Natural Doesn’t Mean Safe, Unnatural Doesn’t Mean Dangerous: The Problem With Growing Trends in Alternative Medicine

1.

A few days ago I was visiting a friend of mine.  She was putting her kids to bed, and I knew that if I wanted to actually get time with her that night I would have to help.  With that in mind I volunteered to assist with them brushing their teeth.

Before starting I asked if the two kids—ages 4 and 6—were able to do it themselves or if they needed help.  Both of them proudly told me they could do it themselves, so I left them to their tasks and merely stood back, supervising.  The older of the two—Andy—had no problem.  My heart raced however when I noticed that Amy—the younger—had swallowed a mouthful of toothpaste.

I began searching around to see what she had used and saw only Tom’s of Maine toothpaste, nothing meant for children.  I asked her which she used and she pointed to that tube.

Tom’s of Maine Toothpaste: another way to spend more money to show people how awesome you are.

Keep in mind that I knew that a small amount of toothpaste probably wouldn’t kill anybody, even a young child like her.  Nonetheless, I couldn’t know that for sure and figured I had to let their mom know.  I ran out into the living room where my friend waited—sliding into the room as frazzled as Kramer—and told her what happened.  For all of my worry, I was astounded at the answer I received:

“She can swallow that stuff.  It’s all natural so it’s okay if she swallows it.”

The next statement to come out of my mouth came as a matter of reflex, not forethought.  I told my friend, and I quote, “I don’t think that means what you think it means.”

I began an explanation about the fact that many of the ingredients in normal, not-natural toothpaste were technically natural and probably also in this toothpaste.  Nonetheless, I kept being met with ardent denial that any harm would come to Amy, always because the toothpaste was natural.

Exasperated, I realized I was probably overreacting anyway.  (It was a small amount, after all.)  But I still couldn’t help but think about her statement.  Throughout the night I curiously asked her about the issue, soon beginning to discuss medicine in general.

What I found was that my friend—in matters of her own and her children’s health—was completely mistrustful of the medical discipline and ardently refused to take herself or give to her children any medicines that weren’t natural as anything but a matter of last resort.

I tend to have a problem keeping my opinion to myself, which meant that this discussion soon led into a debate of sorts.  I kept hearing arguments from her about how little she trusted doctors because, after all, they are know-it-alls who are wrong more often than not, who overprescribe medicine and, above all, are just another cog in the machinery that is “Big Pharmaceutical”.  The doctors we once trusted were now the enemy.

Perhaps I’ve kept myself in the dark on this to avoid facing the truth, but attitudes like those of my friend are more widespread than ever.  I can’t help but feel that a decade or two ago my friend would be looked at as nothing more than a conspiracy nut, an outlier.

Which led me to wonder, then, why thinks took such a sharp turn.  Why is it that doctors and medicine are taking a back seat to alternative treatments?  The kind of mind-body and herbal treatments that once laid on the fringe of medicine now find proponents in seemingly reputable places.  What is it that drives people away from medicine and into the arms of the alternative?

2.

Pictured: stress relief, the cure for cancer and how to prevent heart disease.

Perhaps I should first define my position on this topic and, more so, the reasons for that position.

I find myself of the mindset that doctors have trained themselves and honed their skills and that, for that reason, they are reputable sources of information.  Is every doctor going to be totally trustworthy? No. That is why there exist ethical review boards and second opinions.  But are some untrustworthy or incompetent doctors a reason to turn away from medicine?  I, personally, think that is a rash and potentially dangerous decision.  Let me be clear: if there isn’t a damn good, peer reviewed study that supports the claims of this treatment I don’t think people should be using it.

If people were seeking alternative treatments for only minor ailments and in conjunction with “traditional” medical treatment, I think that I would not be so opposed to this.  However, somehow people have gotten it into their heads that traditional medicine is less effective than these alternative treatments. Yet, every year Americans spend $27 billion on alternative treatments, especially herbal remedies.

Unfortunately, the FDA does little to regulate these alternative treatments and independent labs often come up with results that are inconclusive or show that alternative treatments are ineffective.  The National Center for Complementary and Alternative Medicine continuously says that these treatments are effective, yet the contrary seems to be empirically true.  If they are ineffective, you’d hardly know it from the 48% of American adults who sought alternative treatments at least once in 2004.

3.

I should be clear about the reasons people seek alternative treatments.  The ones I’m focusing on are herbal remedies and certain holistic, mind-body methods as well as integrative medicine (mixing these bullshit procedures with traditional medicine.

Though I cited that kind of example at the start of this post, cases like that are actually the minority of people who eschew traditional medicine because of bad experience or mistrust. At least, that’s what “research” by the NCCAM and other entities suggest.  Instead, they say, people just find that alternative treatment methods fall more in line with their belief systems.

All doctors look like this to the proponents of alternative treatments.

Understandably, though, some people also wish to avoid the unpleasant and potentially life-threatening side-effects of traditional medicine.  What good does it do, the thinking goes, to fix one illness at the risk of other side-effects?

I would argue that despite the NCCAM claiming otherwise, mistrust Americans feel for doctors plays a significant role in seeking alternative medicines.  Doctors, like all people, are people.  (I know, you wouldn’t have thought that, right?)  Unfortunately, these people have our lives in their hands.  It’s no surprise, then, when some people don’t like it when doctors make mistakes, something that—being people and all—they are wont to do.

In the NY Times article I linked above about mistrust toward doctors, one Ms. Newman—who has moved toward alternative treatments—says, “I don’t hate doctors or anything, [. . .] I just know they can make mistakes, and so often they refer you on to see another doctor, and another.”

I can understand Ms. Newman’s frustration with being referred in a circle.  But she said it herself, doctors make mistakes.  Wouldn’t you prefer that your doctor ensures his opinion is well-founded before he goes on with treatment?

In the case of Ms. Newman—and the many others like her—it seems doctors can’t win.  If they make a mistake they will have undermined the fundamental trust they require from patients and thus drive her toward alternative treatments because, you know, how dare they make mistakes.  But when they refer her for second opinions to help ensure her safety, she is equally pushed toward alternative treatments.

Recently I was watching an episode of Warehouse 13 involving a woman who worked for a drug company.  When she was asked why she didn’t follow in her father’s footsteps and become a doctor, she responded with the entirely convincing: “Have you ever noticed that doctors seem to know everything already?”

Or like this. Just look at how self-satisfied she is. She probably gave her expensive sports car a name and lights cigars with your money.

To many, that would seem to be incredibly arrogant.  To me it just means he is a good doctor.  This is the man who diagnosed my appendicitis—before any diagnostic testing—by just looking at me.  Was it a hard diagnosis? Probably not.  Is it a good thing that my doctor can accurately diagnose me that quickly?  Yes, because any delays or wrong diagnosis could have cost me my life.  (My appendix was, after all, just shy of bursting.)

There is a concept called “systemic arrogance” within medicine, the idea that highly impersonal healthcare systems—such as our own—force doctors into seeing patients as objects, rather than people.  They are a mechanic and you are the vehicle.

To the doctor, treatment needs to happen quickly and efficiently, else that is wasted money and potentially loss of a job.  There are more patients than doctors by a large margin, and there is only so much time to see each one.

To the patient, the doctor comes off as a know-it-all who disregards the patient in favor of his own expertise.

I understand all of these things, but there are some reasons I regarded my doctor’s ability to diagnose me and finish the office visit in about five minutes with a sort of reverence, rather than considering him arrogant.  The first of those is that, despite his need to be efficient, I have been a part of his practice for a long time and he knows me well.  He has put his time in over years, five-to-ten minutes at a time.  Not all doctors have this luxury, though.

But the other thing I wish I could explain to people is that doctors have a ridiculous amount of education and, in most cases, actual experience.  He has a title in front of his name—doctor—that implies a certain level of expertise in medicine.  We, as patients, do not have that.

So while we may not like the doctor’s diagnosis, that doesn’t mean that we suddenly have the expertise to question it.  Doctors are there to treat us, not coddle us.  Just because your symptoms came up as cancer on webMD doesn’t mean that it’s not a far simpler disease.

So of course, what that also means is that when it comes to matters of health, that doctor is a much better source of information than you about anything medical.  When we feel condescended to it is unfortunate—and a sign, perhaps, that the doctor’s bedside manner could use some improvement—but it seems like the knee-jerk reaction lately is to ignore the knowledge behind that arrogance or, even worse, to avoid doctors.

I know it’s hard for people to accept, but doctors far outstrip the general population in that sense and the sooner we accept this fact the sooner we can improve our health.

4.

I can think of no person more representative of this shift toward alternative treatments than Dr. Oz.

He’s on TV! He must be more trustworthy than any other doctor. Television never lies to us!

As a general rule, many doctors don’t like him.) Why? Because Dr. Oz is a medical professional willing to step outside of the mainstream to push alternative methods to wellness that other doctors won’t.  This is important, so keep it in mind.

I believe I’ve discussed before the idea of the insider connection.  People, in my experience, seem more inclined to believe information when it is attached to someone within said establishment, regardless of actual expertise.  It makes some sense.  If you’re going to take advice on how to get the best deals at Wal-Mart, it makes sense to talk to a Wal-Mart employee.  Similarly, if you want medical answers you’re going to get them from a doctor, not the homeless guy on the corner.

Dr. Oz is not only an insider, but an insider that has a great personality and couchside manner (I call it that for hopefully obvious reasons) on his show.  So we are already more likely to trust him more than other doctors, and this is even more exaggerated when he tells us what we want to hear, like when he tells us something that disagrees with the rest of the medical profession.

When doctors agree that X is a good treatment for Y, some people resist it because they have an inherent mistrust for doctors.  But people love it when Dr. Oz comes along and says W is a great treatment for Y.  People eat that shit up.

When Dr. Oz says that stinging yourself with bees (to use the enzymes in the venom to do scientific shit) on purpose works to help arthritis, among other illnesses, we eat that shit up.  Never mind that there is literally not a single shred of peer-reviewed evidence that apitherapy does anything at all, because Dr. Oz says it works.  Never mind that it would typically be administered by an acupuncturist—someone whose main practice depends upon energy gates in our body being opened by needles (to be glib)—it must be safe and effective.

This is only one example, but how much nicer must it be to hear that there is a non-medicinal treatment for your arthritis?

Of course apitherapy is on the crazy end of the spectrum, really.  Most people wouldn’t want to be stung by bees, and definitely wouldn’t find it invigorating.  But people do rely on herbal treatments.

5.

Perhaps its unfair of me to focus so much of my effort on attacking alternative treatments and the proponents of those treatments while saying little of traditional doctors and medicines.

I can completely understand people’s reticence toward becoming overly reliant upon either traditional doctors or traditional medicine.  After all, seeing doctors as arrogant and not trusting them is one thing, but most people would say there is a reason for said lack of trust.  Often those people will point to traditional medicines.

After all, just listen to the last ten seconds of any medicine advertisement.  Listen to the side effects.  Terrifyingly, death is sometimes included among those side effects.

Is it really so shocking that people would want natural treatments?  These lab-born medicines may seem to do more harm than good.

Of course, I should not have to do much to defend these medicines, but I may as well do it anyway.

For one, many of us seem to see drug companies as big, heartless corporations intent upon making money on our illnesses.  We think of companies withholding cures, rushing medicines to market without regard for patient health and, most commonly, charging exorbitant prices for the medicines we so often need.

I could write many posts just about the process behind creating a drug.  Needless to say, the majority of costs from medicines come not from researching it, but from performing the studies required to get FDA approval.  Once the drug hits the markets—and if the company has a patent—they will charge an amount that helps them recoup some of the losses.  If they didn’t do this they would be out of business and we wouldn’t have any medicines to blame for society’s ills in the first place.

6.

But let’s go back to the all-natural piece.  Think of my friend’s daughter, Amy, eating her toothpaste.  It’s all natural, so it must be safe.  Right?

Clearly if these doctors say it’s safe, it must be!

While people have no illusions about the general dangers of taking any traditional medicine—because there are always some, even if the dangers are merely minor side-effects—they seem to shut off that part of their brains when it comes to herbal or natural remedies.

What people don’t seem to realize is that just about any combination of herbs can make its way to your store shelf, regardless of safety.

Medicines undergo years of testing to find out if they’re safe and what side effects are common.  In the cases where you hear “death” as a side effect, the FDA and drug company must determine the cause of such incidents.  Sometimes they are related to something like a drug interaction or are so isolated as to be statistically insignificant, other times the severe side effects are more common and, as a result, the drug must go back to the drawing board.

No such process exists for herbal remedies.  If you go to your vitamin section of your local store, you’ll see shelf after shelf of supposedly natural remedies.  The thing is, the company can take any plant or other natural substance, claim it does something and sell it to you without the FDA ever testing those claims.

Any company can put out a natural supplement and claim it helps something.  All they need is some supporting evidence, but it does not need to be independently verified.

It should be no surprise that there are unscrupulous doctors and researchers out there—as there are in any field—that will author a study with a certain result in mind.  These studies can then be used to support the claim on the bottle, so long as it has the familiar disclaimer that the FDA has not evaluated those claims.

Enzyte: because fancy cars don’t help once you get to the bedroom.

We often ignore that disclaimer, but it is important.  Consider, for example, Enzyte.  This pill is a remedy that claims male enhancement.  You’ll always see fine print on the bottles and the commercials stating that those claims ahven’t been evaluated by the FDA.  While some people ignore that and fall for it, the rest of us laugh because how would some stuff actually make a dude’s unit bigger.

Does it make sense that we dismiss those claims and yet equally believe that somehow a combination of herbs will actually reduce stress, help prevent heart disease or any number of other benefits?  In either case, though, people will often say that it can’t hurt, because it’s just natural remedies.

Though, that’s not really true.

Once the item is on the shelves, the FDA need only ensure that no safety issues arise from the supplement.  Only if someone reports an adverse reaction or illness is there a chance that said supplement is either removed from the shelf or the company sanctioned.

Next time you wander down that vitamin aisle, keep an eye on all the bottles.  Each one will say what it supposedly helps.  Typically those claims are beyond unclear, stating that they lead to the health of some organ, rather than claiming to reduce the chance of some disease or disorder.

You might see a supplement that claims to support “heart health”.   Planters has a line of nuts that come in various mixes that support heart, digestive and other organ health.  Some claims are even more nebulous, such as a “stress formula” that is claimed to reduce stress levels. There is little to no evidence that any of these claims are true, but there is no need for the companies to do anything other than furnish a single study that supports their claim.

Were the only concerns about herbal supplements the misleading nature of the packaging, I perhaps wouldn’t be writing this post.

In fact, vitamins and supplements can be just as dangerous as prescription drugs.  Even Dr. Oz admits that too much can be dangerous.

This is monkshood. It will kill you dead and never feel bad about it. It also happens to be natural. Therefore, it must also be safe.

The problem is that the FDA is also not really monitoring the amounts within supplements terribly closely.  While companies are expected to attempt to keep contaminants (such as other ingredients) out of and the right ingredients in the right doses in their supplements, there is still gross inconsistency with some supplements.  Often, the amount you think you’re taking and the amount you get are not the same.

One supplement that was recently recalled contained belladonna, an incredibly toxic plant.  In large doses belladonna can be lethal, and in smaller doses symptoms include tachycardia, blurred vision, rash, hallucinations, delirium and about ten other nasty-sounding health issues.

Just imagine if carelessness on the part of the company resulted in large doses making it into some batches. The problem is, that’s not too uncommon.

Beyond all of this, herbal supplements and vitamins, as with any drug, can interact with OTC and prescription drugs in potentially fatal ways.  Additionally, in the same vein as “too much of a good thing”, some of the supplements can be absolutely dangerous in large doses.

So does natural mean safe?  Absolutely not.

7.

As I’ve pointed out, I totally understand why people are tempted to shy away from traditional medicine—at least to an extent.  The reasons I pointed out above certainly are big ones, but there is a deeper reason that I didn’t touch on.

Ultimately, I think that the move toward traditional medicine comes because it is easy and it makes us feel good.  The general idea that people like Dr. Oz espouse is that if we love our bodies hard enough, if we eat healthy enough, take the right herbal supplements and buy the self-help book that Dr. Oz is pushing that week, we can be healthy enough to never need a doctor or traditional medicine again.

On one level, this provides us with control. We love control.  The idea of putting our lives in someone else’s hands is terrifying.  If we can avoid it, why wouldn’t we.

Sure he may have just ripped you off and convinced you that you needed $1000 in repairs you actually didn’t. But the joke is on him, because he’s just a working class schlub. He’s one of Romney’s 47%.

But I think there is an even deeper component to it than that.

It’s one thing when your car breaks down and you have to take it to a mechanic for a fix.  He may spew some words you don’t understand and leave you with a hefty bill, but at the end of the day his position in society is low enough that any arrogance we might see in him is undermined by the fact that society looks down on mechanics.  And not just because they’re blue-collar workers, but also because they are frequently stereotyped as trying to take advantage of customers.

Doctors, on the other hand, seem to stand above us both intellectually and socially.  We see doctors driving nice cars and then we go to their offices to be looked down on.  It is something wholly unsettling for the average person.

In the same way that looking down at the mechanic’s social standing is a way to retain control in that situation, moving toward alternative treatments is the means by which people can knock doctors down a peg.  If all it takes to get rid of your illness is a few herbs, a book Dr. Oz is shilling and some happy thoughts then it is well worth it.  Why?  Because that cure is common sense, and that takes the power away from the doctors and places it back in our hands.  Now doctors are just people with fancy degrees who rely on unnatural drugs to do the same job that herbs can do.  We have undermined them by making their field useless, and in the process made ourselves feel better.

Is this how every person thinks of the situation?  Probably not.  In those for whom this is true, is this a conscious thought process?  Probably not.  But it gets the job done.

Perhaps the best of all of this, though, is that alternative treatments are easy.  To treat your illness traditionally you have to make doctor visits, go to the pharmacy, take medicines and basically spend a lot of time and effort.

Conversely, if you eat right, think happy thoughts and take a few herbal supplements you can avoid all illness and in the end it’s even easier to do than going to the doctor.

8.

The market for alternative treatments is probably not going anywhere anytime soon.  As an industry it is seeing extreme growth across the globe.  People are increasingly wary of traditional medicine and traditional doctors, and until that is fixed people will flock toward alternative medicines.

I typically like to make things personal on my blog.  While I’ve certainly made clear my feelings, I have to say that this is something I have recently become passionate about.  The idea that natural means safe has recently become a part of American culture and it leaves a very sour taste in my mouth, all because it isn’t just my one friend that thinks this, it’s a great deal of Americans.

A lot of people seem to think that natural means something it doesn’t, and they think that wellness is something to be achieved through happy thoughts and watching a doctor on television.

I can’t see that being a good thing in the long term.