stimulate hair growth, a magnetic mask to reduce wrinkles, magnetic insoles to boost energy, and magnetic jewellery to ward off arthritis. Some researchers claim to have shown that magnets can ease period pains, lift depression and cure aching joints. Separate studies at Harvard University, in the US, and the Peninsula Medical School, Plymouth, even found that wearing a magnetic sleeve eased the pain of osteoarthritis of the knee.
    Magnets’ healing powers are said to have enthused Cleopatra, and current users are reported to include Bill Clinton and Sir Anthony Hopkins. But when the NHS includes a product in the Drug Tariff, you have to sit up and take notice. Since last week, a device called the 4UlcerCare – a strap containing four magnets that is wrapped around the leg – has been available on prescription from GPs. Its maker, the Bristol-based firm Magnopulse, claims that it speeds the healing of leg ulcers and prevents their recurrence.
    The announcement has created excitement in the world of alternative medicine. Every purveyor of magnetic devices has been pumping out press releases and advertisements, hoping to capitalise on the new development. Lilias Curtin, one-time therapist to Cherie Blair, sent a poster-sized announcement to newspapers last week declaring her “sincere belief that, in the next five to 10 years, magnets will be seen in first-aid boxes”. Kleshna, a maker of magnet jewellery, claimed in another release that magnets created “a whirlpool effect to the iron in our blood to get it pumping round much faster than usual”.
    People may scoff at the idea that the lumps of metal used for sticking notes on to the fridge have healing properties, but, presumably, those who control the NHS purse know what they are paying for. And anyone who doubts that magnets have physical effects on the body need only try an experiment conducted at the Institute of Neurology in London. Ask Professor Tom Rothwell to wave a magnetic wand over the left side of your head, and watch your right arm jump involuntarily. The excitation of the neuronal pathways that this demonstrates suggests, according to Professor Rothwell, that the technique might be useful in the rehabilitation of stroke victims. A trial of transmagnetic stimulation of the brain in stroke-sufferers is soon to begin.
    This does not prove that magnetic necklaces have medicinal effects. But after 10 years of making and selling magnetic devices such as the 4Ulcer-Care leg wrap, Derek Price, the 64-year-old founder of Magno-pulse, is convinced that they work. Having had initial success on his dog, Kiri, who suffered from arthritis; and then on his own arthritic ankle, Price sent the leg wraps to four local surgeries to be tried on patients. To his surprise, word came back that they were helping to heal ulcers. A trial was run on 28 patients in Suffolk, Norfolk and Cambridge by the London GP Nyjon Eccles, and the results published in the Journal of Wound Care in February 2005. A second telephone survey found that 211 of 289 patients who used the device had not had a recurrence of their ulcer for at least a year, Price says.
    Whether this was what convinced the NHS Prescription Pricing Authority to include it in the Drug Tariff is hard to tell. No one was available from the authority to comment last week, and a spokesman for the Department of Health could throw no light on what evidence is required before a product can be included in the Drug Tariff. “It is for the GP to decide whether a listed product is suitable for the treatment of individual patients,” he said.
    The leg-ulcer wrap is worn just below the knee, above the calf muscle. It does not come into direct contact with the ulcer, which is covered by its own dressing. It is believed that the magnets stimulate the circulation but it is not known how. Leg ulcers tend to occur in the elderly and those with poor circulation such as diabetics. Their treatment costs the NHS at least £300m a year. The cost to the NHS of the leg-ulcer wrap is £13.80 – about half the retail price of £29 – and Price claims that it could save £150m a year on conventional treatment and nurses’ time.
    Other experts are sceptical. Professor Edzard Ernst, head of complementary medicine at the University of Exeter, said that he was puzzled by the NHS decision. “As far as I can see, there hasn’t yet been enough research to prove that these magnets help people with ulcers. You need more than a study on 20-odd people to have a compelling case.”
    More powerful electromagnets could help to heal tissue injuries, and are used in hospitals elsewhere in Europe, but that was different, he said. His own study of small magnets on arthritis sufferers had failed to yield compelling results. “There is a huge market out there and lots of money is being made, but the evidence is far from convincing.”
    In January, researchers from the Kaiser Permanente Medical Center, in California, published a paper in the British Medical Journal that cast doubt on the therapeutic use of magnets. “Patients should be advised that magnet therapy has no proven benefits. If they insist on using a magnetic device, they could be advised to buy the cheapest – this will alleviate the pain in their wallet,” they wrote.
    That could be good advice for the NHS.
    Jeremy Laurance is health editor of ‘The Independent’
    Magnets: do they really work?
    * The origins of magnet therapy can be traced back to ancient Egypt, but they became popular in the West in the 1990s. Around five million Americans were using magnets in 2001.
    * Magnets are said to help with arthritis, aches and pains, circulation problems, migraine, backache, period pain and sleep problems.
    * Magnets used for therapy are the size of a 50p piece and eight-10 times stronger than fridge magnets.
    * At the University of Virginia, in the US, researchers concluded that magnet therapy reduced the intensity of pain from fibromyalgia – a rheumatoid disorder – enough to be “clinically meaningful”.
    * At Harvard University, patients with osteoarthritis were given magnetic “sleeves” for their knees, which they wore six hours a day for six weeks. The researchers found that the beneficial effects kicked in after four hours, with a sevenfold difference between those who had the magnetic sleeve and those who had a sham device.
    * For a study at the University of Washington, researchers put a magnet on the shoulder of patients who had suffered chronic pain for years. After the magnet had been on the shoulder for one hour, pain levels halved.
    * A study published in the British Medical Journal in January concluded that there was no evidence that magnet therapy worked, and warned magnet users that they were being exploited.

  72. Roger Macy said,

    March 7, 2006 at 1:28 pm

    I agree with Delster on massage (post70). For muscle spasm, which includes a range of back problems, I find a skilled massager the obvious and effective treatment. Nothing alternative about it. But would be happy to take that to a new thread, so we don’t bore people solid with our backaches.

  73. Delster said,

    March 7, 2006 at 1:29 pm


    “Professor Edzard Ernst, head of complementary medicine at the University of Exeter, said that he was puzzled by the NHS decision. “As far as I can see, there hasn’t yet been enough research to prove that these magnets help people with ulcers. You need more than a study on 20-odd people to have a compelling case.”
    More powerful electromagnets could help to heal tissue injuries, and are used in hospitals elsewhere in Europe, but that was different, he said. His own study of small magnets on arthritis sufferers had failed to yield compelling results. “There is a huge market out there and lots of money is being made, but the evidence is far from convincing.”

    and thats from a head of complementary medicine!

  74. Delster said,

    March 7, 2006 at 1:31 pm


    The massage i had was not for back but for fairly wide spread injuries following a bit of a bike accident, esp the quads.

    For the medical among us this included a compound open book fracture of the pelvis, broken knee and broken wrist.

  75. Roger Macy said,

    March 7, 2006 at 1:39 pm

    If anyone is claiming that magnets are actually biomedically active, as opposed to a placebo, shouldn’t NICE be considering the question of safe and effective doses?
    Drugs and radiation are only of benefit under prescribed regimens at standard doses.
    Are magnets always ‘good’ whatever the polarity and strength?

  76. coracle said,

    March 8, 2006 at 9:14 am


    Sorry to burst anyone’s bubble over the “iron in blood is magnetic” chestnut, but iron in blood IS magnetic. I am a Chemistry Masters student and have recently done a course in macromolecules which include metalloporphrines like oxyhaemoglobin and deoxyhaemoglobin.

    I was wondering whether you know of any reputable links that provide background to this? I quite often see various cranks trotting out the potential of magnetism and I was hoping to get some background to counter it.


  77. Delster said,

    March 8, 2006 at 9:48 am


    the whole idea of the scientific process is that you have to prove that it works…. which they can’t, as opposed to disproving it.

    Unfortunatly that doesn’t seem to apply to “alternative” treatments

  78. coracle said,

    March 8, 2006 at 10:28 am


    Sure, the trouble is, as you say, the idea of proving a theory isn’t adhered to by cranks. If I have background information as to why it wouldn’t work then at least I have something that might get them to think twice. Also, the more I know about something, the less I’m likely to make an arse of myself.

  79. Delster said,

    March 8, 2006 at 10:52 am


    one of the earlier posts pointed out that the magnets in question would only support their own weight through a thickness of a millimeter or 2 of paper. So you immediatly have a limit on the depth of penetration of the field as the strap is thicker than that,

    It would be good to find out about any proper studies that have been done.

    One thing i did hear about for treating ulcers and other conditions which result in dead tissues on the surface was from Russia i think. They have a place with natural hot springs containing a specific type of fish. Apparently these will eat the dead tissue leaving only the healthy tissue behind. If i get a chance today i shall have to see if i can find more on that.

  80. raygirvan said,

    March 9, 2006 at 4:43 pm

    Alastair: metalloporphrines like oxyhaemoglobin and deoxyhaemoglobin
    Coracle: I was wondering whether you know of any reputable links that provide background to this?

    A Google on deoxyhaemoglobin paramagnetic diamagnetic finds plenty of technical sites describing blood oxygen level dependent imaging (BOLD MRI). It’s pretty neat: oxyhaemoglobin is diamagnetic and deoxyhaemoglobin is paramagnetic, so under the applied field, develop different magnetic properties that affect proton spin on adjacent water molecules differently. That means, with a suitable MRI setup, you can see a contrast between oxygenated and deoxygenated blood.

    However, none of this should be taken as confirmation of “blood is magnetic” in any lay sense. Paramagnetism is typically at least a million times weaker than the everyday ferromagnetism, diamagnetism weaker still, and they generally only manifest under humungous magnetic fields.

  81. Jay said,

    March 10, 2006 at 11:46 am

    From the Independent article quoted above, this caught my eye. It seems to be stated with a degree of certainty.

    And anyone who doubts that magnets have physical effects on the body need only try an experiment conducted at the Institute of Neurology in London. Ask Professor Tom Rothwell to wave a magnetic wand over the left side of your head, and watch your right arm jump involuntarily.

    Can anyone verify this statement: I doubted it, we’ve got some strong magnets here, and I just tried it….nothing. Further research reveals that the pulsed magnetic field mentioned induces an electrical current, and appears to be a non-invasive alternative to sticking wires through the skull. Somewhat different to the context of the article.

  82. raygirvan said,

    March 10, 2006 at 8:17 pm

    Yep. Ask Professor Tom Rothwell, and he ‘ll say, “That’s not my name, matey.” Professor John Rothwell has done some work into TMS (transcranial magnetic brain stimulation). As you say, it’s a pulsed field – lots of techie details here. We’re talking about a coil driven by kiloamps to produce an alternating field of several Tesla, so it’s complete handwaving to cite it as evidence that piddly little static magnets (that produce a few milliTesla) will do anything.

  83. Varicose Vane (sic) said,

    August 17, 2006 at 3:47 am

    THis thread seems to have gone quiet.

    But given all the experts on it – how do you stop ulcers caused by varicose veins

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  85. Treating cancer with magnetism « said,

    September 20, 2010 at 9:50 pm

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