Holford and Histadelia

[BPSDB] Patrick Holford’s book Optimum Nutrition for the Mind (ONM) includes information on a condition known as histadelia. Weirdly, it doesn’t seem to get a mention on his website. Similarly, a seach of Pubmed returns zero results. I’m not surprised to see that Patrick Holford has been suggesting nutritional treatments for a condition that may not exist – but I am surprised he isn’t doing so on his website. Maybe you have to buy the book to get such specialist knowledge? Since writing this opening, I have found out that he does still write about histadelia – but he now refers to it as “high histamine” and the full article is available only to 100% Health members. Fortunately, I don’t have to sign up as I have access to a copy of ONM and can check there for his views [pp 183-7 of the hardback edition]. So I was wrong that histadelia may no longer be something Patrick believes in, but right that you have to pay for the info.**

Another thing you have to pay for is the test – it will cost you £55 if you want to know whether the Orthomolecular Medicine crowd thinks you have high histamine. Ths FftB info pack [PDF] includes prices for tests. Once you have been “diagnosed” as histadelic, you will then require treatment for your condition. There seems to be no good evidence that the condition known as histadelia is actually a problem for anyone [I can't find any evidence it actually exists*]. There is no evidence that the test for histadelia works. There is no evidence that the remedies for histadelia (vitamins and minerals, natch) work.

Holford was diagnosed by Carl Pfeiffer as “high histamine”. This rigorous diagnosis was reached at by Pfeiffer after taking one look at Holford and his white, marked nails. That’s it – he could tell just by looking at his nails. If it is true that diagnosing histadelia is that simple, and if it is true that such a diagnosis is accurate then (1) why hasn’t it been recognised by anyone apart from the Orthomolecular Medicine crew and (2) why would anyone need to pay for a test kit?

What is the scientific evidence for Holford and Pfeiffer’s belief that histamine is a real condition, that can be accurately diagnosed and treated by pills? I don’t know. Despite Patrick’s famous referenciness, the section of his book Optimum Nutrition for the Mind that deals with histadelia has no references. That’s right, not one single reference to back up the claims of these advocates of Orthomolecular Medicine. He cites a single case study, quotes some opinions from Carl Pfeiffer and speculates about Marilyn Monroe being high histamine. Marilyn Monroe? At least in “The Sixth Sense” that kid only saw dead people – Patrick Holford diagnoses them as histadelic!

What treatments does Holford recommend for high histamine? Well, he reckons a low-protein, high-carb diet is best. Does this mean that those following Holford’s low-GL diet are at greater risk of histadelia than people who don’t follow a low-GL diet? Do you think he’s warned them? Aside from the dietary changes, Holford recommends… pills. And lots of them. Two grams of Vitamin C, 15mg of Zinc, 5mg of Manganese, at least 50mg of Vitamin B6. If you are “experiencing undesirable symptoms”, Holford expects you to fork out for more pills: 500mg Calcium and 500mg Methionine [an amino acid found in abundance in, e.g., eggs] twice daily. All these pills must cost a fair bit, and by this point the customer has already paid for the information Patrick provides about histadelia via books and paywalled articles. Not to mention the £55 for a test. Expensive condition, this histadelia. He also refers to phenytoin, the anti-epilepsy drug, and claims 100mg morning and afternoon will usually provide some relief for certain patients. So the guy who wrote “Food is Better than Drugs” with Jerome Burns thinks that anti-epilepsy pharmaceuticals are appropriate for histadelia? Not only does he advocate pharmaceuticals, but he thinks off-label prescribing is a good thing. He also recommends you avoid taking more than 200 microgrammes of Folic Acid if you are histadelic – does he warn those taking his recommended Optimum Daily Amounts (ODAs) that they are in danger of triggering this condition? ONM on Google books shows an RDA of 400 mcg and an ODA of 800 mcg for Folic Acid – quite apart from the EU RDA being 200 rather than 400 microgrammes, this shows that Patrick Holford believes that it is OK to tell the general population that they should take four times the EU RDA for Folic Acid (the EU RDA is, of course the limit that Holford reckons should be a maximum for ‘histadelics’).

They have their own un-evidenced test – for an un-evidenced condition that requires un-evidenced treatment.

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*Side-issue
Does the publicising of a medical condition that may-or-may-not-exist remind anyone of the tactics of Evul Big Pharma? Here’s a quote from Ben Goldacre’s latest column on the medicalisation of everyday life, an edited extract from his book [Bad Science]:

So the story of “disease mongering” goes like this: because they cannot find new treatments for the diseases we already have, the pill companies have instead had to invent new diseases for the treatments they already have.

Selling dietary supplements is a bit like selling drugs. It should come as no surprise that similar tactics are used. Despite the blustering of those who make money from nutritional therapy (whether nutritionists, firms selling test kits, food supplement manufacturers – though not perhaps retailers such as chemists and supermarkets) about Evul Big Pharma, they benefit from the same tactics and it is disingenuous of them to assert otherwise, not to mention hypocritical of them to criticise Big Pharma.

** Cialdini:
Robert Cialdini’s book “Influence” discusses the principle of scarcity. When something is scarce, we find it more desirable. This is true of information as well as goods, but there is more – when information is scarce it not only becomes more desirable it is also treated as being more reliable. If he knows what he is doing, then Patrick Holford is very clever to make his information on histadelia unavailable to those who choose not to pay for it (by subscribing to 100% Health or buying the book) – he is using a weapon of influence in order to persuade people to want his information more and to make it seem more trustworthy. A fine piece of marketing in my opinion.

Who’s talking about histadelia on the internet?
Holford’s Food for the Brain organisation has a bit about histamine release in allergy sufferers, but funnily enough the list of symptoms has little in common with the list of symptoms of histadelia. ["Skin rashes, hayfever, rhinitis, sinusitis, asthma, eczema, swelling in the face or throat and anaphylaxis."]

According to the Powerset website, “Histadelia is a medical condition in orthomolecular psychiatry, part of complementary and alternative medicine, which [is] characterized by elevated serum levels of histamine and basophils. It was identified by Carl Pfeiffer. Treatment generally involves the aminoacid methionine, vitamin B6, as well as other supplements.” Hmm, really? Treatment generally involves supplements? Well, I can see why Patrick would be interested. And it was identified by Carl Pfeiffer, eh? Would that be the same Carl Pfeiffer who had largely ceased to publish in the mainstream scientific and medical journals by the 1970s? Yes, it would – it is also the same Carl Pfeiffer who directed the Princeton Brain Bio Centre, which was not affiliated in any way with Princeton University (perhaps a bit cheeky to call it the Princeton Brain Bio Centre, one might think). See Dr Aust’s Spleen for more on Pfeiffer: Holford’s Mentors.

According to someone on an internet health forum, “supplements which help are methionine, SAMe, calcium, manganese, magnesium, B6 and zinc. Histadelics are supposed to avoid folic acid and B12. A higher carbohydrate, moderate fat and lower protein diet is recommended for histadelics by Patrick Holford”, which is weird – Holford is always pushing that low-GL diet. As I asked earlier, has he warned his followers that the low GL diet may psychologically damage those with histadelia?

Links: Powerset, Health Forum, FftB on allergy and histamine.

Of course, the best place to visit if you want to read about Patrick Holford is http://holfordwatch.info/. He’s also made some appearances on the Bad Science blog. And on various blogs aggregated on the excellent badscienceblogs site. I would like to thank these sites for inspiring me. Holford’s heroes may be Pfeiffer and Hoffer, I think mine are the HolfordWatch and BadScience blogs.

Comments, clarifications and additional information are welcomed.

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