Thursday, June 08, 2006

Alternative

A few days ago our newspaper ran an article noting that an alternative medicine advocate was coming to town to give a presentation or sign books at a store. This particular alternative medicine practitioner strongly believed in cleansing the GI tract, apparently by eating properly and giving yourself enemas. I was too turned off by the article to finish it to see his exact methods.

I don't have much good to say about alternative medicine. I don't mind that it's alternative; what bothers me is that most of it is not evidence based. Some alternative medicine is evidence based, that is, has been shown in well done studies to be beneficial. For example, I think that acupuncture has been shown useful for certain types of pain, and that hypnosis has worked for some things, but most alternative medicine practitioners simply make unfounded claims for their treatment, or rely on the claim that it is "natural", as if that automatically infers magical properties upon it. Even when an alternative therapy is shown not to be helpful, it is still promoted. For example, a study published a few months ago showed that echinacea was not useful in the treatment of upper respiratory infections (colds), but it is still touted in and sold at health food stores.

Alternative medicine can be harmful, too, both directly (does anyone doubt that you can be harmed by too many enemas?) and by making someone forgo needed conventional treatment. When I was a medical student I had a patient who was a young man in his twenties who had Hodgkin's disease. Instead of finishing his conventional therapy of chemotherapy and radiation, he went to Mexico and tried laetrile instead. Unfortunately, while on the laetrile his Hodgkin's disease progressed and a tumor compressed his spinal cord, turning him into a paraplegic. He came back to our medical center to finish conventional treatment. His Hodgkin's disease would be cured, but he would be a paraplegic for the rest of his life.

Personally, I think we should do away with the terms "alternative" and "conventional" medicine, and simply describe medicine as evidenced based or not evidence based. If good evidence shows a medicine works and is safe, it doesn't matter if it's a natural herb or a manufactured chemical pill.

We could talk a long time about why people spend billions of dollars a year on alternative, unproven therapies. Maybe it's a failure of conventional medicine to properly attend to the emotional ramifications of physical disease. Maybe it's an almost innate tendency of at least some people to distrust the "establishment" method and try something different. Whatever it is, it's a huge waste of health care dollars, and we don't have unlimited amounts of those to go around. Ideally, we would take some of the money spent now on alternative medicine and use it to study the treatments, so we could keep the worthwhile ones and throw out the rest, but I don't see that happening real soon.

33 Comments:

Blogger stockingup99 said...

Alternative treatments work well for me. I have saved money by treating minor conditions with changes in my diet. The thing is, you need to jump on it right away, and if it doesn't work, then go get help from the medicos.

For many female conditions modern medicine causes more troubles. Controlling yeast by cutting down on sugars works better than repeated Monostat. Controlling bladder infections by eating better, adding blueberries, garlic and cranberries, and cutting down on black tea works better than repeated antibiotics. Controlling thrush with Grapefruit Seed Extract and healthy bacterias works much better that the Nystatin.

Before I learned better, the medicos gave me topical Nystatin for Thrush. When I called to say it made it hard to pump, their answer was use formula. I called back and spoke with their lactation consultant, and she hooked me up with Gentian Violet which cured what the Nystatin couldn't.

When I have a minor malady, I go to the health food store. This saves many urgent care dollars and provides me with relief sooner.

Fortunately I have a family doctor who supports the less meds is better model.

10:41 AM  
Anonymous Dianne said...

If good evidence shows a medicine works and is safe, it doesn't matter if it's a natural herb or a manufactured chemical pill.

In general I agree with this statement, but I have one quibble: It is very hard to control the dosage given when an herb is used. Plants may make radically different amounts of a given chemical depending on growth conditions and the genetics of any given individual plant. The classic example of this is digitalis, which, when given as an herbal extract, killed as many people as it helped. Therefore, I would much prefer that the active ingredient(s) be isolated and given in controlled dosages rather than continuing to use a whole plant, even after it has been shown to be effective.

11:12 AM  
Anonymous Anonymous said...

I agree that what turns people to alternatives is that western medicine is sadly lacking in some areas. I had suffered for years from repeated UTI`s. All my doctors could offer was to live on abx. Then, a midwife told me to take 1000 mg of vitamin c each morning & night to make urine too acidic for bacteria. 7 years later I have had no UTI`s. Sometimes alternatives are just common sense and regular medicine is not thinking about the whole person, it just treats the symptoms.

I do want to add that all of my kids have spent time in the NICU. One specialty that is very necessary & that there are no real alternatives to is neonatalogy.I feel the same way about perinatalogy and orthopedics.

Routine male circumcision is a good example of modern medicine going out to lunch & never coming back. That was obviously a big mistake for that to ever catch on. Now, medicine is so caught up in the $ from it that very few doctors will even dicuss the risks, which are greater than the risk of keeping the body intact. Obviously the surgery is known to be problematic because now circs are done looser than ever, which creates a new host of problems. Yet, if you point out the common sense of the design of the penis already being fine, then you`re looked at as some kind of alternative medicine anti-circ freak. American medicine is not even practicing sound medicine in the case of circ & it makes you wonder about trusting it in other areas. Hormone replacement vs. normal menopause anyone?

11:16 AM  
Anonymous Anonymous said...

I agree that what turns people to alternatives is that western medicine is sadly lacking in some areas. I had suffered for years from repeated UTI`s. All my doctors could offer was to live on abx. Then, a midwife told me to take 1000 mg of vitamin c each morning & night to make urine too acidic for bacteria. 7 years later I have had no UTI`s. Sometimes alternatives are just common sense and regular medicine is not thinking about the whole person, it just treats the symptoms.

I do want to add that all of my kids have spent time in the NICU. One specialty that is very necessary & that there are no real alternatives to is neonatalogy.I feel the same way about perinatalogy and orthopedics.

Routine male circumcision is a good example of modern medicine going out to lunch & never coming back. That was obviously a big mistake for that to ever catch on. Now, medicine is so caught up in the $ from it that very few doctors will even dicuss the risks, which are greater than the risk of keeping the body intact. Obviously the surgery is known to be problematic because now circs are done looser than ever, which creates a new host of problems. Yet, if you point out the common sense of the design of the penis already being fine, then you`re looked at as some kind of alternative medicine anti-circ freak. American medicine is not even practicing sound medicine in the case of circ & it makes you wonder about trusting it in other areas. Hormone replacement vs. normal menopause anyone?

11:16 AM  
Anonymous Anonymous said...

sorry about the double post!

11:18 AM  
Blogger stockingup99 said...

Many herbs don't respond well to the isolation process.

Feverfew is a good example. If you eat the fresh leaves regularly like lettuce in a sandwich it has been shown with research to prevent Migraines. If the herb is put into pills, it has no effect.

11:20 AM  
Anonymous Dianne said...

stocking: Obviously, if you have a plant that works in a situation where no synthetic drug or extract is effective, but you don't know the active ingredient or haven't figured out how to isolate or stabily store the active ingredient, then it's better to use the intact plant. There's simply no other choice in that instance.

However, any drug, natural or artificial, that is powerful enough to be effective is powerful enough to have potentially nasty side effects. And the better you can standardize a dose, the less likely it is that someone will get an accidental overdose or get inadequate treatment because of an underdose. Remember, most of the plant derived drugs we use (ie aspirin from willow bark, taxol from yews, digitalis from foxglove, caffeine from coffee, even the anti-bacterial properties of cranberries) are things the plants made to make themselves toxic so animals wouldn't eat them.

As far as feverfew in particular goes, there are studies showing efficacy from feverfew extract in migraines
>here, for example.
Several components of feverfew are being tested for efficacy against cancer cell lines as well. In general, it looks like an interesting plant that may have one or more chemicals within it that could be useful in medicine. But I see no particular evidence that intact feverfew has some sort of mystical properties that make it impossible to study.

12:34 PM  
Anonymous Anonymous said...

i have agreed with you on 99% of your posts, but this one i disagree strongly.

i have seen evidence based results for alternative medicine. Eg. A baby on morphine and still unconsolable but has max the dose. i was asked to give it an infant massage. The pain melted off that baby and it slept for six hours.

i don't believe in alternative as in replace of - i do believe in it as a compliment to.

12:02 AM  
Blogger Flea said...

If a therapy works, why is it called alternative?

The name alone defines it's purpose. It's derives from an anti-scientific impulse that's with us for a long time and probably always will.

My only caution is that we apply the same degree of scrutiny to so-called conventional modalities.

best,

Flea

5:30 AM  
Blogger La Lubu said...

There are probably a lot of factors driving the popularity of alternative medicine. Here's one: the cost of conventional medicine (there are many people who fall in-between being poor enough to get Medicaid and rich enough to buy insurance on top of other routine household expenses like shelter, food, utilities, transportation, childcare, etc.). When there's only so much money to go around, yeah, it's cheaper to buy the echinacea for the placebo effect for your nasty sinus infection than to visit the local clinic for the antibiotics you really need (not that the clinic is going to see you anyway, because they want the payment up front if you don't have insurance.)

Seriously. There is a huge number of people who fall in-between the cracks when it comes to being able to afford medical care. I was unemployed last year for nine months (translation: no insurance, and I ran out of unemployment benefits after six months). The $400 a week I got in unemployment benefits meant I didn't qualify for Medicaid, child care assistance, food stamps, or utility assistance---but it wasn't enough to pay my COBRA payments either. I live pretty frugally, so I was able to "make it", but for that time, medical care was as out-of-reach for me as a Caribbean vacation. Mostly, I prayed I didn't get sick.

Now, I'm lukewarm on a lot of alternative therapy, but utilitarian enough to use what works. I know other folks for whom cost wasn't the issue, but distrust of conventional medicine. And they have a point---thalidomide, anyone? Conventional medicine has had its share of disasters too, and the perception that is out there is that "alternative" medicine has fewer or slower side-effects---people feel a better sense of control over the herbal remedies (even if that isn't the case).

And I think people respond to that, because hey, when you're sick, you're already feeling a certain loss of control.

8:06 AM  
Blogger Ex Utero said...

I'm cow's milk intolerant and I eat soy yogurt because it re-colonizes my GI tract with lactobacilus and helps me manage my irritable bowel. You're not going to find that in conventional medicine anywhere.

The vitamin C trick also sounds rational for recurrent cystitis (as does cranberry juice). These things aren't evidence based but they are unlikely to be harmful and they fall under the heading of the art of medicine.

The problem is that conventional medicine doesn't have (or take) the time to understand the whole patient and alternative medicine has a distrust of conventional medicine. The smart patient will try to exclude neither and integrate both.

Having said that, there is nothing rational about homeopathy which should be made illegal in my opinion. Like NeoDoc, I have a handfull of horror stories associated with this discipline, most of the associated with oncology or immunocompromised patients.

9:57 AM  
Blogger Fat Doctor said...

I recently saw an informercial in which an MD and a health food store owner interviewed a guy selling some pill that would clean the colon. The average adult, he says, carries 15-25 pounds of petrified poop in his or her colon. It interferes with healthy living, he said. By the end of this infomercial, I was hooting. He actually bragged that his own BMs were twice the volume they used to be, since he started using the product.

12:04 PM  
Anonymous Shamhat said...

The problem with using herbal medicine is that many people have no information about what to use and how to use it.

For instance, someone mentioned using echinacea for a sinus infection. A better choice would be calendula. Echinacea isn't an antibiotic. That's tincture of calendula flowers in alcohol, taken orally.

It's quite possible to buy useless remedies. Echinacea should be used in the form of a tincture of the roots in alcohol--not the leaves in a tea or the whole plant ground and placed in a capsule (and it should be taken during the first few days of a viral illness, not constantly). Does it really help a cold? Who knows. Nothing else really does, either.

Uva ursi is a good remedy for urinary tract infections, but it's not exactly a "tea"--it's a cold infusion. The active ingredient doesn't survive boiling water. You need to set the leaves in warm water and leave it overnight to get the effect. It's still quicker than getting an antibiotic from your doctor, particularly if you happen to get sick on a weekend.

Interestingly, the medicinal taste of plants with medicinal properties (which is hidden by pills) is probably a feature rather than a bug. Uva ursi tastes just awful. It's very easy to tell a tea or tincture that is nutritional (oatstraw, anything made from dandelions) from a medicine by the taste, and that probably helps prevent overdosing. And some people actually report that the remedy tastes good when they need it but awful when they aren't sick.

However, one example where hiding the taste helps is cranberry juice, mentioned by anothe rposter. Cranberry juice tastes awful. Medicinal, even. Anything you buy in the store is mostly apple juice, which doesn't help. Those Cranactin capsules are better. Also, ginger ale is a great remedy for nausea but only if it's made with real ginger and not artificial flavors.

It's also possible to buy very hazardous medicines at health food stores. Blue and black cohosh and pennyroyal (tinctures in alcohol) can be used to induce a miscarriage in early pregnancy or to induce labor in late pregnancy. But I've heard of women with wanted pregnancies drinking pennyroyal tea from the health food store because they like the taste and miscarrying repeatedly.

6:57 PM  
Anonymous maribeth, CNM said...

We all want evidence-based... but how much does the average study cost? Who foots that bill? Who's going to, for example, pay for a study showing acidophilus reduces yeast infections when the OTC yeast creams are a billion dollar industry? Who's going to pay for a study showing castor oil compresses are like magic on phlebitis? I agree with the laudable goal of using only evidence-based remedies, but it's a pipe dream.

11:06 AM  
Anonymous Dianne said...

how much does the average study cost? Who foots that bill?

The manufacturers of alternative medicines. "Alternative medicine" is a billion dollar industry itself and if you think the manufacturers are in it for pure altruism you're not in touch with reality.

Incidently, a number of studies of acidophilus and yeast infection have been done. It's one of the reasons that Lactobacillus is an accepted treatment for yeast infection, especially in the context of antiboitic use.

12:22 PM  
Blogger neonataldoc said...

Very interesting comments, thanks everyone. If someone says an alternative medicine works for them, great, use it. But before we recommend it to a whole population of people, let's get more than anecdotal evidence that it works.

Anonymous, I'm happy to discuss risks and benefits of circumcisions with my parents, but 99% of them have already made up their minds by the time I see them. Flea, correct, conventional remedies should be evidence based too. I also agree that homeopathy is ridiculous.

Alternative medicine companies should pay for studies demonstrating their effectiveness, but they probably won't, because they have too much of a cash cow now.

Fat doctor, you are too funny. Are you sure you weren't on fentanyl when you wrote that?

12:43 PM  
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5:53 PM  
Anonymous D.E.M. said...

Regarding the anti-homeopathy comments: I gather those of you against homeopathy feel this way because you've actually read the historical development of medicine and homeopathy, done some research, taken the time and trouble to analyze a case, and chosen the appropriate remedy? You couldn't have, because if you did, you may have actually discovered that it works and works well. Like most people in the allopathic medical practices, I'm sure all it takes to dismiss homeopathy is knowing that the process of making a remedy results in an extremely dilute composition which couldn't *possibly* work.
Most western practioners can't get past this point to continue a sincere inquiry.

I choose "alternative" treatments, including homeopathy, for my family and me because they work. They are simple, effective, inexpensive, and honor the body's ability to heal itself. I choose allopathic medicine when I must because allopathic medicine by its nature, is good for the crisis; the emergency. That's when its philosophy of treating the "parts" comes in handy. Not surprisingly, my family and I haven't seen a doctor for an illness since 1998 when I gave up using antibiotics on my children and starting using homeopathy for their illnesses. You are not seeing us (and other consumers of alternative health care methods) in your office when we have successfully treated an illness with an "alternative" modality. You may only see us if we haven't started the treatment soon enough, or if the case is particulary challenging--and you will only see this as a failure of alternative treatment. You will not have seen the many successes.

"First, do no harm." Considering the carte blanche attitude of allopathic medicine and its practitioners--you people have a long way to go.

12:12 AM  
Blogger Clark Bartram said...

d.e.m.,

"I gather those of you against homeopathy feel this way because you've actually read the historical development of medicine and homeopathy, done some research, taken the time and trouble to analyze a case, and chosen the appropriate remedy?"

I've done these things. I in fact take the time and trouble to analyze a case and choose appropriate treatment on an almost daily basis although that treatment will never be homeopathy unless the irrefutable evidence which has shown it to be utterly useless is somehow overturned. You see there has been much "sincere inquiry" although not the kind you mean. You think that anecdotal evidence is all that is needed to prove that a remedy works. Scientists such as physicians, with many exceptions I am saddened to admit, learn in their training that there are many biases and variables that must be controlled in order to properly evaluate a treatment. There is no real evidence that homeopathy provides any benefit for any illness.

There is a lot to be said for plausibility when it comes to evaluating therapies and homeopathy is the least plausible of all unfounded "alternative" remedies. Your anecdotes are meaningless and I especially love the excuses you mentioned for when people must go to see a medical doctor.

The vast majority of illness gets better on its own with no intervention. This is a huge part of why you think homeopathy works. Your children don't need homeopathy or antibiotics for those viral upper respiratory infections. When someone doesn't get better and needs the help of a physician it has nothing to do with how quickly you shoved your delusional dilutions down their throats.

Medical doctors aren't perfect by a long shot but imagine life without them. But you probably aren't able to give credit where credit is due because you believe and will always believe in your particular brand of magic. You are a lost cause. I fear for the safety of your children though. Hopefully they will never be ill with something requiring quick action by trained medical professionals while you delay appropriate treatment.

12:53 AM  
Anonymous D.E.M. said...

Along with assuming I am ungracious, (“But you probably aren't able to give credit where credit is due…..”) you assume I don’t know the difference between a truly serious illness and minor one in which the body can be comforted and assisted in healing. (“Hopefully they will never be ill with something requiring quick action by trained medical professionals while you delay appropriate treatment.”)

Your mistake on both counts, but it can’t be helped in the anonymous world of the blog.

As far as my anecdotes for “evidence” goes—sorry, can’t help you there. We are only four, not four thousand. Doesn’t your clinical experience tell you anything the studies do not? Or do you disregard your own clinical experience as anecdotal? Give me a doctor any day with loads of clinical experience—not one who quotes me studies. In the realm of the parent, what matters most is your own child. (e.g. I don’t care if your statistics tell me the MMR, DPT, etc. are “statistically safe.” If my child is vaccine damaged, those numbers become meaningless.) If the remedy works for my child or my self, it works for us. What could be your problem with that? You seem to be assuming I’m not feeling or seeing any observable change after administering a homeopathic remedy. Well, right after I get done shaking my rattles, calling down the sun gods, and doing the hokey pokey, I write down observable changes, keep track of the symptoms, chart the progress of the illness and whatever home treatments I have used. My records are manna to anyone collecting a health history of my family.

I don’t expect the medical world to embrace alternative modalities in the near future, but I want to be free to pick and choose those treatments I feel are appropriate for the situation. So that’s what I do. I view my skepticism of western allopathic medicine and choice of alternatives as someone who wishes to take charge of my health and well-being rather than turn it over to someone else who spends fifteen minutes with my kids or me and is expected to make choices for us from there. I want collaboration and all the medical establishment seems to want is my compliance with a flawed system—that and my check.

“You are a lost cause.”
Why? Because I don’t buy into a medical system where the only thing that has ever been offered in the way of “healing” is drug, drugs, and more drugs? As far as lost causes, one of my original points was that allopaths reject homeopathy without examining it. I don’t think that a stack of studies is going to convince a western doc homeopathy has merit, there would always be some excuse to tear it down. The systems are too different, and the pablum of medical socialization too thick.

12:53 PM  
Blogger glorified midwife said...

FYI to the person who said "Routine male circumcision is a good example of modern medicine going out to lunch & never coming back."

New England Journal of Medicine [March 30, 2000, vol. 34, pp. 921-929]

"The finding that circumcision afforded protection against HIV infection, with no infections among 50 HIV-negative circumcised men as compared to 40 infections among 137 uncircumcised men, suggests another potential biological method of HIV prevention. Previous studies among high-risk populations have shown that uncircumcised men have an increased risk of heterosexual acquisition of HIV compared to circumcised men. This is probably due to the biological characteristics of the foreskin of an uncircumcised man, which is prone to microulcerations, is associated with an increased frequency of STDs, and provides an increased surface area of epithelial tissue that is susceptible to HIV. Of interest, this association between male circumcision and decreased risk of acquisition may partially explain the relatively lower risk of female-to-male transmission in the U.S. since the vast majority of men in the U.S. are circumcised."

9:38 PM  
Anonymous Clark Bartram said...

d.e.m.,

You seem to have a poor understanding of "Western" medicine and a lack of recognition of your, and any one human beings, fallibility when it comes to using personal experience as a means of guiding clinical management. You have been lucky so far and for that I am thankful.

You have the right to choose what to do to and put in your own body, something I would fight for, but your children are at risk and that is unfortunate.

Are you medically trained in pediatrics? Do you have experience with ill children in hospitals or clinics? If not, I more than assume you don't know the difference between a serious illness and one which gets better on its own, I know it. You have no idea how many serious maladies can present in a mild fashion that can easily fool the best trained physicians.

Your feelings are very typical of the anti-medicine community. You state things like medicine is only good for emergencies and doctors only want to give drugs for everything. These things are clearly not true and this flawed system you speak of, and of course I agree it has many flaws, is a likely reason you even exist today. Do you really reject the overwhelming good that real science and medicine has done for mankind? Do you truly discount antibiotics, vaccines, radiological imaging, etc, etc?

As a physician, I know enough to understand that I am only human and am subject to any number of biases and logical fallacies. This is why I temper any personal experience with evidence from properly controlled studies as much as is possible. You clearly think that you are above these biases and fallacies. Like I said, you, well really your children, have been lucky.

10:47 PM  
Anonymous AndyD said...

Gloified Midwife -

The point is more that conducting an irreversable amputation on someone who is in no position whatsoever to give consent is a massive breach of medical ethics. I don't see how people can argue with that. The right to your own body is about as fundamental a freedom as you can possibly have.

Maybe you should do a survey of 25-year-old men who are uncircumcised, giving all the pro-circumcision information that you can find, and see how many go for it.

8:42 AM  
Blogger stockingup99 said...

Homeopathy is too scary for me. And I think homebirths are safe. Poisons that strong need to be carefully managed by a professional.

Herbs on the other hand, especially teas are self regulating. Often I crave a certain kind of tea, or can't stand the taste depending on whether my body needs it.

Pills are not the answer. How can mutilating a plant make it safer. Feverfew for instance. If we grow it and eat it like lettuce, the medical industry doesn't get to sell it to us.

Eat a rainbow, and cook with herbs and spices, and you will be reaping amazing alternative health remedies. Let the kids pick what they want by the smell, and season their piece before cooking.

Research clearly shows that cultures which prodominantly drink teas have much lower health care costs than those which drink sodas.

My first born was vaccine damaged. Her HEPb shot was recalled for overdosing newborn babies with mercury. My son is intact.

9:33 AM  
Anonymous D.E.M. said...

You say 'potayto', I say 'potahto'....

9:57 AM  
Blogger cluelesscarolinagirl said...

I've suffered all my life from IBS and all the docs could do was give me Miralax. Desperation led me to try some stuff on the internet and it works and works great. Much better than the expensive Miralax.
I'm willing to try "alternatives" when doctors have no true solutions.

10:05 PM  
Anonymous VancouverLori said...

Hmmm,
Well, not all conventional medicine is evidence-based. And while doctors may be trained to know the difference between conditions that will resolve spontaneously and those that will not, why do so many not act on this?

I speak from the perspective of a pharmacist. But I have an open mind too. For the most part, I actually am so sick of being a pawn of the pharmaceutical industry, that were it not for my enormous mortgage, I would do something else.

Re: Evidence-based medicine:
AAAAAAHHHHHH
ok, I see the need for it, to minimize snake-oil sellers. And to have some sort of standard on which to make aggregate decisions (like will a company pay for a certain treatment). But we really need to bear in mind that these large studies are really not intended to decide what is best for one individual.

The resources required for these studies (especially the ones that get peddled to you in your office/hospital with fancy acronyms) are mind-boggling. And the only people who can afford to do them are either governments (e.g., the NIH WHI study) or huge pharmaceutical companies. And big companies will do anything to make sure you learn all about their wonderfully positive studies. And they are only willing to do them because they have patent protection.

The natural products industry is huge, yes, but it's very fragmented and competitive and therefore doesn't have the same resources for these sorts of studies, not to mention lack of patent protection. And if they were to do smaller studies, we'd all be suspicious, wouldn't we? Oh wait, they do and we are.

I have to admit, I'm sort of with you on the homeopathy thing. The general idea is fine with me, but the whole dilutions thing (1/1,000 is NOT greater than 1/1,000,000) just makes me suspicious. And I'd be more ok with it if it was cheap, but damn that fancy water's expensive. I'm all for placebo effect, but not at that cost!

And as for echinacea not being effective - I'd like to see that study. Around the time I graduated, there were several studies saying that the *tincture* was effective. And I've used it, and it usually is. And even better, a drop under the tongue actually does relieve sore throat. Got me through a singing competition a few months ago while I had a raging sore throat/cold thing and almost couldn't talk. Hey, maybe it was just the alcohol, but it was relatively affordable for all that - cheaper than the number of throat lozenges I'd have had to take and easier on my sugar intake!

And as for tea drinkers being healhier than soda drinkers. DUH! It's not the tea, it's the lower sugar intake. Compare water drinkers to soda drinkers and you'd see the same thing. Only, people in the wild might occasionally get sick (and/or bored!) if they only drank raw water, so tea drinking is a survival and boredom-avoidance strategy. Though I'll grant some self-medication into the mix.

Most of all, I believe in people making their own health decisions and that health-care professionals (allopathic and other) have a role in giving guidance and providing their skills (surgery, massage, etc) in a helping rather than directing mode. There was an interesting little article on Medline the other day about patients and primary-care doctors developing action plans that touches on this. People have to take responsibility for their own health one way or another.

Honesty is absolutely critical here, and the focus on "evidence" is clouding this a little. It's overly encouraging alternative providers to lie (and people to believe those lies), like your example of the patient with Hodgkin's. And we're all relying too much on the "evidence" - whose evidence will we go with today? I feel very comfortable telling a few patients who aren't doing well on conventional stuff, that they could try X, because some people have found it helpful, and obviously what they're doing isn't working, so it may be worth a try. But I would be wrong to misrepresent some anectdotal evidence with a glowing recommendation - it's just trying something different. And it's either a diet or lifestyle modification or my tiny pharmacy doesn't carry it, so my employer seldom profits from these suggestions! But my patients trust me, and appreciate my desire to suggest what's right for them as an individual.

There are so many things that conventional medicine doesn't even look at, because there's no drug being flogged for it, therefore they don't get to learn anything about it. Like insufficiency of gastric acid: no one but a few naturopaths have studied this. And poor conversion of T4 to T3, where the patient will be depressed, (and overweight and cold and losing hair if anyone ever thinks to aks) despite apparently normal TSH. And no one is paying attention to the basics! My step-dad had classic signs of thiamine deficiency for months and no one clued in until I took a class that mentioned them - tick, tick, tick! He's feeling a little better now that I've got him on some B's. And food allergies - you can't just avoid everything - you do have to eat to stay alive, and just taking drugs to suppress the allergic symptoms doesn't seem like the best answer to me. After my son developed an allergy to eggs in addition to the rest of the stuff he's allergic to, I decided that enough was enough. What foods do you like? Well, unless it's a botanical vegetable (as opposed to anything with seeds, which would be a botanical fruit), my son most likely can't eat it without getting itchy and peeing the bed (and he sleeps next to me, so it sucks for both of us) so we are looking into gut healing strategies, including the use of Acidophilus. Is there evidence for it? Not really. But there's some science behind it, and it can't hurt and it might help, so it's worth a try.

Oy, I'm rambling... off to bed!
-Lori

4:44 AM  
Anonymous Anonymous said...

A large portion of modern medicine is not evidence based.

http://www.businessweek.com/magazine/content/06_22/b3986001.htm

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