How Alternative Medicine Fails Us

rhodiola-roseaI’m forever fending off the alternative medicine brigade who seem to clump around this website and email me all kinds of supposed miracle cures that will spell the end of all health ills. One herbal remedy I recently focused on is Rhodiola rosea, in which I critiqued a promotional email from a vested interest in the product. They made all kinds of claims for this material on the back of very limited clinical trials. Needless to say advocates of alternative medicine commented aplenty.

As a chemist, I take what I hope is a healthy and skeptical view of all the biochemical and physiological claims these people make for their products. I’m just worried that there are so many people who are perhaps desperate to fix their lives that they become easy prey for such marketing. Anyway, for those who feel a chemist has no place criticising their beloved remedy, I turned to a pharmaceutical expert in Sheryl Torr-Brown of the Future Trends in Health blog to provide some additional support for my argument. She has many years experience in pharmaceutical science and has no axe to grind and offers an honest appraisal of my original post and some of the comments left by Sciencebase readers.

A glance at the scientific literature covering this herb seems to be minimal and biased in the main, she told me, and as such she agrees with my argument.

“When dealing with alternative medicine,” she says, “it is not enough to be right if you want to avoid the attacks. You also have to be sensitive to the highly personal views of those who find benefit in the drug albeit most likely due to placebo effect.”

This is perhaps an important point. Yes, the placebo effect is valid, but these remedies are usually very expensive and people are often spending their hard-earned money on what amounts to sugar pills, something that should be avoided perhaps especially in the current economic climate when every penny counts.

“A major point that most of the non-scientific public do not understand is that there is no such thing as a safe drug, natural or not,” adds Torr-Brown, “The dose is the poison, as the father of modern toxicology, Paracelsus said in the fifteenth century. Anything and everything will be toxic if you have enough of it or it gets into the wrong place. Unfortunately, people are tired of Big Pharma advertising and the media frenzy around drug withdrawals.”

She points out that ‘natural’ is sounding better and better to many folks, despite the existence of natural belladonna, natural cobra venom, oh, and natural background radiation. In the age of the Internet, it is now very easy to get positive anecdotes about anything. “Basically, one can decide what one wants to believe and then go find the evidence to support it,” Torr-Brown adds, “For scientists, we look for controlled studies to prove a point, whereas the general public are happy with a personal story or two of success.”

Many people, including several of the original, negative commenters on my R rosea post, are grasping to find something that works for them. “You cannot discount [some of these views] from a human perspective, but it makes no sense scientifically, adds Torr-Brown, “I am shocked by the number of people I know who pay huge amounts of money for the latest panacea only to give it up after a couple of months, usually due to lack of interest.”

31 thoughts on “How Alternative Medicine Fails Us”

  1. Regarding the natural ionizing radation background: studies of populations in areas of differing background radiation levels show that the curve of mortality rate / exposure has a hook at the bottom. That is, there is a certain (low) level of ionizing radiation that is better for you than none at all. This flies in the face of the “linear no-threshold” assumption that is enshrined in hundreds of laws and regulations. In retrospect, it’s not that surprising. The Earth has always been slightly radioactive, so ionizing radiation is one of the things that life has adapted to from the beginning.

    The first axiom of toxicology is “The dose makes the poison.” Too much oxygen will kill you almost as fast as too much chlorine. There are several compounds that are deadly in gram quantities, but are essential nutrients in microgram quantities.

  2. How does one consume Reiki therapy in the raw state? Reiki is like homeopathic massage, the so-called therapist doesn’t even need to be in the same room (ditto Bowen technique). I presume you’re talking about herbal remedies. Yes, there is some evidence of synergistic effects of different active components in herbal products for some symptoms and also some anti-synergistic effects that inhibit toxicity. However, more often than not a herbal product that works can be stripped down to the single primarily active ingredient and prescribed in a much more controlled way than any random botanical extract. Moreover, fine-tuning of the chemical structure of an active ingredient can reduce side-effects and lead to a better remedy. Viz, ephedra extract used for breathing problems and asthma was redesigned as the bronchodilator salbutamol which has a far less detrimental effect on the heart than its botanically-derived predecessor ephedrine.

  3. Lots of people are there who are switching towards Alternative Medicines.I think that they are most effective when consumed in raw state insted of altered forms.

  4. Bridget, I think you’ve missed the point of this post totally! Thankfully, most doctors can see through the smoke, mirrors, and snake oil, that underlies much of alternative medicine and recommend only those practices that have some evidence-based validity unlike homeopathy, for instance.

  5. It’s great to see Doctors realizing the benefits of alternative medicines. Most doctors won’t even bother to do the research because their practice requires them to help patients with modern health procedures and prescribe only FDA approved prescription drugs. Legally a doctor is not allowed to inform a patient of an alternative to treatment if it has not been approved by the FDA. The use of essential oils and carrier oils may benefit people as well, along with taking the proper vitamins on a daily basis. Keep it up doctors, we are heading towards a healthier tomorrow.

  6. And conversely, life is a fact of death. I’m not for or against any form of medicine either. I’m writing a blog, trying to point out the failings of various forms and discussing the issues surrounding the marketing and selling of practices and placebos that often exploit the vulnerabilities of the sick, dying and desperate.

  7. Death is a fact of life.

    Coming to medicine i’m not for or against a form of medicine.

    And no one can really guarantee which form of medicine works well. But there are a few practitioners who are on constant research on medicine coupled with his experience in dealing with medicine for a particular symptom/ disease / patient situations.

  8. David,

    I’m an active 68 year old retired airline captain who has been taking supplements for over 30 years. I play tennis four to six hours a day with many talented younger people and hold my own. I’ve been taking rhodiola for two years and definitely notice the difference in my energy level and my competitive results. I often give it to my 65 year old girlfriend when she needs some extra energy. At first I just put it in with her other vitamins without telling her specifically that she was getting something extra. She finally asked me if I had gotten some new vitamins because she was feeling incredibly well. I confessed- and now she insists on taking it every day. So much for the placebo effect. Legally prescribed pharmaceuticals are responsible for about 100,000 American deaths a year. Supplements do not harm anyone- and I believe are responsible for getting me through a 45 year career in aviation. Linus Pauling lived to be 93 after being diagnosed with heart disease in his early 60’s. He started taking large doses of supplements and outlived his critics by decades. I don’t believe that your interest is in saving people’s money. I believe that you are an active promoter of big Pharma. Let people be responsible for their own health instead of trying to debunk natural supplements because they haven’t been “tested” by so called “scientific” methods that have brought us many hundreds of toxic “medicines.”

    The scientists that I have known, including many physicians, are some of the most unhealthy people on the planet. If you want to look at some valid studies on the benefits of many supplements go to http://www.lef.org It’s free and is maintained by the Life Extension Foundation.

  9. Tom, Tom, Tom…who’s counting, eh? Long-term health failures are common on both sides, but let’s look at the arsenic, mercury, and other toxic elements deliberately added to certain TCM remedies, shall we?

  10. You comment on how “alt med ” fails people , how about “real med” that according to tha AMA’s own stats kills over 100,000 people per year when taken the prescribed way. Alt med stats for death rates are zero. Still want to promote more drugs to our children ,family and friends so we can kill them off also?

  11. Matthew Theriault:

    And this is because of the lack of “pharmceutical” grade scientific research, development, and trial processes performed on the specific compounds? Well then what if a company took the pharmaceutical route?

    There’s no such thing as “pharmacetical grade scientific research.”

    Chemists, physicists, doctors, car mechanics, historians, jurors, all use the same basic rules of evidence. To state them simply:

    1. Corroboration: Observations that can be corroborated by independent parties are more likely to be true than observations that can’t be corroborated.
    2. Falsification: Hypotheses must be subjected to tests which might prove them false before we take them seriously.
    3. Logic: Hypotheses or explanations must not violate logic, must not be self-contradictory, and must not contradict things we already know.
    4. Parsimony: The fewer unproven assumptions required, the better.

  12. @Govindan – I have to disagree. If the patient dies; whatever form of medicine was in process has surely failed.

  13. @Govindan I’m really not sure what that comment means “no medicine fails if a thorough professional who is continually studying prescribes the medicine”. There are dozens of medicines that fail on both sides of the fence despite practitioners and studies.

    @Matthew – I never said that at all, so your “restatement” of my post is false. Indeed, I’ve said on several occasions that many forms of alt med have activity, my problem is with the claims of those selling these products that hype the activity and extrapolate their products to the status of panacea when that is so obviously false.

    @Anthony – Fair comment, yes there are snake oil sellers and there are those using valid CAM that has simply not yet succumbed to proper scientific study for an explanation of its efficacy.

    @Dan – Yes, if a product is demonstrably safe and provides benefits then why shouldn’t someone be allowed to use it, except that how do you know any of these products are safe in the long-term (that of course applies to both sides of the argument, but some random herb with hyped claims is not the same as a conventional product aimed at a specific disease state)

    @Nadine – “Cleansing the body of residual toxins”, purleez, you’ve got a liver and kidneys to do that, adding random herbs to one’s diet does not “detox” the body.

    @Alex – “balance”? Like all four humours and one’s chakras are realigned, right?

    @twicker – alt remedies most certainly do have side-effects. Misguided osteopathic manipulation can lead to a severe and debilitating worsening of a condition such as a misdiagnosed prolapsed vertebral disc for instance if the practitioner believes the symptoms presented are caused by myofascial problems…

    @Mike – you’re right about the “want it now” attitude, the desire for immediate gratification in all areas including health is rife, people forget the subtle lifestyle changes (exercise, reduced calorie intake, increased water intake) that can help in so many health conditions.

  14. No Medicine fails if a thorough professional who is continually studying prescribes the medicine. Be it Allopathy or the other Alternative Medications, each has its own merits and demerit to some extent.

  15. David,
    To restate your proposition (so that I understand you correctly)…You’re saying that nutritional supplementation / alternative medicine (horrible name) has no valid scientific basis or support for positive, measurable, specific impact on the human body? “If I take herb A in X amount at Y times per day, I will get B result.”
    And this is because of the lack of “pharmceutical” grade scientific research, development, and trial processes performed on the specific compounds?
    Well then what if a company took the pharmaceutical route?
    Let’s say they employed ethno-botanists to work with indiginous peoples around the world to identify plants with “anecdotal” healing / curative properties.
    And let’s say that those plants were then harvested and shipped to a full scale genomic and proteomic research lab staffed by PhD’s, MD’s and other research scientists to first break down the plant into all it’s component parts (fractions), then do studies as to how each of those component parts impacted the human genome (let’s say using a 96 well plate that could compare one fraction to each genome or one genome to multiple fractions).
    And then let’s say to make the research even more “pharmaceutical” let’s say you actually built and staffed TWO of these full scale facilites.
    And then let’s say once you identified a fraction that interacted positively, you could then match it up with other fractions that had symbiotic effects on each other to magnify that positive reaction.
    Then what if you partnered with Cleveland Clinic, Brunswick Labs (owned and operated by M.I.T.) and other top medical research facilities to conduct and validate numerous clinical trials on the newly developed mixtures over a period of several years to establish the duplicatible effectiveness of those mixtures and compounds.
    Would that be sufficient for you to believe in the effectiveness of supplements (at least those provided by such a fictional company?)
    Take a peak at Unigen Pharmaceutical ( http://www.unigenusa.com/ )
    And sister companies:
    AloeCorp ( http://www.aloecorp.com/ )
    Univera ( http://www.univera.com )
    And then feel free to email me if you’d like to know more. I would be more than willing to

  16. I think you need to separate true alternative medicine (which saves lives) up against people who peddle bogus products in the name of alternative medicine. I don’t think the people emailed you are the hard working naturopaths and other alternative medicine professionals that spend their days saving lives. My wife went to over 20 doctors before a naturopath saved her life. Allopthic medicine wanted to pump her full of pills and tell her it was all in her head.

  17. While we can certainly argue and find factual support for either side all day long, I believe the bigger picture is people are simply looking for alternatives to getting taken advantage of by big industry.

    The catch is, many of these companies promoting “natural” alternative products carry the same (if not higher) profit margins than pharmaceuticals and they don’t have to adhere to strict guidelines from the FDA or spend millions on testing. Most people don’t realize that over 60% of the nutritional products in the USA, regardless of brand, company or distribution system (yes, even those sold by popular ‘networking’ companies) are all made by the same company, usually even in the same building. Such businesses create “designer” products and label them accordingly. A typical $40 bottle of “ultra-healthy juice” costs around $5 (or less) to produce.

    There’s nothing wrong with profits, even lucrative profits, but there’s something to be said for the fact that these nutritional companies are simply using marketing tactics to make the “evil” pharmaceutical companies look bad only to put themselves in a good light (naturally). They’re just as guilty, possibly even more so.

    Your article brings up a going point about how things work in the body. Years ago I had high cholesterol and my Dr. wanted to put me on the popular statin Lipitor. I suggested I wanted to try an OTC brand that was a “natural-based” red yeast rice product. He was familiar with the product and explained (scientifically) to me how even though it was “natural” it is still a statin and functions the same way in the body to produce the desired results.

    Another component of the argument is the availability to access remedies that cause people to turn to alternative sources. I have minor sinus problems and chronic post-nasal drip. This used to cause me to get frequent respiratory and throat infections. Each time I would schedule an appointment (for several days later), then go to the doctor and pay my deductible, after wasting 3 hours of my day he’s say, “Yup, you’re sick, here’s a prescription,” and I’d pay another deductible and get my meds.

    With the time delay I’m sicker, only to be told what I already know and paid $50 or so to cure a disease plus now manage symptoms for what could have essentially been quickly resolved with $2 worth of Penicillin caught early. Now, while taking better care of myself I get sick less frequently, I still keep a large bottle of Penicillin around that I acquired south of the border for under $12.

    My point isn’t about what’s working or not working for personal health, it’s that many people are probably turning to alternative medicine because the “system” is so corrupt and broken that it’s forced them to find an easier path to fulfillment of a solution in out “want it NOW” society.

    Nutritional companies simply answered the call with great marketing.

    The #1 rule of business is to make it as easy as possible for people to do business with you. Somebody should inform Western Medicine of this.

    Then again, with 10-figure profits, they probably won’t listen anyway.

  18. Mr. Brown,

    Two quick points:
    1. You are correct that something may provide benefit to one person in 1,000 – meaning that 99.9% of people would be wasting their money on it. Admittedly, it doesn’t diminish the effectiveness for the rest of the people, but it *does* call into question whether or not the “effectiveness” is placebo effect or true therapeutic benefit.

    2. The other issue is that herbal remedies also have side effects. These are chemicals that are (if therapeutic) changing something about the body’s operations – this will almost always produce a side effect. The difference is that FDA regulations require pharma companies to disclose side effects; however, chemicals that are sold as “nutritional supplements” or simply as food don’t have to disclose side effects. For example, are you aware that the same types of studies that have suggested the cholesterol-lowering and anti-cancer effects from soy have also suggested side effects including memory loss, premature dementia, and increases in breast cancer? Now, the soy makers don’t have to tell you about that – but they *are* allowed to tell you about the cholesterol-lowering properties and market soy as such.

    Any remedy that has an effect is changing your body’s current internal state to a different one – that’s the point. Even fiber has side effects (e.g., gas).

  19. Alternative medicine’s purpose is not to cure disease and fix symptoms – this is the pursuit of medicine. Alternative medicine comes from a different paradigm – asking the question of what promotes health irregardless of symptoms or disease. The plants that you speak of act to modulate the body to coax it back into balance. You will not see clinical trials showing benefits to fixing specific symptoms associated with disease and so even if they had ample randomised clinical trials, the results would still be mixed, this is a model that works for medicine albeit with limited clinical use.

    But what these plants have been proven to do time after time is act to modulate our gene expression correctly, allowing us to express health the way our body intends. This typically leads to any number small results in multiple systems. You should read into xenohormesis – the idea that when plants are stressed (famine conditions) they produce more phytochemicals which then help boost our reserves and signal that a famine is coming…therefore these phytochemicals are like the hormones of plants which then act hormetically in humans to alter our physiology -often through the alteration of genetic expression. It is accepted wholeheartedly in science now that when you eat food, you talk to your genes. What messages are most of American’s telling their body?

    I agree that there is a lot of business in alternative medicine and it frustrates me as a practitioner that gets looped in with these other guys. There is a lot of crap out there but this is why you need to seek out experts without financial ties whose interests are in simply adding to existing knowledge or to simply get patients better.

  20. I believe the issue is NOT natural remedy versus pharmaceutical drug, but rather, allopathic medicine versus an holistic approach.

    The western/allopathic approach is about squelching the symptom. A holistic approach is about 1.) clearing the inner and outer environment of all toxins 2.) cleansing the body of all residual toxins, and 3.) supporting the body nutritionally w/food, herbs, etc. so that the body can do what it does best: HEAL ITSELF.

    Merely using natural remedies to treat a symptom is not Alternative/holistic medicine. A truly alternative/holistic approach addresses the cause.

    (BTW- my 8-year-old dog was diagnosed w/cancer after 2 biopsies and given 6 weeks to live without surgery, chemo, and radiation. I did none of them and instead implemented a strict, purely holistic regime as described here. The cancer disappeared and she thrived for an additional 11 (yes, 11) years.)

  21. But David, where’s the scam exactly? Yes, there are sleazy herbal companies that sell bogus claims about “cures this” or “cures that” and the FDA/FTC has every right to climb on those companies and squeeze till they run them out of business. But a majority of companies in that sector seem to promote products that “support healthy lifestyle,” or “reduce stress and increase energy,” etc. Very mild claims. If a person buys that product, and DOES experience that benefit, isn’t that something that they should be allowed to continue with? And if a company like the one you mention has sponsored clinical trials (just as a pharma does), and the results were good enough to make it to peer-reviewed journals for publication, can’t they use that in their literature just as a pharma would?

    Compare those herbal claims with the TV commercials driving pharmaceutical sales. A decade or two ago, if you had heartburn after a big Italian meal, you’d reach for a Bromo Seltzer or a TUMS and you’d be fine. Now, you’ve got GERD – a disease! And you’d better run to your doctor and get an expensive prescription! Do you see what I mean? Where’s the scam here, David? It seems to me there are scams on BOTH SIDES of this particular fence.

    I believe there is another controversy at the heart of this matter on your blog. It isn’t “pharma” vs.”natural” or anything like that . . . Instead, it is the age-old chemists vs. biologists problem. In companies all over the world, chemists and biologists get into arguments or have trouble working together. The biologist can understand how a plant can have a direct benefit on neurotransmitters, for example, while the chemist wants to take the fractions out of the plant, synthesize them, etc. From the appearance of the blog and the comments herein, it seems as if this is a chemistry oriented site. Until you get some counterbalance, you’ll always run into this argument when natural products are discussed alongside pharmaceuticals.

    Dan

  22. Sir, you are a pharmaceutical industry supporter — and in this post, you invited the comments of another “pharmaceutical science” supporter. What does that do for the argument? Absolutely nothing. I’m not here to bash your blog, but in the case of Rhodiola (as one example) there are more quality studies there than on most herbs. Of course, there aren’t pharma companies investing in these or sponsoring larger trials. They couldn’t see profit from something they can’t patent, unless they synthesize the fractions that they are interested in. There’s no difference in clinical trials sponsored by a drug company from clinical trials sponsored by an herbal company (as long as the company’s role is simply to provide an extract, just as Pfizer supplies the drug on a drug trial). You are so “anti-herbal” that you can’t seem to get past these basic issues.

    I urge you to contact a respected person from the OTHER SIDE to comment – Perhaps Dr. James Duke, or Dr. Norman Farnsworth, both whom have a couple of hundred quality, peer-reviewed publications dealing with this subject. Having an open mind is one of the main ingredients of a scientific mindset. What I’m reading on your blog is so closed, so oriented around the pharma industry. It’s sad.

    DJ

  23. While not an alternative medicine enthusiast, I note major difficulty in terms of “proving” the effectiveness of any remedy, conventional or otherwise. This is due to variability in the biochemical makeup of individuals. (Google “Biochemical Individuality by Roger J. Williams”) If a drug or alternative medicine formulation provides benefit to one person out of a thousand, it is a useful remedy but difficult to study in a statistical trial.

    To be sure, drugs, herbs, supplements, or nutrient formulations that produce therapeutic benefits are not a substitute for correcting dietary indiscretions that give rise to disease states. But given the poor quality of the modern food supply, it makes sense to experiment with supplements or nutrient formulations if one is experiencing pain. For example, my family has joint problems and circulation problems in the lower extremities. My dad had a hip and a knee replaced before he was my age. My younger sister had a hip replacement before she turned fifty. My youngest sister who just turned 54 has hip problems as well but is trying to avoid hip replacement by using herbal remedies. In have problems with stiffness in the connective tissue both above and below both knees and muscle pain as well. The joints seem to be OK thus far. The problem is far worse in winter when I do not have fresh garden produce available. For about six months I’ve been experimenting with a formulation called Ultimate Bionic Plus (I hate that name) that is supposed to improve muscle strength. It’s working for me. I am doing far better both strength-wise and pain-wise than last winter.

    Finally, I would point out two major differences between most drugs and so-called natural remedies. Drugs more often then not have side effects and drugs rarely, if ever, supply beneficial nutrients. The fact that the effectiveness of an herbal remedy cannot be demonstrated for a broad spectrum of the population does not detract from its effectiveness for individuals who experience benefit. It’s not always the placebo effect.

  24. It seems to me that one of the biggest problems is the blind acceptance of anecdotal evidence. Anecdotal evidence is NOT evidence, but it is used without exception to sell these alternative medicines.

    I feel bad for many of these people as they get swindled by these con men and women who make a living preying on ignorance.

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