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Dr. Gina Honeyman’s False
Claims
About Metabolic Rehabilitation:
Demand for a Retraction
Dr. John C. Lowe
For the past two months, I
have talked with my attorney and other advisors and pondered what to do
about a matter that deeply disturbs me. I would prefer that this matter
not exist. As it turns out, however, I have no option but to deal with it.
And, as unpalatable as it is to do so, I must deal with the matter
publicly.
Dr. Honeyman created her own website several months ago.
By court order, I must keep a link to her site on each page of drlowe.com
until March 1, 2008. However, the ordered link is requiring me to refer
readers to false information written by Dr. Honeyman. As a result, the
court order forces me to violate my own ethical standard of providing
readers only with information that I believe evidence shows to be true.
Hence, for reasons I detail below, but especially because of the
court-ordered link, my demand for a retraction from Dr. Honeyman is
imperative.
To get right to the point, I have an ethical obligation to
correct gross misrepresentations of my clinical and scientific work,
especially when false representations are likely to reduce the potential
benefits of my work to patients’ health. Because of this, I am forced to
refute the false claims about metabolic rehabilitation (rehab) being made
by Dr. Gina Honeyman.
Over the years since I first created metabolic rehab, I’ve
written and lectured a great deal about it and its scientific bases. I've
done so in a conscious effort to pass the clinical protocol on to patients
and other practitioners for their use and refinement. I did this from a
deep-seated desire and commitment to relieve as much human suffering as
possible during my short time here.
Because of this, I'm motivated to do everything possible
to see that metabolic rehab is accurately represented by those who write
or speak about it. Dr. Honeyman’s misrepresentation of what metabolic
rehab is threatens to diminish, if not fully dissolve, the potential
benefits of the protocol for patients. The same desire and commitment of
mind that brought about metabolic rehab now compel me to show her claims
to be false.
On her website and in another document, Dr. Gina Honeyman implies that
she created metabolic rehab, and then cavalierly claims that she "termed"
it. On her site, she writes:
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I became intrigued with Dr. John
Lowe's hypothesis that inadequate thyroid hormone regulation of the
tissues was the culprit behind fibromyalgia symptoms. In 1996 I
incorporated his research-based protocol into my practice. |
This statement is mostly true, except that it was actually 1997 when I
became earnestly involved in teaching Dr. Honeyman how to use metabolic
rehab. After she seemed proficient enough at using the protocol, I began
referring patients to her. Eventually, I referred to her all patients who
sought my care so that I could concentrate on writing about the protocol
and its scientific underpinnings. I remained in the background, however,
as clinical consultant on all her cases. As such, I researched and usually found
solutions to patients’ problems that evaded Dr. Honeyman.
She also writes:
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While effective for many patients
[referring to metabolic rehab], some did not respond as expected to
the protocol. They needed some different diagnostics and therapies,
so I quickly added functional medicine testing. [Emphasis
mine.] |
This is a false claim. Dr. Honeyman could not have "quickly" added
functional medicine procedures to my protocol. The reason is that it was
my now-deceased friend, Dr. Nicholas Calvino, who introduced Dr.
Honeyman—through me—to functional medicine, long after she claims to have
added it.
Dr. Calvino graduated from chiropractic college in 1998. [4]
He soon began to work for a company named Metagenics. The President
of Metagenics was a founder of functional medicine, and through working
with the company under the President's influence, Dr. Calvino began
learning functional medicine. Shortly afterward, he
began communicating with me about
this valuable clinical approach.
I was duly impressed with what Dr.
Calvino communicated to me, and I began imparting it to Dr. Honeyman. She and I occasionally talked about the concept. But
at that time, we
did nothing to integrate any feature of it into metabolic rehab.
She was simply too busy better learning and practicing metabolic rehab,
and I was too busy researching and writing
The Metabolic Treatment of
Fibromyalgia.
That she and I didn't integrate
functional medicine procedures into metabolic rehab until after 2000 is
obvious from an email I wrote to Dr. Calvino on September 23, 2000. At the
time, he was considering coming to work at our clinic in Boulder: "Our core
protocol," I wrote to him, "is well-honed and highly effective, but it’s not 100%
effective, and as I said on the phone recently, I believe we need to
integrate features of functional medicine and possible other approaches
into our protocol in an effort to increase our success rate. And I feel
that working as a team, you, Gina, and I can accomplish that and build on
the solid base we've already established."[1]
It was Dr. Calvino, then, who stirred our interest in functional medicine,
but we had not yet integrated it into metabolic rehab, even some three-to-four
years after Dr. Honeyman claims she "quickly" added it.
Dr. Honeyman also says on her website:
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By addressing suboptimal adrenal
gland function, hypoglycemia, and sex hormone imbalances my
patients’ success rates increased to 85%. The research-based
protocol evolved into what I termed "metabolic rehabilitation."
[Emphasis mine.] |
If she had quickly added the needed ingredients for success, then the
protocol wouldn’t have "evolved," which by definition means to
gradually change into a different state. This may seem a quibble, of
course, but it is important to mention the contradiction, as it is
emblematic of Dr. Honeyman’s carelessness in writing about metabolic
rehab.
To summarize, Dr. Honeyman states that by quickly changing my protocol
(adding some other diagnostic and therapeutic procedures), my protocol
became something different that she created—something she then "termed"
metabolic rehabilitation. The sheer audacity of this claim is shocking.
It arouses in me what a parent must feel when someone jerks her baby from her arms
and runs down the road yelling, "My baby; my baby!"
How the Term "Metabolic Rehab" Really Came About.
I first began using the term metabolic rehab to describe my protocol
roughly about the time I met Dr. Honeyman in 1995. I met her when I was
on campus to speak to the faculty and student body at an assembly of the
chiropractic college from which she was soon to graduate. In late
May of that year, I would meet her again at a symposium on myofascial
therapy where I received an award for my contributions to that field. It
would be about another year before I would begin to train her to use my
metabolic rehab protocol.
It was sometime early in 1995 that I first realized that my treatment
protocol was a form of rehabilitation. What caused me to realize this was
an experience with a patient who had an especially fragile heart
condition. I referred the patient to a cardiologist for an evaluation.
During my twenty years of work in this field, I’ve referred many patients
to cardiologists. But this patient with a fragile heart was unusual: she’s
the only patient whom a cardiologist has ever advised to go through
cardiovascular rehab before starting to use thyroid hormone.
The patient investigated different cardiovascular rehab
programs and finally settled on a hospital-based program. As she
studied various programs, I was curious about them and learned along
with her. I wanted to know what was common to all of them and what made
these programs different from other protocols. This is how I came to
understand the style of clinical work called "rehab."
The Crux of Metabolic Rehab. As I
learned what the patient would be doing in cardiovascular rehab, I saw
that the program had in common a feature with musculoskeletal rehab
programs—those that a physical therapist or chiropractic physician might
design for individual patients. That feature, I realized, is the very
heart of all rehab programs: a practitioner repeatedly assesses a
patient’s condition through periodic measures. Based on what the
practitioner learns from those measures about the patient’s response to
the treatment program, he or she alters the program at proper times to
enable the patient to further improve. Scores on tests the practitioner
gives the patient are in some cases posted to graphs. The graphs let the
patient and practitioner clearly see how the patient is progressing.
I had been using the same type of repeated reassessments with
fibromyalgia patients as they went through what, at the time, I most often
called "metabolic therapy." Dr. John Gedye (physician, surgeon, and
philosopher of science) wrote the Foreword to
The Metabolic Treatment of
Fibromyalgia, which was published in 2000. One of his major emphases in the Foreword was that,
central to my treatment protocol, was the use of systematic feedback.[9,pp.40-41,44]
My use of this, he noted, came from my early training in behavioral
psychology, in which he, too, had been initially educated. I had been
trained in a clinical form of behavioral psychology called behavior
therapy. An essential feature of behavior therapy, the systematic use of
feedback, was the same type of monitoring and graphing that clinicians use
in cardiovascular and musculoskeletal rehab.
After my experience with the heart-fragile patient who needed cardiovascular
rehab, I suggested to Jackie Yellin that we call our metabolic
treatment "metabolic rehab." Neither she nor I was especially fond
of the term at first, partly because it wasn’t as succinct as
"metabolic therapy." But we nonetheless began using the term
interchangeably with metabolic therapy. After all, our patients were
truly going through a process of rehabilitation.
In 1996, a member of my research team Richard Garrison, MD, who was
then with Baylor College of Medicine, objected to the term metabolic
rehab. He trained family medicine residents and communicated with many
practicing physicians. Based on his teaching and communications, he argued
that the term "rehab" implied a different system from what most physicians
use. And he was right, which is one reason more physicians haven’t taken
up the full, proper protocol of metabolic rehab.
Rather than systematic
monitoring at close-enough intervals, and then using the outcome scores—"the feedback,"
as Dr. Gedye referred to it—they prefer a protocol of simply having
patients check back with them at intervals and report how they feel in
response to the treatment. As Dr. Gedye noted, this is a problem in modern
outpatient clinical medicine. By contrast, medical staffs
extensively use feedback in post-surgical wards. However, in outpatient
medicine, the standard approach simply isn’t systematic and
objective enough to maximize the effectiveness of many treatments.
In 1996 my research team—which did not include Dr. Honeyman—used
rehab-type monitoring and graphing in three double-blind placebo
controlled studies.[3][7][8]
In a 1997 report of one of those studies,[3]
we described in detail how the monitoring and graphing was done,
especially the repeated visual inspection of graphs. I want to emphasize
that when we performed
those studies, Dr. Honeyman was not part of my research team because at
the time, I had just begun communicating with her about metabolic rehab.
Dr. Honeyman’s Misrepresentation of Metabolic
Rehab. From the foregoing
narrative, it should be clear what features of metabolic rehab warrant its name: repeated testing and the use of systematic
feedback to tweak a patient’s individualized treatment regimen. These are
the backbone of metabolic rehab; without these, the clinical approach
wouldn’t classify as rehabilitation. These features were intact long
before I began tutoring Dr. Honeyman in the protocol—in fact, long before
I even met Dr. Honeyman. In 1993 and 1994, for example, I published my
first two papers describing the periodic collection of data and its use as
systematic feedback for treatment assessment.[2][6]
That the term metabolic rehab existed before Dr. Honeyman began using
my protocol is conceded in her own words. Consider, for example, the
following statements from page 53 of the book titled Your Guide to
Metabolic Health. In the book, she and I wrote:
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We can’t over emphasize the importance of
graphing for you to get satisfactory results from your metabolic
rehab. A little work is involved in getting scores for your symptoms
and posting them to line graphs. Because of this, many people would
prefer not to do it. But that’s a mistake; failing to graph your
scores can sabotage your efforts to get well. |
Then she wrote:
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I . . . know this from personal experience.
When we guide patients through metabolic rehab, we collect our
patients’ symptom severity scores, and we post them to line graphs.
When I first began treating patients with metabolic rehab, [emphasis
mine] I declined to do the "busy work" of graphing my patients’
scores. Instead, I just looked at the changed scores on the
monitoring forms I had patients fill out. [This would have been
in mid 1997.] |
She continued:
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It was a mistake not to graph my
patients’ scores. At that time, I had just begun learning metabolic
rehab from Dr. Lowe. When I was having trouble making decisions
about my patients’ treatment, I had to consult with him. He pointed
out the source of my trouble—no graphs of my patients’ scores. I
promptly made the graphs, and doing so eliminated my trouble making
clinical decisions. The graphs enabled me to make quick and precise
decisions. And I immediately felt a sense of control in guiding my
patients in the right direction. There is no substitute for
graphing, and we urge you to do it. [Emphasis mine.] |
Dr. Honeyman makes it clear in these statements that she learned
"metabolic rehab" (the term she herself uses in the paragraph above) under my tutelage. I
supervised her and taught her the value of the most basic feature, the
backbone, of metabolic rehab. And even while I was training her—long
before she imagines that she improved the protocol and then coined the
name metabolic rehab—she was using the very name itself. The term’s birth,
then, did not have to wait for her, as she says, to intermingle the
protocol with other diagnostic and treatment methods.
Understanding the nature of metabolic rehab, its true origin, and the
source of its name is essential for practitioners and patients
alike if they want to use the protocol successfully." Otherwise, Dr.
Honeyman’s distortions may sabotage doctors’ and patients’ attempts to get
the patients well. Understanding the protocol so that both doctor
and patient can use it correctly makes it likely that patients will get
well; they are far less likely to get well, however, if they misunderstanding
it, and therefore misuse it. For the sake of doctors and patients who
might learn of the protocol from Dr. Honeyman, then, she must
retract her false statements and let the truth prevail.
Refining Metabolic Rehab. During part
of the time Dr. Honeyman and I practiced together, the following
statement, which I wrote, was on the homepage of my website drlowe.com:
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Another of our goals is to provide
information about the treatment we've developed and refined for
hypometabolism patients, whatever their symptoms and diagnoses. We
call the treatment ‘metabolic rehabilitation.’ Metabolic rehab is a
comprehensive treatment program designed to eliminate, control, or
correct factors that are impairing the metabolism of the patient.
The aim of rehab is for the patient to acquire normal metabolism and
freedom from symptoms of slow metabolism. The rehab program is
tailored to meet each patient's individual needs. |
Some readers might say, "Well, even if Dr. Honeyman didn’t name
metabolic rehab, this statement suggests that she at least helped modify
and improve it." I readily give her credit for minor contributions,
basically refinements, to the protocol. But any credit due her in
this regard must be taken within my position on contributions by others.
I recently interviewed a doctor who was considering coming on board at
The Lowe Clinic and Research Center. I told
him: "I invite science-based improvements of metabolic rehab. Anything to
improve it is welcome, as long as the addition is science based, and our
scientific testing of it shows that it improves our ability to help get patients
well. I’ll thank you for any such refinements you make to
metabolic rehab." However, I emphasized to him, the integrity of the
skeletal core of metabolic rehab—its essential feature, systematic
feedback—must be respected and preserved. The doctor concurred.
I, myself, am continually looking for ways to improve the protocol.
Over the last two years, for example, I’ve integrated home glucose
tolerance testing into my use of metabolic rehab. The addition has proven
immensely beneficial to many of my
patients. And the addition has taught me things I previous hadn't known.
For example, after scores of my patients did the testing, I learned—contrary
to my previous presumption—that high blood sugar is far more common
among them than low blood sugar. This revealed the mechanism of
many patients’ fatigue and cognitive problems. I now understand
this mechanism, and when I identify it, I give the patients evidence-based treatments to correct the high
sugar levels. [5]
Ongoing innovations to metabolic rehab, like the one I just
described, are essential if the protocol is to progressively
improve and help even more people. These innovations, improvements, or additions, however, are
refinements, as I’ve already noted. The core of metabolic rehab never
changes. If that core were to change, we would no longer have metabolic
rehab. We might have treatment, therapy, or something else—but not
rehab.
To her credit, Dr. Honeyman did help refine the protocol over the years
by suggesting that at least two additions be made. And while I thank her
for those contributions, I must also remind her that small refinements
to metabolic rehab are not the same as creating the clinical approach, nor
the same as naming it.
Conclusion. In Dr. Gina Honeyman’s bio
on her website and through other documentation, she makes false statements
about the creation of metabolic rehab and its naming—wrongly attributing
both to herself. Before I ever met Dr. Honeyman, others had made valuable
contributions to this clinical protocol which I created and named. Among
these others are my collaborator of some twenty years, Jackie Yellin;
nurse practitioner Mervianna Thompson; biochemist Malford Cullum; and
physicians Alan Reichman and Richard Garrison.
For Dr. Honeyman to essentially ascribe the creation and naming of metabolic
rehab to herself—with only vague, passing mention of some research-based
protocol of mine, but no mention of these other contributors who preceded her
involvement—is to devalue the contributions of these
individuals. Knowing the true history of the protocol, however, I must
stand up in defense of these individuals’ contributions. Without their
contributions (along with mine, which Dr. Honeyman
belittles), she would not have metabolic rehab as a specialty to practice.
In my last conversation with
Dr. Richard Garrison, he was understandably perplexed and dismayed at
Dr. Honeyman’s false claims. He was fully aware that he and others had
been at work with me developing metabolic rehab before I ever met Dr. Honeyman.
For example, before she became involved at all, he had arranged research
meetings for me on behalf of my clinical and scientific work. These meetings were with
individuals and groups at both Baylor College of Medicine and the
University of Texas Health Science Center in Houston. The meetings were partly to
brainstorm with other researchers over our studies and the development of metabolic rehab.
And all of this occurred before I began training Dr. Honeyman to use the
protocol. Why would she make such false claims and disregard Dr.
Garrison's
contributions and those of others? The answer is one Dr. Garrison won’t be
able to hear from Dr. Honeyman, as
he passed away a couple of weeks ago.
I am outraged by the short shrift Dr. Honeyman gives to all, myself
included, who contributed to metabolic rehab. I can live with that.
However, the world has too many doctors and patients who need metabolic
rehab, who need to accurately understand it and correctly use it. Dr. Honeyman’s false claims about the protocol are likely to
deprive these doctors and patients of what they need. Because of that, I
cannot stand by quietly and ignore her false statements. Instead, I
emphatically demand that from a simple respect for truth, she retract her
false representations of the facts.
References
1. Lowe, J.C.: Personal written communication with Dr. Nicholas
Calvino. September 23, 2000.
2. Lowe, J.C.: T3-induced recovery from fibromyalgia by a hypothyroid
patient resistant to T4 and desiccated thyroid. J. Myofascial
Ther., 1(4):21-30, 1995.
3. Lowe, J.C., Reichman, A.J., and Yellin, J.: The process of change
during T3 treatment for euthyroid fibromyalgia: a double-blind
placebo-controlled crossover study. Clin. Bull. Myofascial Ther.,
2(2/3):91-124, 1997.
4. http://www.zoominfo.com/people/Calvino_Nicholas_535239873.aspx.
5. Low blood sugar despite a complex carb diet: finding it and
fixing
it. News from Dr. John C. Lowe: The Lowe Clinic & Research Center, July
29, 2007,
http://www.drlowe.com/emailnewsletter/2007archive11.htm.
6. Lowe, J.C., et al.: Improvement in euthyroid fibromyalgia patients
treated with T3 (tri-iodothyronine). Journal of Myofascial Therapy,
1(2):16-29, 1994.
7. Lowe, J.C., Garrison, R.L., Reichman, A.J., Yellin, J.,
Thompson, M., and Kaufman, D.: Effectiveness and safety of T3 (triiodothyronine)
therapy for euthyroid fibromyalgia: a double-blind placebo-controlled
response-driven crossover study. Clin. Bull. Myofascial Ther.,
Vol. 2, No. 2/3, 1997, pp. 31-58 (Haworth Medical Press/1-800-haworth)
Our Menu of Services:
Long-Distance
Consulting,
Metabolic Evaluations & Treatment
by Tammy Lowe
We have a menu of my husband's
clinical services and fees. We put
the menu together so that you can avail yourself of some or all of the
services, whichever best fits your budget. If you want to talk
about Dr. Lowe's services, you can reach me
at 603-391-6061. If you prefer, you can email me at
Tammy@drlowe.comm.
However, we
also have a webpage where we describe our menu of services:
Your Options for Metabolic
Evaluations and Treatment.
Dr. John C. Lowe, LLC
Tel (603) 391-6061 Fax (303) 496-6200
Tammy@drlowe.com
© 2007 John C. Lowe. All rights reserved.
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