3 years vegan, constipation

[Amarillyde]

You have recommended alt-med and had some very disparaging remarks about doctors' ignorance clearly intended to shake the OP's confidence in mainstream medicine, and you've explicitly recommended seeking help from a non-doctor and explicitly recommended against mainstream medication.

No, you are biased and mistaken. I said that doctors might not be aware that certain tests are useful: if you think that when you go to a GP, in a less than ten minutes visit whose course will dramatically depend on how and what you decide to tell him/her, he/she will immediately prescribe you all the tests that might be able to help you, you clearly have a very difference experience of going to a GP than most people have in the countries I have experience of. I simply suggested that there are some tests, and they might be discussed with a doctor, who might or might not decide to go with them. The tests I linked were an *example*, as I specified, of tests which are available and are used by some professionals. Along with that, information on who these professionals are, so that the information is available for anyone who might want to look more into such tests or others, such nutritionists or others, and so on. You can assume all you want that I "clearly intended to shake confidence in medicine", but that's you assumption and your assumption only, based on your incredible bias. I have indicated that other things exist. If it is your opinion that nobody should seek a nutritionist's help ever, you're entitled to it, but unfortunately nutritionists are not out of law and people have the right to inform themselves about them, to consult them, to despise them or whatever *they* want.

Your recommendations around doctors were couched in them being able to do the tests you want them to do for free,

Again, you are biased and mistaken. The fact that I pointed out that such tests exist does not mean that "I want them to do" anything: if anything, you are showing how you are the one who wants people to do exactly what you prescribe, here, certainly not I.

and the very strong implication was that if they do not then they are incompetent and the OP should go to gojiman for help and ignore their ignorant mainstream medicine prescriptions.

you are dreaming, or again incredibly biased. I did not know you had the OP under your care! The "medicine prescription" was *yours*, not their doctor's. You are completely out of line, and frankly your accusations based on your bias that I must be anti-medicine are getting ridiculous.

You can't hide behind not having explicitly said some particular thing when the thrust of your argument was very negative about mainstream medication and carried an inordinate certainty that the issue is microbiome related. The implications were very clear to me, and I think anybody reading your post can see that.

Mate, I simply suggested something the OP might look into. Thanks god they have you to save them from taking bad advice, but frankly this fight for the truth you are putting on is quite worrying: people have the right to inform themselves if they want to. If the science around gut issues is not there or not solid, anyone has exactly the same right that you have to look into it and form their own opinion about it, otherwise you're just doing pointless censorship. I think anybody reading your posts can see how out of proportions you are blowing this, instead, as if your opinion had absolutely to be the ultimate truth about anything anybody had the right to do or know.

Any recommendations for treatment outside the mainstream should be explicitly framed as a last resort, not as something for patients to demand from doctors and regard them as ignorant if the doctor will not comply. The doctor almost always knows more than the patient, even if the patient read something on the internet... or saw a youtube video

GPs in the UK google your symptoms in front of you when you go see them, more often than not, from my experience and the experience of people around me. If they do that, I'm pretty sure they would be open to discuss the appropriateness or validity of such or such tests. Again, I did not recommend anything specific, I explicitly said that I don't know which or whether any test at all would be useful, I merely suggested it could become part of a dialogue if the existence of such tests were a factor.

If you agree with all of that and your intention was not to promote microbiome testing or cast doubt on or discourage conventional constipation treatment then I apologize for misunderstanding your comments. I can only recommend you try to be more clear in the future to avoid such misunderstandings.

I cast doubt on your suggestion to get constipation treatments, at no point I've cast doubt on the OP's doctor's suggestion to proceed with such constipation treatment. If anything, you suggested that the OP should get hold of such treatment if available over the counter, rather than discussing this with a doctor. Obviously nobody should take advice from a forum (and this thread is living proof), but clearly the OP turned to it before, or altogether without the intention of, seeing a doctor; so, while your suggestion might be useful and informed, it still remains your suggestion, not a doctor's, and as such as valid as anybody else's -- only a little more dangerous, since you prescribed something, while others simply suggested things people might be willing to inform themselves about.

I understand there's a language barrier here, so maybe that's all it is

I can assure you there is no linguistic barrier: as with my opinions about medicine, you largely assume things on the basis of the tiniest things I mentioned here or there, while reality is quite different.

Do try to see this from my perspective though:
How would you react if a Scientologist dropped into the thread disparaging your advice as "blind" and claimed constipation was caused by disease thetans and that if your doctor won't prescribe a Scientology audit then your doctor is just ignorant of the science on E-meters?

I simply pointed out that taking drugs is a 'blind approach' because it is unlikely to address the cause of what is a long-standing problem, it sounds like a quick fix which is unlikely to have long-term effects. What you proceeded to explain *afterwards*, on the contrary, finally showed how and why that might be addressing causes, too, but before that it was easy to assume the contrary. Again, if tests are available to verify *whether* certain symptoms might be explained with causes that can be addressed, I don't see why one should not take them. All I said was to bring them up with someone who, unlike me, knows what they're doing. You have the freedom to say you disagree and that such tests are useless or nutritionists frauds, and I'm sure the OP is grateful for your opinion, but the giant mess you're making around it is sheerly based on your assumptions about me (and that's a problem).

I really think you are blowing this out of proportion, and reading what I write through the lenses of your pre-formed opinions about what I must think of x and y, based on other threads. If you take a step back and look at how the OP or others might read this, they're probably thinking we're crazy You have all the right to say you disagree with people consulting nutritionists, or testing the gut microbiome, or anything you want, but I simply mentioned something and you turned it into a whole philippic, whereas you could simply have said you disagree and let others the freedom to inform themselves rather than forcing them to accept your opinion.

I truly hope we can drop thin soon-ish, because all of it is really quite useless.

[brimstoneSalad]

Amarillyde, this is all getting pretty silly and I feel like you haven't read your original response since you made it. I'm going to break it down for you to help you see where you went wrong.

You might have some underlying gut issue that was at the origin of your constipation even before going vegan.

Awesome, perfectly fine.

You should have your gut microbiome checked,

Uh oh, you told the OP what he or she *should* do. You didn't just mention some things he or she might try (which is what I did).
The only thing I stressed in my post was seeing a doctor to rule out anything major.

In fact, constipation is a very common issue. It's not usually dangerous and most of the time it can be treated successfully at home or OTC either with dietary changes or mild "drugs" (is prune juice a drug?).
The only issue is that it could be a symptom of something more dangerous particularly when it's occurring despite eating enough fiber. Cancer is an example of something that could be a life threatening cause. Microbiome... isn't.

Even if it is microbiome related, which is very unlikely since it has recurred on two drastically different diets that would support profoundly different microbiome populations (and with plenty of time for the microbiome to completely change in between events), having a sub-optimal bacterial population isn't going to kill the OP.
Unforutunately even if it were microbiome related and he or she got a test, that wouldn't necessarily tell him or her anything at all because our knowledge on this is in its infancy and there's no evidence based diagnostic criterion available for anything but SIBO for which the majority of symptoms just aren't there ( https://www.hopkinsmedicine.org/gastroe ... rowth.html )

The only issue is the fact that the OP can't poop, and anything that serves as a safe long term solution to that is perfectly fine. A microbiome test just won't help with that.
It's an option, sure, but so is getting his or her palm read by a fortune teller. Telling the OP that he or she *should* take the test is making a strong claim on its diagnostic efficacy that you can not support.

I encourage you to start a new thread on microbiome, and we can go over the evidence and I can explain the evolutionary issues with species testing in bacteria (in short, bacteria are not like us, a specimen of the same species can be drastically different from another so determining what species are most prevalent in somebody's gut means virtually nothing; with very few exceptions they can not be neatly categorized into good and bad guys and there's no established healthy ratio. A bacterial species that's beneficial in one person may have evolved to be detrimental in another, and vice versa. You would need extensive genetic sequencing as well as epigenetic testing, and the knowledge to interpret those results which we just don't have).

and you want a specialist for that

Recommending specialists is good, but... it needs to be an actual specialist in this area. A gastroenterologist. I think you're confused on what kind of credentials are credible here. There are a lot of pseudoscience specialists, and that's of no help at all.

I mean, a fortune teller can be a specialist too, but it's in a quack field.

because most doctors are lagging behind on this.

Here's another claim, and I'm detecting some MAJOR shade being thrown on the medical profession and GPs.

You can't be "behind" on something when nobody is "ahead" on it. People who claim to be (e.g. gojiman) are making shit up.
It's like doctors being "behind" on the science of E-meters as in my Scientology analogy in the last post.

I take a big issue with claims like this because they're a hallmark of pseudoscience when somebody wants to discredit medical professionals.

https://gojimanstore.myshopify.com/coll ... /test-kits
It's also the page of a vegan nutritionist specialised in gut issues who might be able to help if you get in touch.

Let's just say it's really triggering for somebody to promote getting in touch with a quack here.
Gojiman is welcome to the forum to argue his case, but please don't do this.

I don't know if any/which one of those tests I linked is appropriate specifically,

*Those* tests listed, but you still insisted a microbiome test is something the OP should take. You're just not sure of which test.
This doesn't exonerate you from your should claim from earlier.

but just to say that constipation is a common symptom of disfunctions in your gut microbiome,

Constipation is a common symptom of a lot of things, but microbiome issues that we can actually diagnose and treat have more extensive symptoms than that, like abdominal pain and severe gas.

SIBO is an abnormal number of bacteria in the small intestine that can lead to:

bloating and increased passing of gas (flatulence)
diarrhea or constipation
abdominal pain
nausea
fatigue
In more extreme cases, the small intestine may not be able to absorb nutrients. In these situations, you may also experience weight loss and anemia (iron deficiency).

https://www.hopkinsmedicine.org/gastroe ... rowth.html

and there are tests that you can take and can give you a good amount of information before you have to even think to get a colonoscopy.

Are there? Are there really? Because this is a strong claim. I think I've explained why these tests in fact do not give you a good amount of information; I explained why it's information that's basically useless to us right now given our current state of knowledge. The tests themselves are also very likely not even appropriate.

You need to understand what's causing your problems, rather than trying to fix them blindly with drugs.

This is what really got me.
Not only are you going to tell the OP what he or she *should* do, and it's based on very bad information, seemingly disparaging doctors, and even potentially sending him or her to a quack, but you're making absurd assumptions about my suggestions which are based on mainstream treatment options.

There's a reason I suggested what I did as things to try. I see that now you realize that:

I simply pointed out that taking drugs is a 'blind approach' because it is unlikely to address the cause of what is a long-standing problem, it sounds like a quick fix which is unlikely to have long-term effects. What you proceeded to explain *afterwards*, on the contrary, finally showed how and why that might be addressing causes, too, but before that it was easy to assume the contrary.

The trouble is you making that assumption at all, which really reveals how you think about mainstream medicine. You seem to have this dogma that mainstream medicine is all about short term quick fixes, but very little of it really is.

Even if the OP is never able to go off these things, for instance some people are just naturally genetically predisposed to constipation perhaps because their digestive systems absorb too much water from their stool making it too hard and dry quickly, there is no harm to prune juice and suppository glycerine.

I really hope I don't have to explain why drinking prune juice every day is a harmless addition (and even healthful) and a long-term remedy to constipation.

Glycerine is a natural compound that makes up the backbone of all fats you know of (triglycerides), and your body digests it perfectly fine (fats are broken up into their fatty acid and glycerine parts during digestion). It's just about the most benign compound in existence.
When you put it into your butt (you will poop it out so it's not even entering the rest of your body) it works to soften the stool by drawing in more water over the next hour or so. It's basically moistening and lubricating things. I can not stress how benign this is.
If your stools are too hard and difficult to pass (which is typically the case in constipation where too much water has been absorbed from the stool), then glycerine 100% fixes this problem.

It does not matter why your poop was hard at that point. Your problem was that you couldn't poop. Glycerine fixes that problem. You can use it today and every day for the next hundred years and it won't hurt you. You'll never build up a "tolerance" to it like some drugs. It will never stop working. The mechanism is more mechanical than biochemical in nature. It's on the order of a "drug" like chapstick for your dry lips.

The *only* reason it might be a problem is if your constipation was actually caused by something dangerous like cancer and using glycerine masked those symptoms. Which is why I said see a doctor to make sure.

Now some doctors will not recommend long term use of glycerine because they think you might become dependent on it and not be able to poop without it -- not because it might harm you. There's no evidence of that but it's conceivable. You're less likely to see that kind of skepticism from a specialist when this literally changes people's lives. The thing is, if you can't poop without it anyway is that really a problem? And you could always wean yourself off it if you wanted.

Glycerine is typically used short term to help clear a blockage, and up to a few months to help re-establish sensitivity. But there's no danger to its permanent use beyond maybe you'll forget how to poop without it if you use it for years on end (again, no evidence this has actually happened, it's just speculative) and have to wean yourself off if you wanted to quit. But since it costs a couple pennies a dose and it's harmless... being dependent on it even for life when it means the difference between constipation and regular movements and a much better quality of life is probably a very good price to pay.

You might claim that's the "wrong way" to solve a problem, but the reality is that "getting at the root" is not always possible or practicable. Sometimes we just don't know what's ultimately causing an issue, or sometimes the fix to the "root cause" is more harmful and disruptive to a person's life than a benign symptomatic approach.

On treating things the "right" way:

I’ve made this argument before and gotten a reply something like this:

“Transgender is a psychiatric disorder. When people have psychiatric disorders, certainly it’s right to sympathize and feel sorry for them and want to help them. But the way we try to help them is by treating their disorder, not by indulging them in their delusion.”

I think these people expect me to argue that transgender “isn’t really a psychiatric disorder” or something. But “psychiatric disorder” is just another category boundary dispute, and one that I’ve already written enough about elsewhere. At this point, I don’t care enough to say much more than “If it’s a psychiatric disorder, then attempts to help transgender people get covered by health insurance, and most of the transgender people I know seem to want that, so sure, gender dysphoria is a psychiatric disorder.”

And then I think of the Hair Dryer Incident.

The Hair Dryer Incident was probably the biggest dispute I’ve seen in the mental hospital where I work. Most of the time all the psychiatrists get along and have pretty much the same opinion about important things, but people were at each other’s throats about the Hair Dryer Incident.

Basically, this one obsessive compulsive woman would drive to work every morning and worry she had left the hair dryer on and it was going to burn down her house. So she’d drive back home to check that the hair dryer was off, then drive back to work, then worry that maybe she hadn’t really checked well enough, then drive back, and so on ten or twenty times a day.

It’s a pretty typical case of obsessive-compulsive disorder, but it was really interfering with her life. She worked some high-powered job – I think a lawyer – and she was constantly late to everything because of this driving back and forth, to the point where her career was in a downspin and she thought she would have to quit and go on disability. She wasn’t able to go out with friends, she wasn’t even able to go to restaurants because she would keep fretting she left the hair dryer on at home and have to rush back. She’d seen countless psychiatrists, psychologists, and counselors, she’d done all sorts of therapy, she’d taken every medication in the book, and none of them had helped.

So she came to my hospital and was seen by a colleague of mine, who told her “Hey, have you thought about just bringing the hair dryer with you?”

And it worked.

She would be driving to work in the morning, and she’d start worrying she’d left the hair dryer on and it was going to burn down her house, and so she’d look at the seat next to her, and there would be the hair dryer, right there. And she only had the one hair dryer, which was now accounted for. So she would let out a sigh of relief and keep driving to work.

And approximately half the psychiatrists at my hospital thought this was absolutely scandalous, and This Is Not How One Treats Obsessive Compulsive Disorder, and what if it got out to the broader psychiatric community that instead of giving all of these high-tech medications and sophisticated therapies we were just telling people to put their hair dryers on the front seat of their car?

But I think the guy deserved a medal. Here’s someone who was totally untreatable by the normal methods, with a debilitating condition, and a drop-dead simple intervention that nobody else had thought of gave her her life back. If one day I open up my own psychiatric practice, I am half-seriously considering using a picture of a hair dryer as the logo, just to let everyone know where I stand on this issue.

Miyamoto Musashi is quoted as saying:

The primary thing when you take a sword in your hands is your intention to cut the enemy, whatever the means. Whenever you parry, hit, spring, strike or touch the enemy’s cutting sword, you must cut the enemy in the same movement. It is essential to attain this. If you think only of hitting, springing, striking or touching the enemy, you will not be able actually to cut him.

Likewise, the primary thing in psychiatry is to help the patient, whatever the means. Someone can concern-troll that the hair dryer technique leaves something to be desired in that it might have prevented the patient from seeking a more thorough cure that would prevent her from having to bring the hair dryer with her. But compared to the alternative of “nothing else works” it seems clearly superior.

https://slatestarcodex.com/2014/11/21/t ... ategories/

You may not think "just use glycerine" or "just take the hairdryer with you" or even "just have a gender reassignment operation and take hormones" is the right way to solve the problem because it doesn't get at whatever you believe to be the "root cause", but it can be the right thing for the patient, and that's what medicine is about.

Now aside from the fundamental philosophy of how disease should be treated (caring about the actual outcome for the patient vs. some ego obsessed process of getting at the "root" of everything even if that's not practical or what will realistically be best for the patient), the rest of your post is essentially an exercise in motte and bailey technique and alt-med talking points.

I simply suggested that there are some tests, and they might be discussed with a doctor, who might or might not decide to go with them.

I think I've shown that isn't an accurate representation of what you did.

unfortunately nutritionists are not out of law and people have the right to inform themselves about them

What is unfortunate is that there are so many credible seeming pseudoscience credentials and people don't have the education necessary to discern which so called "professionals" are practicing evidence based diagnostics and treatment and which are not. You don't know what you don't know, and because of that you assume the average person is able to discern the difference between a con artist and a legitimate professional -- they can not.

"Do your own research and decide for yourself" is one of the catch phrases of alt-med and charlatans, because they know people don't have the necessary education to tell the difference between science and pseudoscience. Do you know what p value is? Do you know how to calculate it? Do you understand how registration works in research and its importance? Do you have even the most basic background in chemistry and cellular biology to be able to read and understand a jargon filled study, or do you only rely on what people tell you it says?

What we have here is very similar to the clergy in antiquity interpreting the bible for an illiterate public. One person says this, one person says that -- you don't have the toolset to tell the difference, so you go with whatever is more enticing.

It is absolutely more comforting to believe that we have all of this data on the microbiome and we can fix it and all that ails you without drugs if you just take these tests. People want to feel in control, and the unknown is terrifying. Of course they are more enticed by the lies of pseudoscience which are designed to prey on psychological vulnerability.

If they do their own "research" without the toolsets of a background in science education and critical thinking OF COURSE your side will win. Your side tells them what they want to hear, people will always be drawn to charlatans who claim to have the answers and to be able to cure you, and all science can offer is a very humble admission that we have very little idea of anything to do with the microbiome yet.

It's a problem. But perhaps you can see at least why you telling people to "do their own research" is fundamentally disingenuous when they clearly don't have the tools to do so and you should very well know they are much more likely to favor your offering of false hope and appeals to nature vs. my naysaying and suggestions for "unnatural" mainstream treatment.

I'm going to leave it at that one example for now rather than break down your whole response, but my point is clear:
You are using the language of alt-med advocates, employing the same motte-bailey tactic, and are responding step for step with all of the classical points of alt-med rhetoric.

For somebody who typically follows the if-it-looks-and-quacks-like-a-duck philosophy, consider me very surprised if you aren't alt-med.
I would be glad to change your mind on the core anti-medicine philosophies you seem to hold, but you saying you don't hold them all the while behaving exactly like every other alt-med advocate isn't going to get us anywhere. If you aren't anti science/evidence based medicine, then please drop the alt-med rhetoric so we can have a real discussion about your concerns.

What would convince you that you're wrong?

As for me: evidence.

[Amarillyde]

Amarillyde wrote: ↑Sun Jun 09, 2019 12:25 pm
You should have your gut microbiome checked,
Uh oh, you told the OP what he or she *should* do. You didn't just mention some things he or she might try (which is what I did).

Really? Oh dear... The verb 'should' is not only used to indicate a duty or a command, but can be used to express an advice, which was most evidently the only possible use of such verb in a post answering to someone who was asking for advice. I really don't image you expect me or anyone else to specify 'this is just my opinion by the way' every single time I compose a sentence – especially since elsewhere in the post I stressed on how I am not competent and the OP should find someone who is. Obviously I was talking about what the OP "should do in my opinion", or what I would do in their shoes. The verb there has like 2% ambiguity, and you must really, really try to interpret it like you suggest, sorry.

Cancer is an example of something that could be a life threatening cause. Microbiome... isn't.

Even if it is microbiome related, which is very unlikely since it has recurred on two drastically different diets that would support profoundly different microbiome populations (and with plenty of time for the microbiome to completely change in between events), having a sub-optimal bacterial population isn't going to kill the OP.

You keep suggesting that I invited the OP to underestimate their condition, or not to see a doctor. At no point that happened, on the contrary: my comment was *an additional advice*, something else they might want to consider, *after several people had already mentioned that the OP should see a doctor*. I did not disagree (it was *obviously* my first thought, too), and I don't see how me saying the same thing again would have added any useful information, which is what I instead tried to provide. You can argue the information was not useful, as I've already said way too many times: but that really does not justify the lengthy and outraged reaction you're having.

The trouble is you making that assumption at all, which really reveals how you think about mainstream medicine. You seem to have this dogma that mainstream medicine is all about short term quick fixes, but very little of it really is.

You literally make assumptions continuously, as I've pointed out several times, in several places. It's human, and I do not read minds, so everything you explained afterwards concerning your suggestion was simply not a factor in my judgement of it at that point. Perhaps if you had explained it immediately, that would have been more useful for everybody, given that pretty much anybody who can manage a google search can come up with the answer you gave *in the way you gave it*. So you can't really blame people if they feel like you're not really helping, and I'll go out on a limb and say that the OP had already googled their symptoms, and if they came here it's because they were after something a little more elaborated. Which you eventually provided – but again, the impression your suggestion gave was completely different, and you simply can't blame people for not reading minds as much as you can't censor them if they want to bring up a piece of information.

What is unfortunate is that there are so many credible seeming pseudoscience credentials and people don't have the education necessary to discern which so called "professionals" are practicing evidence based diagnostics and treatment and which are not. You don't know what you don't know, and because of that you assume the average person is able to discern the difference between a con artist and a legitimate professional -- they can not.

On this and your following, obvious and lengthly explanation on how people do not have the ability to judge scientific research: yes, that's why I said that people, as everybody knows, should not take advice from forums. If you do, this is what you get: a plethora of advices, and the risk that some of them could be bad. Either people are aware of it, or they aren't. When you answer, you can do your best to explain what you think is good advice but you can't shield people from what they do to themselves when they ask for advice on a forum. And most importantly, you're not god, and you do not hold the ultimate truth, and no matter how learned you think you are, you're not their doctor either. So if they want to look into something, they can, and there is nothing you can do about it, no matter how many aggressive pages you write towards other people.

Finally, on my alleged fear mongering around doctors because I said that some are "lagging behind", I am pretty sure that most people on this forum, by the mere fact of being interested in veganism, are likely to have some experience of how most doctors are simply unaware of the benefits of a plant-based diet, and go ahead and recommend to diabetics or CVD patients to eat animal products without any qualms. It's not a mystery that there is some social resistance for all doctors to be on board with what science is making clearer and clearer, namely that a plant-based diet is healthy, and this does not in any way entail a mistrust towards medicine, only an awareness of how people are and society works. Saying that a doctor might not be aware of something which is not part of a long-established training curriculum in medicine or which is taking its first steps (like the science around the guts) does not undermine doctors nor the importance of medicine. With regard to the gut microbiome, I simply suggested to look into it, and you could have explained why you don't think that was good advice. End of the story. Instead, here we are...
In conclusion, I will ask you once again to stop attributing to me things that I've told you several times I do not believe.

[brimstoneSalad]

Really? Oh dear... The verb 'should' is not only used to indicate a duty or a command, but can be used to express an advice, which was most evidently the only possible use of such verb in a post answering to someone who was asking for advice.

I did not interpret it as a command. The 'should' here as you used it was a claim of what actions rationally follow from the pursuit of the hypothetical norm to be healthy or resolve the OP's concerns. You claimed a microbiome test would be effective to that end (that you were not sure of which test is beside the point).

That's what makes a "should" claim which includes an evaluation different from a "could" or "might" claim.

It was a claim, and claims carry with them some burden of proof -- particularly extraordinary claims like this which do not represent consensus in medicine.

I really don't image you expect me or anyone else to specify 'this is just my opinion by the way' every single time I compose a sentence

No. But when you make claims of a factual nature I expect them to be supported with evidence if challenged. This is actually in the forum rules.

You claimed that a microbiome test of some kind would be useful here, otherwise you would not have said "should". "Should" is not used in contexts of agnosticism, it's used to convey a positive assertion of utility.

A true agnostic does not typically say "You should believe in God" nor typically "you should not", those are the domains of the theist and positive atheist who are making existential assertions.

Like I suggested, and you denied, this could all be an issue with English not being your first language and you not knowing what these words mean.

If you tell somebody that he or she SHOULD do something, you're making a factual claim. Unless, of course, it was a command after all...
If you're just commanding the OP to take a microbiome test for no reason and not because you're claiming it has utility, then that's different.

Were you making a command, or a claim of utility?
Or did you mean to say "could" or "might" instead of "should"?

You are welcome to amend your statement, but you aren't going to weasel out of this by claiming it's an opinion (yet another motte of alt-med promoters).
"Poop is delicious" is an opinion, it's subjective. We may disagree strongly, but if you said that you wouldn't carry any burden of proof and you wouldn't be objectively wrong.
Claims like "The Earth is flat" or "Microbiome tests have diagnostic utility" are claims about objective facts that can be (and in this case are) wrong. Claims like these carry a burden of proof.

If you want to avoid that burden, just avoid making controversial fact claims. You've made a lot of them. It's fine (good even!) to make fact claims, but just be prepared to bring some evidence.

If he has time maybe @Red can make a thread on this fact/opinion thing, should statements, and burden of proof sometime to link from the rules so I don't have to explain this all the time.

I don't see how me saying the same thing again would have added any useful information, which is what I instead tried to provide.

Actually it would be: it's not just about information. If more people respond recommending a doctor first the OP is more likely to take that advice to heart.

You can argue the information was not useful, as I've already said way too many times: but that really does not justify the lengthy and outraged reaction you're having.

I don't think you understand the responsibility we (the core members of this site) have in platforming.
If somebody responds to a thread asking for advise and recommends pseudoscience, we have a duty to debunk it. The length is a product of being thorough and breaking down your claims for others.
You do realize we're not the only ones reading this thread and that it will come up in Google searches for years, right? (Hi future people, credible microbiome tests and flying cars might be real by now, but don't assume they are: look at consensus among medical professionals)

Which you eventually provided – but again, the impression your suggestion gave was completely different, and you simply can't blame people for not reading minds as much as you can't censor them if they want to bring up a piece of information.

We choose not to censor because we believe competent debunking is more effective.

That said, as I explained the kind of assumptions you were making reveal an underlying anti-science/medicine kind of attitude which I have addressed in previous posts in this thread.

that's why I said that people, as everybody knows, should not take advice from forums. If you do, this is what you get: a plethora of advices, and the risk that some of them could be bad.

That's why we have higher standards here. People know they can get better advice here specifically because we don't just let junk science claims go unchallenged.

I am pretty sure that most people on this forum, by the mere fact of being interested in veganism, are likely to have some experience of how most doctors are simply unaware of the benefits of a plant-based diet

Plant based diets (which is distinct from 100% vegan) are consensus in health and doctors are aware of this. It's not hard to demonstrate this.

and go ahead and recommend to diabetics or CVD patients to eat animal products without any qualms.

Certain animal products like fish (twice a week) and fat free dairy.

In the context of standard diet, these items displace more harmful animal products and are correlated with better health outcomes.
Doctors don't recommend large dietary changes because adherence is very poor. Sometimes if you ask for more you get less.

Public health advice is very easy to understand in terms of patient compliance and opportunity cost.

However, this is very different from a simple test, which if it gave diagnostically useful information would not suffer those issues. There's no reason doctors wouldn't order these tests if they were actually useful.

only an awareness of how people are and society works.

If you had awareness of that, you'd know you're comparing apples and oranges here.

Saying that a doctor might not be aware of something which is not part of a long-established training curriculum in medicine or which is taking its first steps (like the science around the guts) does not undermine doctors nor the importance of medicine.

Doctors have ongoing education and stay informed on new developments, particularly something this broadly relevant to conditions they deal with daily.
Non-oncologists aren't necessarily going to know about the most recent cancer vaccine treatments, but any GP is going to know about a credible revolution in treating something as common as constipation.

In conclusion, I will ask you once again to stop attributing to me things that I've told you several times I do not believe.

You are welcome to amend your claims, but from what you have said and how you have responded it's very difficult to take your word on this -- particularly because virtually every pseudoscience promoter claims not to be anti-science.

If you aren't convinced that gut microbiome tests are pseudoscience due to the lack of evidence based diagnostic criterion, please start a thread on it where we can get into more detail.

[Red]

If he has time maybe @Red can make a thread on this fact/opinion thing, should statements, and burden of proof sometime to link from the rules so I don't have to explain this all the time.

I skimmed what are we doing now? And why do we need a new thread?

[Amarillyde]

I did not interpret it as a command. The 'should' here as you used it was a claim of what actions rationally follow from the pursuit of the hypothetical norm to be healthy or resolve the OP's concerns. You claimed a microbiome test would be effective to that end (that you were not sure of which test is beside the point).

I actually forgot to answer to this point you raised in your previous post, too, but what I said -- as you quoted me, too -- is that I was unsure 'what tests' or 'if any' test would be useful. You quoted me and yet chose to ignore that part. The should "was a claim of what actions rationally follow from the pursuit of the hypothetical norm to be healthy or resolve the OP's concerns.", aka *an advice*, in simpler words: yes. I agree that a more accurate formulation could have been "you should ALSO...", because that would have avoided the impression that you clearly had that I was saying "you should do x, INSTEAD of y", but to be honest nobody without a biased opinion of what I meant would read so much into it. My advice could have been more complete? Of course... the point of my suggestion was by no means to be a complete recipe of what the OP should do, as already demonstrated by the fact that I omitted any obvious mention of the basic obligation to consult a doctor rather than the internet.

No. But when you make claims of a factual nature I expect them to be supported with evidence if challenged. This is actually in the forum rules.

As far as I'm concerned, I would much rather the conversation had developed around the factual problems and the problem of testing the gut microbiome, I'm sure it would have been educative. Unfortunately, you made it about all but that.

You claimed that a microbiome test of some kind would be useful here, otherwise you would not have said "should". "Should" is not used in contexts of agnosticism, it's used to convey a positive assertion of utility.

Yes, I suggested that would have been a possible thing to do.

A true agnostic does not typically say "You should believe in God" nor typically "you should not", those are the domains of the theist and positive atheist who are making existential assertions.

I've already agreed that one use of the verb should is to indicate what is correct, but that's not the only one nor the most likely in a context of advice giving: https://www.lexico.com/en/definition/should

1.2Used to give or ask advice or suggestions.
‘you should go back to bed’
‘what should I wear?’
1.3I should Used to give advice.
‘I should hold out if I were you’
‘I shouldn't worry if I were you.’
‘I should dress warmly if I were you.’

I think you're only choosing a partial reading, or maybe you are genuinely confused, due to the fact that later on I suggested that this approach would be preferable to the drugs you recommended – and yes, I did claim it would have been a better approach. That does not mean that I meant that the OP should=had to follow my advice.

If you're just commanding the OP to take a microbiome test for no reason and not because you're claiming it has utility, then that's different.

Were you making a command, or a claim of utility?
Or did you mean to say "could" or "might" instead of "should"?

I was claiming a test might be useful, I gave an example of what a test could look like, and I specified I did not know *whether* such particular tests would be useful or *what* tests might be, but gave the information that such tests and such praxis exists, and that constipation happens to be a symptom of a dysfunctional microbiome. Would my advice have been more complete, had I specified that it could be a symptom of many other things, too? Of course. But it was not my intention to give a complete advice, as it would have given the impression that I am qualified to do so, as your advice did. My post was deliberately incomplete: I was offering a piece of information that the OP in my opinion should take into consideration: that's something I would want to know if I were in their shoes.

Claims like "The Earth is flat" or "Microbiome tests have diagnostic utility" are claims about objective facts that can be (and in this case are) wrong. Claims like these carry a burden of proof.
If you want to avoid that burden, just avoid making controversial fact claims. You've made a lot of them. It's fine (good even!) to make fact claims, but just be prepared to bring some evidence.

I would have much rather been discussing that, perhaps learning something, rather than wasting everybody's time discussing everything else around that because of some absurd claims about me.

Actually it would be: it's not just about information. If more people respond recommending a doctor first the OP is more likely to take that advice to heart.

I agree, but that's really beyond the point.

I don't think you understand the responsibility we (the core members of this site) have in platforming.
If somebody responds to a thread asking for advise and recommends pseudoscience, we have a duty to debunk it. The length is a product of being thorough and breaking down your claims for others.
You do realize we're not the only ones reading this thread and that it will come up in Google searches for years, right? (Hi future people, credible microbiome tests and flying cars might be real by now, but don't assume they are: look at consensus among medical professionals)

I do realise that, that's why I wished you had simply addressed the point, instead of burying it under personal grudges or accusations.

That said, as I explained the kind of assumptions you were making reveal an underlying anti-science/medicine kind of attitude which I have addressed in previous posts in this thread.

I've explained how that's not the case. Is it really useful to keep insisting that it must be like you say, rather than perhaps questioning how you interpret what people say, especially when they have the courtesy to clarify any ambiguity that might have occurred?

That's why we have higher standards here. People know they can get better advice here specifically because we don't just let junk science claims go unchallenged.

Yes, but look at what you've done: 20% debunking, and 80% talking about everything around it.

Plant based diets (which is distinct from 100% vegan) are consensus in health and doctors are aware of this. It's not hard to demonstrate this.

Amarillyde wrote: ↑
Sat Jun 15, 2019 6:22 pm
and go ahead and recommend to diabetics or CVD patients to eat animal products without any qualms.

Certain animal products like fish (twice a week) and fat free dairy.

I don't know where you live, but I can assure you I would be met with skepticism if I told my GP that I follow a plant-based diet in more than one of the places where I've lived.

f you had awareness of that, you'd know you're comparing apples and oranges here.

In fact I'm just stressing on how the mechanisms for which the spreading of medical practices is filtered by other social and political factors that prevent plant-based diets from being recognised for what they are everywhere, from doctors of every generation, are the same mechanisms that can be at work with other areas of science which are less solid right now. I said since the beginning that I am not competent – but someone else claims to be, as a matter of fact. We can then discuss on how and why and the validity of it, but again, I wish you had done that only.

Non-oncologists aren't necessarily going to know about the most recent cancer vaccine treatments, but any GP is going to know about a credible revolution in treating something as common as constipation.

Because it's common, it's also likely to have multiple possible causes.

You are welcome to amend your claims, but from what you have said and how you have responded it's very difficult to take your word on this -- particularly because virtually every pseudoscience promoter claims not to be anti-science.

Since I have made no anti-science claim, I wouldn't know what to amend. You clearly have no problem insulting people, so keep at it, what else to say.

If you aren't convinced that gut microbiome tests are pseudoscience due to the lack of evidence based diagnostic criterion, please start a thread on it where we can get into more detail.

As soon as I have time, I will.

[brimstoneSalad]

If he has time maybe @Red can make a thread on this fact/opinion thing, should statements, and burden of proof sometime to link from the rules so I don't have to explain this all the time.

I skimmed what are we doing now? And why do we need a new thread?

Read the few paragraphs above it if you have a chance. If not no worries. Just about what constitutes making a claim and differences between facts and opinions.

I actually forgot to answer to this point you raised in your previous post, too, but what I said -- as you quoted me, too -- is that I was unsure 'what tests' or 'if any' test would be useful. You quoted me and yet chose to ignore that part.

You said (emphasis mine):
"I don't know if any/which one of those tests I linked is appropriate specifically,"

So no, I did not ignore that part. You weren't sure if the tests offered on that page were the right ones, but you indicated nothing but confidence that a microbiome test of some kind was the way forward.

If you really think you didn't indicate that, then your grasp of the English language may be too poor for us to rely on anything you say being what you really mean.
Tell me if you honestly don't think you misspoke and made a mistake there...

I agree that a more accurate formulation could have been "you should ALSO...", because that would have avoided the impression that you clearly had that I was saying "you should do x, INSTEAD of y", but to be honest nobody without a biased opinion of what I meant would read so much into it.

Nobody is free of biases, the only question is if it's possible that you could have by omission led somebody astray and done harm -- and yes, it is.
By recommending something else (which happens to be alt-med), by saying something (anything) negative about doctors and the advice of others, that's the implication you are giving unless you disclaim it.
That it was not an explicit rejection of following a doctor's advise is not a defense against your responsibility there.
Anti-doctor advice is common in alt med circles and unfortunately among vegans. It's not at all difficult to get that from your post, and if you don't see the risk there that somebody will be misled by your post then you are either woefully ignorant of the harm done by alt-med online or aren't capable of processing English.

People go online and follow advice on things like using black salves to treat cancer:
https://www.quackwatch.org/01QuackeryRe ... schar.html


This is serious as murder, and nothing to f*ck around with.

If you're happy to risk somebody misinterpreting your advice to be anti-doctor and coming to serious harm by getting lost down an alt-med rabbit hole (which is likely where you're sending them when you tell them to go research alt med stuff) or even dying -- all because you weren't willing to wiggle your fingers for three seconds to work in a disclaimer about following doctors' advice -- what does that say about you?

If you want to promote anything even remotely fringe, particularly if you're throwing shade on medicine, it's going to give that impression. Just please take the time and be more clear in the future.

the point of my suggestion was by no means to be a complete recipe of what the OP should do, as already demonstrated by the fact that I omitted any obvious mention of the basic obligation to consult a doctor rather than the internet.

No it was not. For all anybody knows that was an intentional omission. Maybe stop victim blaming people who are harmed by bad advise because they're too stupid not to do the obvious thing and take more responsibility when you give health advise?

You claimed that a microbiome test of some kind would be useful here, otherwise you would not have said "should". "Should" is not used in contexts of agnosticism, it's used to convey a positive assertion of utility.

Yes, I suggested that would have been a possible thing to do.

Is this ESL 101?

You did not say "could", as in a possible thing, you said "should". I'm not going over this again.

I've already agreed that one use of the verb should is to indicate what is correct, but that's not the only one nor the most likely in a context of advice giving

It's a hypothetical norm based on the goals of the person receiving the advise. I covered all of this.

I think you're only choosing a partial reading, or maybe you are genuinely confused,

No, you don't understand what English words mean and can't even understand the definitions or explanations I give.
Or you do understand and you're lying to try to avoid admitting you used the wrong word.
Either way, I'm not going to teach you English here.

Be informed: The language of this forum is English, and you are using the word "should" incorrectly. The implication is not always a moral norm, but it is a hypothetical norm in advice contexts. It carries with it a claim unless it's a command or something that is actually opinion (even then there can be an implicit claim, but that's another topic).

That does not mean that I meant that the OP should=had to follow my advice.

I have explicitly explained that I am not interpreting it as a command. Nobody is saying that's what you meant.

Look, if your English comprehension it not good enough to even understand what YOU said in this thread, you need to stop defending it.

I was claiming a test might be useful,

Maybe you tried to convey more uncertainty, but that's not how it came out (even in this post you've not been very good at conveying uncertainty). This has nothing to do with my interpreting things wrong. There was no ambiguity with most of what I criticized. That's what the words literally mean.
Simple, just say something like "my bad, I just meant it might be possible, not to suggest it would surely be useful. Just something to ask your doctor about to see what he/she thinks." That's all there is to it.

If you aren't convinced that gut microbiome tests are pseudoscience due to the lack of evidence based diagnostic criterion, please start a thread on it where we can get into more detail.

As soon as I have time, I will.

Alright then, thank you.

[Amarillyde]

Amarillyde wrote: ↑Sat Jun 15, 2019 11:40 pm
I actually forgot to answer to this point you raised in your previous post, too, but what I said -- as you quoted me, too -- is that I was unsure 'what tests' or 'if any' test would be useful. You quoted me and yet chose to ignore that part.
You said (emphasis mine):
"I don't know if any/which one of those tests I linked is appropriate specifically,"

So no, I did not ignore that part. You weren't sure if the tests offered on that page were the right ones, but you indicated nothing but confidence that a microbiome test of some kind was the way forward.

'I don't know *if any* of those tests I linked is appropriate": that's the part you ignored, that indicated that I'm saying that while some tests might be appropriate, neither could be, too. I really don't know how you can say "you indicated nothing but confidence that a microbiome test of some kind was the way forward", it's clearly logically wrong, but I don't know what to say if you don't want to see it.

By recommending something else (which happens to be alt-med), by saying something (anything) negative about doctors and the advice of others, that's the implication you are giving unless you disclaim it.
That it was not an explicit rejection of following a doctor's advise is not a defense against your responsibility there.
Anti-doctor advice is common in alt med circles and unfortunately among vegans. It's not at all difficult to get that from your post, and if you don't see the risk there that somebody will be misled by your post then you are either woefully ignorant of the harm done by alt-med online or aren't capable of processing English.

You can't expect people to give reliable, complete advice or nothing. While I agree on your general point, it was never my intention to tell the OP what to do, but just to provide an additional piece of information about what to look at. I'm really tired of explaining it, since you're not willing to understand it anyway.

People go online and follow advice on things like using black salves to treat cancer:
https://www.quackwatch.org/01QuackeryRe ... schar.html
Image

This is serious as murder, and nothing to f*ck around with.

Sorry, but it's just pathetic that you have to bring things like this up. You keep implying I somehow suggested the OP to underestimate whatever might be going on with them: I didn't.

If you're happy to risk somebody misinterpreting your advice to be anti-doctor and coming to serious harm by getting lost down an alt-med rabbit hole (which is likely where you're sending them when you tell them to go research alt med stuff) or even dying -- all because you weren't willing to wiggle your fingers for three seconds to work in a disclaimer about following doctors' advice -- what does that say about you?

It says about me that I don't have time, and perhaps I should have written 'oh by the way see a doctor, OBVIOUSLY'. It says about me that I think people who come to this forum for health advice know that they must see a doctor, too, because I expect the target audience to be relatively educated. But ask yourself what it says about you to keep repeating that I am anti-medicine, when I've told you that clearly I am not, and why you can't simply accept that a critique *to you* does not equal a critique to all medicine. You're making all this mess because you took it personally, and not for the higher reasons you are trying to appeal to.

You did not say "could", as in a possible thing, you said "should". I'm not going over this again.

I said should, as in 'in my opinion, you should try this', where this was 'this example of test you can look at: some, OR NONE, might be useful'. I'm not going over this again either.

No, you don't understand what English words mean and can't even understand the definitions or explanations I give.
Or you do understand and you're lying to try to avoid admitting you used the wrong word.
Either way, I'm not going to teach you English here.

Alternatively, you can open a dictionary. Your understanding of language is dogmatic and inflexible, and it fails to keep the context into consideration and to appreciate the complexity of the use of language. As a result, you need to bully me with accusations that I do not understand English. I wouldn't recommend you to play with me the game of who's more qualified to talk about language.

It carries with it a claim unless it's a command or something that is actually opinion (even then there can be an implicit claim, but that's another topic).

Yes, the claim is: 'in my opinion you should look at such and such'. I've already written about completeness of my advice.

I'm sorry but, while I agree that, because my post was not meant as a complete advice, it could generate some ambiguities – evidently –, it's also evident that your judgement is clouded by the fact that my post contained a reference to your advice, that you took overly personally. On the one hand, if I had known what you went on to explain after (the only thing to save from this thread), my post would have been different; on the other hand, you're not the OP's doctor, nor a doctor at all (if you are, perhaps you should make it known), so your advice comes with no guarantees either, and the fact that you did mention to see a doctor only partially excuses the prescriptive tone you used. For all you know, the OP (or other readers) could have been helped by someone else's advice which was not yours, perhaps even mine, not because they underestimated their conditions, but because they acquired a new piece of information that led to further research. I've explained how my intentions were in no way anti-medicine, if anything I told the OP to bring something up with a GP, or a professional, and yet you keep holding on for dear life to this notion, because you for some reason have to demonstrate that I am anti-medicine. You do not need to be anti-medicine to look into or to speak with a nutritionist. You could have explained why you think testing the microbiome is not useful, instead your own pride got in the way and you turned this thread into a personal attack to me, refusing to accept what in any other reasonable case would have been a peaceful resolution of any possible ambiguity. Given the situation, I don't think it's useful for anybody to keep discussing this, so I'm out. All best.

[brimstoneSalad]

Important warning from the FDA:

The Food and Drug Administration (FDA) is informing health care providers and patients of the potential risk of serious or life-threatening infections with the use of fecal microbiota for transplantation (FMT). The agency is now aware of bacterial infections caused by multi-drug resistant organisms (MDROs) that have occurred due to transmission of a MDRO from use of investigational FMT.

Summary of the Issue

• Two immunocompromised adults who received investigational FMT developed invasive infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E.coli). One of the individuals died.
• FMT used in these two individuals were prepared from stool obtained from the same donor.
• The donor stool and resulting FMT used in these two individuals were not tested for ESBL-producing gram-negative organisms prior to use. After these adverse events occurred, stored preparations of FMT from this stool donor were tested and found to be positive for ESBL-producing E. coli identical to the organisms isolated from the two patients.

https://www.fda.gov/vaccines-blood-biol ... us-adverse

'I don't know *if any* of those tests I linked is appropriate": that's the part you ignored

I did not. Your qualification was very specific. You even said "specifically" after that, which you have removed perhaps because you realize how it emphasizes the limit of your statement. You explicitly referred only to those tests you linked when you expressed uncertainty, tests which were given only as an example.

If you had said "I don't know which/if any kind of microbiome test would be appropriate" that would have been different. That would have been a broad admission of agnosticism to microbiome tests in general. Instead, you very clearly restricted your claim of uncertainty to SPECIFICALLY those you linked to. You gave no indication of uncertainty that some kind of microbiome test (e.g. perhaps not available at that link) would be appropriate.

Is this really the hill you're dying on Amaillyde? What you said originally was not clumsily written. It was an adept qualification that was very explicitly limited to the link you provided.
There is no shame in admitting you misspoke or even that you were wrong and have changed your mind a little.

You make me miss arguing with @teo123, he'll usually admit when he misspeaks or changes his mind.

I really don't know how you can say "you indicated nothing but confidence that a microbiome test of some kind was the way forward", it's clearly logically wrong,

It's literally what the words you used, in the order you used them, mean.
If you deny that, there are three possibilities:

1. You are lying to safe face
2. You don't understand English
3. You don't understand logic

You can't expect people to give reliable, complete advice or nothing.

I don't, which is why I posted to correct what you said rather than condemning you from commenting at all.
If it was really a problem we'd have a discussion among senior members and add a forum rule against giving such advice.

I do not mind that you commented and tried to give advice. It was not hard to correct you. Just please try to do better in the future when it comes to medical advice, that's all.

And stop pretending that you didn't misspeak or (more likely) change your mind with respect to your level of certainty. My guess is you had no idea those microbiome tests were actually controversial.
You can keep retconning what you said and redefining the meaning of English words, but it's just making you look very silly.

Sorry, but it's just pathetic that you have to bring things like this up. You keep implying I somehow suggested the OP to underestimate whatever might be going on with them: I didn't.

You missed the point entirely. This is alt-med, and that's what's in the rabbit hole you were trying to send the OP down by telling him or her to "do your own research".

But ask yourself what it says about you to keep repeating that I am anti-medicine, when I've told you that clearly I am not,

It says I wasn't born yesterday. Again, anti-medicine people claim not to be anti-medicine. Do you think a con artist admits to being one?
And based on your derogatory comments responding to me about OTC suggestions, in no way has it been clear that you're not anti-medicine.

You could make it clear by saying you were wrong to make those assumptions about the OTC constipation treatments and agreeing that (after ruling out anything more serious with a doctor) those would be good things for the OP to try.
But you won't do that. Instead you've gone on at length trying to justify your assumptions as OK on the basis that you couldn't read my mind (assumptions which you shouldn't have made in the first place even without an explanation of how those medications work), because fundamentally you hold anti-medicine biases and anti-medicine beliefs to which you admit only a few rare exceptions. You believe that mainstream medicine as a rule is not something people should turn to, that's it's a quick fix that doesn't get to the root, etc. and you think that justifies your assumptions about mainstream medical treatments as a reasonable default position.

Every climate change "skeptic" thinks they're following the science too, so perhaps in your ignorance you can't even see how your beliefs are anti-medicine. Perhaps you do not know what it is to be anti-medicine or hold such biases. Like how the "delayed schedule" people who think vaccines cause *some* autism and other problems because babies are (according to them) given too many vaccines and too early don't think they're anti-vaxx.

The science says one thing, and if you believe anything short of that then you are to one degree or another anti-medicine. It's not an absolute statement; you can be 'a little bit' anti-medicine to very to extremely. No matter the degree, it's an irrational bias and a position that needs to be corrected to engage in critical thinking on the matter.

[Red]

You make me miss arguing with @teo123, he'll usually admit when he misspeaks or changes his mind.

That is saying something. I'm sure @MittensTheCat would disagree though.