As an Internal Medicine physician many of my colleagues are less than open minded about natural medicine. Some of them view it as lacking any evidence and likely of no benefit. Some are much more hostile toward the field and view it as nothing more than snake oil peddling in the seek of profiting off poor trusting patients. There is some validity to both of these claims but neither is a full explanation of reality.
Yes it is true that there is little evidence for many of the treatments used by naturopathic physicians and other natural medicine practitioners. This blog lays out many examples of where some evidence is present and points towards a likely benefit but is never followed up with any large good quality studies like the ones seen for pharmaceutical drugs due to madate by the FDA. Unfortunately this is merely the reality that any natural medicine practitioner has to deal with. There are thousands of herbs, vitamins and minerals that have been used for hundreds and sometimes thousands of years for a particular illness or symptom. Through generations of experimentation people found these natural remedies to work, not unlike finding out which foods were good to eat and how to prepare them. However, our reductionist science has refused to merely study the whole herb or food to see if that would work towards treating the illness. Instead our universities and pharmaceutical companies have labored tirelessly to isolate single chemicals that they hope explain the complete effect of the herb and then patent these for mass production. This is not some profit making conspiracy but is merely a result of the limitations our our limited technology and understanding of the extremely complex chemical composition of herbs and foods. Also it results from the incentives set up by the fact that one cannot patent herbs but can patent synthetic chemicals. However, it is not always (and most often is not) true that one isolated chemical can explain the effect an entire herb has on the body. One simple herb like thyme or elderberry has many chemicals in them. Each of them interact with the others, and untangling this interaction is impossible with current technology. And yes, you may find one chemical that is primarily responsible for the effect on the body you are looking for, but there is no guarantee that in isolation it will be as bioavailable and active without the other chemicals in the herb. Not to mention the other chemicals may offset side effects from the chemical in isolation. Almost all pharmaceutical drugs have some very serious side effects yet many of the herbs used in natural medicine have little to no side effects. The simplest way to find this out would be to compare any drug that is isolated from a plant, food or herb head to head in clinical trials to the herb itself to make sure it is as safe and effective. Preferably you would want it to be more safe and more effective as any patented pharmaceutical drug will be more expensive than its un-patented herbal source, unless the herb is extremely rare.
As for the claim that natural medicine is deceitful snake oil peddling, this also has a grain of truth. Given that it is an unregulated field with no FDA or medial boards to oversee it, there are a lot of unscrupulous natural medicine practitioners out there giving out remedies that likely do not work in pursuit of profit. Some may only sell one product and therefore will claim that this one product can cure anything and everything in the interest of increasing their client base to sell more product. However, deceitful profit seeking individuals are not unique to the natural medicine field and can be found in any area of industry where anything is being sold. This is not a reason to discard the field as a whole and give up on potentially less toxic and cheaper treatment alternatives. In fact more research and information can only make this situation better allowing good scientific research to guide people’s consumption of natural remedies. Also we need to come up with innovative ways to have this industry regulated in some way. Naturopathic physicians are a great step in the right direction as they practice natural medicine, but only after a 4 year postgraduate training program and are subject to licensing and medical board oversight. An insurance company or employer sponsored oversight body may also be a good option.
One particular aspect to natural medicine that I thinks is far too rare in traditional medicine practice is supporting the body’s own ability to fight disease. Our body is amazingly capable of fighting cancer and infection and balancing hormone and electrolyte levels and yet all too often these abilitites and many others of the body are ignored completely in traditional medicine. For infections we give antibiotics (which are amazing life saving drugs) but we do nothing to support the body’s own infection fighting mechanisms. When people have cancer we cut it out or try to poison it with chemotherapy (which has saved millions of lives and has changed the death sentence from Hodgkin’s disease and testicular cancer in to greater than 90% cure rates) but we do nothing to support the body’s myriad of mechanisms to fight cancer. Natural medicine has much more respect for the body’s ability to fight disease and find balance that I feel traditional medicine is lacking.
Natural medicine practitioners also place much more emphasis on nutrition which has been almost completely abandoned by traditional medicine. When is the last time your doctor asked you what you are eating, went over a diet diary, or gave you specific dietary instruction? I know even I do not do it much in my daily practice despite how important I know that it is. It is time consuming, frustrating given the lack of change by the patients, and we as traditional physicians merely do not have much training in it. But I strongly feel the importance of what we take into our bodies every single day multiple times a day cannot be understated. What we eat is the underlying cause or at least a contributing factor in almost all chronic disease and could likely far more often be the cure if we spent more time on it and devoted more research to it. Natural medicine gives nutrition much more of the attention it deserves.
Irregardless of what we do, the public will continue seeking out natural treatments to their ailments for a variety of reasons. Many feel in there gut that there must be some herbs that can do some good. Many believe that natural medicines are less toxic and safer than pharmaceutical drugs. Other may desire a doctor who pays more attention to their body’s natural ability to heal itself and to nutrition. And many more are merely unsatisfied or frustrated by traditional medicine’s inability to make them feel any better. We need to start taking natural remedies seriously and give them the solid scientific research they deserve so we can honestly tell our patients what the evidence shows rather than merely reply that there is no research supporting it. No research indeed.