“SCIENCE-BASED MEDICINE”?

7 05 2010

I spent quite a bit of time last month doing something unusual for me–following the comment thread on a blog post.  The post was on a site called “Science-Based Medicine,” and its author (whose name I feel no need to repeat, as she is an avid self-promoter) seemed to be an M.D. version of Ann Coulter, full of venom about what she regarded as “unscientific” medicine and quick to make ad hominem attacks on anyone who disagreed with her.

The discussion she sparked was long and far-ranging, and so I kept reading to see if anybody had already made the points I felt were missing.  They were never addressed, but the acrimony grew so great that the blogger in question left the SBM site, and so there was no chance for me to contribute my observations in the context in which they arose.   I think they are very important considerations, and so I am presenting them here, in hopes that my point of view will be helpful to those who are in a better position than I to influence the future of medical practice in this country.

First, some disclosure: I have had a heart attack and a couple of strokes, been hospitalized for them, and am currently under an M.D.’s care and taking prescription medications.  I wish I could deal with my condition using only natural/non-prescription remedies, but my Andrew-Weil-style doctor encourages me to stay with my prescriptions, and I do.  So, while I am skeptical of mainstream medicine, I recognize that it has some value.  I might not be here without it.  In fact, the circumstances surrounding my birth, which was a C-section, make it absolutely clear that I would not be here without mainstream medicine.

Now for the critique.  I would like to begin by questioning whether our current medical model is best referred to as “science based.”  Science undoubtedly has a great deal to do with it, but I think perhaps the initials “SBM,” which the “Science-based medicine” blog uses as a kind of shorthand, should be replaced with “PBM,” with the “P” standing for pharmaceuticals, procedures, patents, profits–and petroleum.  Also, I think the “scientific” basis of modern medicine is perhaps too narrowly focussed, and a truly scientific medicine would include things currently considered “externalities,” to borrow a phrase from economics:  environmental effects, sustainability issues, and affordability.

As I read through other posts on the SBM website, I came to understand that the Ann Coulter clone had been a bit of an anomaly, and that the other bloggers on the site are much more level-headed, sincerely committed to combatting what they perceive as pseudoscience, but still lacking awareness of  my concerns about the future of medicine.

Let’s look at my first four “P’s”–pills, procedures, patents, and profits.  These are the economic foundations of modern medicine.  For-profit drug companies, whose primary obligation is a good return to their stockholders, are constantly on the lookout for new diseases to treat and new, patentable drugs to address these diseases.  Thus we have, for example,  the spectacular rise of psychiatric drugs, the widespread administration of antibiotics to farm animals, and the common use of concentrated female hormones as a method of birth control and a “treatment” for aging.

All these pharmaceutical uses were approved by the appropriate government agencies, who duly studied the scientific evidence for their efficacy and safety.  Unfortunately, we are now realizing that the studies did not go far enough.  There was no consideration of the consequences of  large amounts of these substances entering the environment–where, it turns out, they wreak havoc.  Male animals that live in estrogen-tainted water are becoming feminized; animals living in water that is a tea of mood-altering psychiatric drugs are losing their natural, and necessary, aggressive tendencies, and pervasive antibiotic use has–surprise!–led to the evolution of ever more stubbornly antibiotic-resistant bacteria.

But the expensive, extensive testing regimen that our government demands has had another unintended consequence–there is no profit in testing unpatentable herbs, and no profit in testing or promoting lifestyle counselling that will not only earn nothing for a drug company, but cost it sales as people  become less dependent on pharmaceuticals.  Insurance companies, for example, will gladly pay a doctor $1,000 or more for the minute or two it takes to insert a heart stent, but will balk at shelling out money for the time a doctor would spend helping a patient develop healthier living habits.

Admittedly,  such things are difficult to test scientifically.  People aren’t really all that much alike; fail to recognize an important variable, and test results may be meaningless.

Indeed, test results can apparently change over time.  When they were first introduced, drugs such as Prozac got high marks from double-blind tests; now, when those same tests are repeated, Prozac’s effectiveness in alleviating depression is about equal to placebo, with the ironic twist that the effects it does have sometimes lead to manic episodes that draw its users deeper into a tangled web of mental illness and psychiatric pharmaceuticals.

Can you say, “gateway drug,” boys and girls?

But the real 1,600 pound gorilla in the room with “science based medicine” is the 5th P–petroleum.  From lab research to production to promotion to distribution, mainstream medicine is deeply dependent on a substance which, according to a number of deeply concerned investigators, is about to be in much shorter supply–and increasingly shorter supply–than it has been.

As our access to petroleum diminishes, the plant-based remedies that the good doctors at SBM have so haughtily dismissed will be all that is affordable or available to most people.  The 35% C-section rate that they consider “acceptable” will, in the absence or unaffordability of hospital care, turn into a 35% death rate unless the “woo-woo,” as they call it, of the intimate bond between a midwife and a pregnant woman is thoroughly understood and appreciated.

Let me explain that a little more.  As some of you are aware, I was a participant in “The Farm” community during its heyday in the 70’s and early 80’s. Midwifery and home birthing were an integral part of our program.  The Farm’s midwives, dealing with a physically random selection of pregnant women, had a remarkably low C-section rate–1.8%.   Episiotimies were likewise rare. How did they do it?

The foundation of the Farm midwives’ birthing philosophy is “the same kind of energy that put the baby in there is the kind it takes to get the baby out.”  That doesn’t mean voluptuously erotic–just relaxed and open.  Women in labor were not hooked up to a battery of medical devices.  They were encouraged to get comfortable with their partner, if they had one. (The birthings I helped my wife through included hours of  delightful deep talk, cuddling and making out.) Nobody was in a hurry, but at the same time, the midwives were sensitive to the delivering woman’s state of mind, because doubt and fear, as much as physical discomfort, can keep a woman’s labor in check.  When psychological issues came up, there was enough trust and communication between the midwives, the mother-to-be, and if necessary, the father, to work through the blockages and get the baby moving again.

The thing about this is, that it can’t exist without the right attitude and level of sensitivity.  A “skeptic” can be incapable of perceiving what is obvious to those who are more open-minded, just as a colorblind person sees black and white where the rest of us see many colors.   There is a science to putting people at ease, but there is also an art involved, and art resists quantification.

The overall lesson, for me, from the Farm Midwives’ intense personalization of birthing, is that the relationship between the healer and the one in need of healing (although being pregnant is not in any way a “disease”) can be as important as the technique applied.  Sure, aspirin or antibiotics work no matter who gives them out, but not everything is simple.  In fact, most things aren’t simple.  We need both the science of knowing what to do and the art of knowing how to do it.

Meanwhile, our planetary gas tank is just about empty, and everything we have been doing that was based on having plenty of fuel is going to have to change.  So, if medicine is truly going to call itself “science-based,” it had best be looking to the future, and coming to a good understanding of how to transition into a post-peak oil medical practice that will know which plant-based medicines really work and be a lot more focused on lifestyle, prevention, and self-care than on thousand-dollar-a-month pills, million dollar machines,  and complex surgical procedures.  It’s not that I’m prejudiced against high-tech medicine–it’s just that it looks to me like what we know as mainstream medicine is going to become increasingly unaffordable if not downright unavailable as the cheap fuel/raw materials boom fades into history.

We are going to have to accept that medicine in the future will be much more about palliative care–that is, making people comfortable–than it will be about heroic, energy-intensive life-saving surgeries.  We are going to have to change our basic medical aim from the avoidance of death at any cost to supplying simple ways to ease suffering and teaching dignified acceptance of our inevitable exit from these fragile bodies.

Q.E.D?

music:  Grateful Dead, “Black Peter”

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11 responses

10 05 2010
Beth D

Another problem with our current testing of pharmaceuticals is that they have only to prove that they are better than a placebo (not better than a medication whose patent is ready to expire and certainly not better than an unpatented alternative therapy). Doctors and patients seem to work on the assumption that newer is better, but the testing process doesn’t require any comparisons except with sugar pills (do they really contain sugar?). There’s also a tendency to develop pills for common ailments or perceived ailments (male pattern baldness, anyone?), not less-common ailments without good treatments, but that’s a whole ‘nother can of worms.

9 07 2010
Clarance R

Wow that was pretty awesomely pointless! I mean you essentially attack a position that is poorly defined and broad to the point of meaningless. You also don’t appear to provide the reference to the article on the site you are talking about so it’s difficult to determine if this isn’t some rather large strawman (which considering the breadth of topics it likely is).

The problem with “plant based remedies” isn’t the question of there is no profit in them. One only has to go into a pharmacists to see the scores of untested or completely ineffectual remedies for purchase. If you were to weigh them on the basis of actual effect they would range from being moderately overpriced (B vitamins) to quite literally millions of times more expensive than conventional medicine (homeopathic remedies). Clearly there are large companies making large amounts of money on these natural drugs. Not only that but many – on the same measure – would be environmentally unconscionable.

The problem is they are often of low effect and the chances that most diseases are treatable that way is unlikely. Illnesses that we encounter today are just too complicated to assume that somewhere just the right plant grew to treat that. The previous poster makes a good point trials need to be changed so that new remedies are compared to some existing standard of care. However considering that often plant-based remedies (especially if you mean that as ‘unrefined’ ones) are of low-effect it will likely keep them out of the game.

9 07 2010
brothermartin

Clarance–
First of all, my apologies for not linking to the particular article on SBM that got me going–my commentary was more about the arrogant attitude I found all over the site, rather than the particular article, but here’s the link:
http://www.sciencebasedmedicine.org/?p=3904

It’s interesting to me that you used the term “straw man” to refer to my article–as I read the original article (the one linked to above) I had the term come up in my head quite a bit–the author seemed to me to be berating her concept of “alternative medicine” rather than any real-world practice of it.

As for the rest of it, I don’t think you read my article very carefully. I am not saying herbal preparations are necessarily superior to conventional medicine, and I am not bashing conventional medicine per se. I am simply saying that, considering the future that we are in all probability heading into, we need to consider the likelihood that increasing numbers of people will not have access to high-tech conventional medicine, and make a careful, even-handed study to determine what traditional/herbal/low-tech treatments actually do work, because that may be all that is available to most of us.

A couple of other points–I didn’t say anything one way or the other about homeopathy, so please don’t try to tar me with that brush. I agree that the environmental impacts of some supplements are very iffy–fish oil, for example. There ain’t enough fish left in the ocean to keep us in fish oil, and these days we’re ripping off the whales to get it. I don’t like that.

I think the main “alternative” practice that we need to implement is prevention–through healthier lifestyles, easier access to medical advice and assistance, and a cleaner environment. How does all that sit with you?

9 07 2010
brothermartin

interesting…my attempt to reach “clarance” at his given email address was bounced, ’cause the email address doesn’t exist…most unfortunate that some people are more interested in expressing their own opinion than in engaging in dialogue…dude, i call you out for cowardice!

10 07 2010
Clarence R

That was a pretty simple article. The general point being is that medicine is the likely culprit for longer lifespans and that naturalism is romanticized at times to the point of lunacy. Calling the writer of the same ilk as the person who said “Earth is yours. Take it. Rape it. It’s yours” is completely inane.

Strawman is probably closer to what you did…by definition if you aren’t directly addressing the argument presented (Medicine as a significant contributor to longevity) then yep…you’re making a strawman. Considering your comment was ostensibly aimed at the article (granted now you want to say it was aimed at some broad target like ‘arrogance’ in which case it isn’t a very good counter argument) – contrast that with an article all of which requires to be justified are some examples of alternative health practitioners romanticizing “natural” things, products and practices beyond all reason? That’s not a very hard target to hit.

As for not reading carefully (the arrogance of your statement astounds!). “here is no profit in testing unpatentable herbs, and no profit in testing or promoting lifestyle counselling that will not only earn nothing for a drug company”. I think I responded rather clearly – First it’s not a question about profit in testing – since most herbs fall under the ‘supplements’ in North America and are close to unregulated in many other countries. It’s about profit in selling and as I stated there is most assuredly profit in selling. However were you required to do similar testing e.g. randomized double-blind placebo controlled – often natural are inferior to zero effect (especially if you are talking about something that has no refining whatsoever – i.e. the notion that chewing willow bark would reduce a fever. ) When weigh for effect – the natural products are both more expensive from a environmental and monetary point of view. So if you do believe that most people in the near future be able to afford anything but to chew willow bark for fevers. That may be so – I doubt it as medicine is an economy of scale – but like many prognosticators you can just keep pushing your prediction further out until say the heat death of the universe or something. Anyway, the more correct statement is just that if medical treatment is expensive (and assuming it’s not socialized) – most people will be treated less. The ‘natural’ element is orthogonal.

The other interesting part of your response is the out-of-the-blue creation of a completely different conclusion. That we need to determine which ‘natural’ remedies work. Fact of the matter is that this actually gets done and not by whom you might think. The journals dedicated to natural medicine publish cheap low-quality studies which are far closer to hypothesis generating than anything else. Large scale studies like say for ‘vitamin c’ (and considering how you have persisted in being ridiculously vague it’s impossible to tell if this falls under your definition of ‘natural’) are sometimes done by large medical organizations (in this case the Mayo clinic). So the fact of the matter is if vitamin C really did say…cure cancer (as Linus Pauling thought when he went nuts) we’d already have the evidence and it would be part of standard practice by now. So if you want a simple, statistical reason for ‘natural’ medicine proponents thinking there’s some great cure that people don’t know about (or the pharma companies are trying to keep down) and the EBM practitioners who pooh-pooh it it’s probably as much about their choice of reading material as anything else. Studies that get published in journals about naturopathy probably couldn’t get published anywhere else (well other than ‘Medical Hypotheses”).

It’s true that you didn’t say anything about homeopathy but that’s irrelevant it’s just a bounding case. Homeopathy represents the high-side of the effect-weighted medicine spectrum. It can not have any effect, ergo creating homeopathic remedies can never make a cost/benefit analysis work – environmental or otherwise.

I think that we can agree on prevention – however it’s interesting to listen to doctors talk about these kinds of things. I’ve yet to year a doctor actually deride prevention and every doctor I’ve met complains about how patents don’t listen to the simple lifestyle advice: Keeping your BMI + Waist size in a healthy range. moderate exercise, stop smoking or other life limiting habits. Considering that these things form the strongest correlations to the worst (and most expensive sociologically) of our diseases and that this kind of prevention advice is taught to the average North American from high-school on. I wonder what kind of prevention advice you think people need. Anything other than these would be majoring on a minor as they say.

wrt my email address. Yes, I don’t give it out. It’s just a mater of privacy – please spare me the drama when this one doesn’t work either.

10 07 2010
brothermartin

Well, bless your heart! I apologize for calling you a coward. Thanks for responding.

Certainly some “natural health” advocates exaggerate what is possible, and I wouldn’t dispute the contention that modern medicine has overall resulted in longer lifespans. The fact that I’m here at all is due to the fact that my mom had a C-section in her 10th month of pregnancy, but on the other hand, I suspect a competent midwife could have figured out the psychological factors that were keeping her from going into labor and helped her deliver naturally….but that IS speculation….

Back to the SBM article–I think Ms. Tuteur’s assertion that “natural health advocates” yearn for the pre-scientific past is completely unwarranted. That’s some of the sense in which I think she was creating a “straw man.”

you said:
Calling the writer of the same ilk as the person who said “Earth is yours. Take it. Rape it. It’s yours” is completely inane.

response: there’s a spectrum of involvement in the degradation of the planet, and we’re all involved, including me…we can’t only call out the worst offenders, we need to work on everybody, including (and especially) ourselves…..I write what i write, as the blog title states, in an effort to see things in a life-centered perspective (and not necessarily a human-life centered perspective)

The profit motive question–i have done some research on pharmaceutical manufacture, and it is shocking–pills made for pennies sell for dollars. In my own life, I found I could buy prescription niacin to reduce my cholesterol for $70 a bottle, or buy the same quantity of non-prescription niacin for about $5 a bottle. The non-prescription stuff worked just fine.

Double-blind tests are a great idea–the problem arises because companies so frequently manipulate the results they get, because they want to earn back the huge sums they have invested in drug development–and pay their executives and stockholders.

My “we need to determine which natural remedies really work” conclusion was not “out of the blue.” It was there all along. As I said, I’m not attacking conventional medicine per se, just questioning its long-term viability and suggesting that we might want to come up with lower-tech alternatives while we still have the luxury of formal research.

“chewing on willow bark to reduce a fever”–i think that sometimes modern medicine gets hung up in stopping symptoms and loses the big picture–as long as it’s not too high, fever is the body’s way of burning out pathogens–and you don’t have to chew on raw willow bark, alcohol extractions of the active ingredients in herbs are an effective, low-tech way to concentrate medicinal alkaloids….

As far as what kind of prevention advice people need, i think people need more than just an intellectual message. Habits that lead to illness (overeating, poor nutrition, lack of exercise, emotional insecurity, just for openers) often have deep psychological roots that are further re-enforced by our highly commercialized society, which of course has no real interest in helping people resist its seductions.

Nuff from me for now….again, my apologies for dissing you, and thanks for continuing the conversation
m

10 07 2010
Clarence R

I suspect that Ms. Tuteurs experience parallels my own seen many natural heath advocates want to not just a return to a more risky historical modality (i.e. raw milk but I could name a hundred – easy!) but actively argue against the scientific method and the use of strong statistical evidence (double-blind placebo controlled studies) in favor of weaker anecdotal systems.

I agree that there’s a spectrum of involvement which is why – without some further evidence – that calling the writer Ann Coulter is unwarranted.

Until today I’d never ever heard of ‘prescription niacin’. I’ve or even heard of a doc writing a script for a vitamin – unless it was going to be claimed on insurance (as insurance regularly requires a script for reimbursement). The only possible reason I could think of to get a pharmacist or pharmaceutical company to produce a commodity product was if there was a significant and specific dose requirement – and now that I look it it up it seems there is. So to backtrack a little – the reason you would want this is because for lipid control you need on the order of 1000x the daily requirement to achieve clinical effect. Off-the shelf vitamins are notorious for bad quality control. Tests have been done showing near-zero to 10x the label value. Considering most people do not have a mass spectrometer at home and this is something which is potentially life-threatening I’d personally opt for the more expensive product – however unjustified that price tag might be. This is similar as to why someone takes a prescription form of ASA to prevent cardiac events. However in this case it’s not that the dose is imprecise (in the case of the pill – if you are using willow bark then it would be a problem) but that clinical effect needs a daily low dose. Taking an 325mg tab of ASA every day is likely detrimental to your health.

Concerning double-blind studies. Companies are out for profit and do attempt to get their money’s worth – that said evidence suggests they don’t manipulate in quite the way you appear to be suggesting. Actual scientific fraud is rare and career destroying (unless like Wakefield you can earn a living playing victim). What pharmaceutical companies do engage in could be corrected relatively easily. For example, if as I’ve mentioned before the FDA complied fully with the 2000 Helsinki Declaration – which requires placebo testing only when there is no existing treatment. It would do at lot for having the market flooded with drugs that are difficult to differentiate.

re “lower tech alternatives” – I’d stand by the fact that for most diseases lower-tech alternatives do not and likely cannot exist. There is simply nothing ‘low tech’ that can approach antibiotics and vaccinations.

re ‘bark” I agree that willow bark for fever is a symptomatic suppression. I also agree that taking an antipyretic is not especially useful to ending ones illness (however I haven’t seen any hard evidence to suggest it’s detrimental). The reason I used ASA (or Saylix) as an example is because it’s commonly referenced as a natural treatment. Ironically – based on the most detailed historical accounts – it’s likely that nobody has actually used willow bark to reduce a fever. The symptom vs disease dichotomy is a false one – the idea that modern medicine is over concerned with symptom suppressing – is an oft parroted but rarely supported statement. Fact of the matter is that likely nobody is in the position to generalize any medical system. What’s interesting about your usage is that you didn’t say what you were comparing it too. Eastern medicine, Naturopathy? Again the facts are all illness presents as symptoms – if it didn’t how would you know you were sick? Ergo all treatment is a response to symptoms and outside of some other hard endpoints (i.e. mortality) every medical modality, every lifestyle choice is going to be measured by symptoms.

wrt “chewing vs alcohol extraction”: The reason I refer to chewing on bark was to talk about the ‘lowest tech’ way of using this compound. Alcohol extractions are fine – however again there is no reason to believe that this is cost-effective or even effective as an antipyretic and likely getting those levels is probably more environmentally detrimental than doing an extract from coal tar.

re “prevention advice” I’d suggest that people already get this kind of advice from their doctors – probably with every physical – not to mention in school. As to why most people don’t act on this? The cause seems likely multifactorial – one novel idea could be something as simple as: “We live too long”. A child in a society with a mean life-expectancy of nineteen (early post agricultural) would at an early age try to adapt to behaviors that would extend their life. Today we work hard to isolate children from anything that would make them responsible for their own actions.

12 07 2010
brothermartin

Clarance–
Sorry to take so long getting back to you—yesterday was that ol’ second Sunday and I had another radio show to write….

The first thing that occurs to me is that, if you or any other reader doesn’t share my perception that our high-powered, high-tech way of life is in the process of unraveling, then my sense of urgency about finding a “middle way” medical practice might not make a whole lot of sense. However, I think that, even if there is no collapse, a more holistic, nuanced, less commercialized medical system still makes more sense than our current model.

What do I means? Some of those words are pretty loaded, nu?

Holistic–an especially loaded term–I mean a medical system that looks at the whole person–body/mind/socio-economic matrix. I think it would take some kind of social revolution, really, because our current society, imfao, fosters illness much more than health. At the physical level, there’s the vast array of, as Michael Pollan calls them, “food-like substances” that are pushed on people by the corporate establishment. Mentally, we see it in the use of psychiatry to adjust people for life in a crazy world rather than challenge the craziness of the world. Of course, that goes all the way back to Freud stepping back from the brink with “Civilization and its Discontents,” and it’s unfortunate that the seminal psychologist who chose to analyze and challenge the craziness of the world–Wilhelm Reich–ended up going over the edge himself, discrediting the brilliant work he did in the thirties with all that woo-woo about orgone energy and cloud-busters…but I digress..

“More nuanced”–health care more along the Chinese or Cuban model, where there is a hierarchy of health care providers from the neighborhood to the hospital, the simplest treatments are tried first, and anybody who can be adequately taken care of at a lower level, at less expense, stays at the lower level. For example: I initially went to a walk-in clinic with my heart condition. They gave me an EKG and told me I had atrial fibrillation and needed to get my ass to the hospital ASAP. That cost me $90. I walked into the emergency room and they gave me an EKG and told me I had atrial fibrillation and charged me $1100. That in itself nearly gave me another heart attack!

Anyway, “more nuanced” also means being more sensitive to the patient’s well-being than the doctor’s–or staff’s–convenience. Example: The last time I went to the heart clinic I started at, they kept me waiting for an hour or two past my scheduled appointment time, in a waiting room where a TV was showing a horror movie–sudden shots of decomposed bodies, ghouls, stalkings–as close to R-rated as they could push it. I finally prevailed on the receptionist to switch the channel. What a thing to do to a room full of cardiac patients!

When it was finally my turn to be seen, i walked into the exam room and a nurse immediately took my blood pressure, while I was still standing up. Not surprisingly, it was 140/90ish, and based on that the doctor, who was harried, hurried, and hard to talk to, wrote me a prescription for an anti-hypertension drug (liosprin?). Once i read the label warnings, i was not interested in taking it, as it seemed incompatible with the way I live–we homestead, and I am involved in cutting firewood, building new structures, gardening, etc…we also live without air conditioning, and it sounded like if you were gonna take this stuff and not have a bad reaction to it, you’d have to hole up in a barcalounger in an air conditioned room for the rest of your life–which would tend to give you high blood pressure, nu? A friend of mine sees a doctor who helped her drop her blood pressure 20 points simply by having her drink a lot more water every day. Excuse me a minute, I’m going to get a glass myself….

Less commercialized–I think we would have a much saner health care system if the profit motive were removed from all aspects of it–from education to pharmaceuticals to hospital care. Sure, MDs have worked hard to acquire a serious skill that can be quite stressful to practice and are entitled to generous compensation in return–but what’s anybody really need more than $100K a year for?

Amy Tuteur as Ann Coulter–I don’t know if you read down the incredibly long comments thread on “Longing for a Past That Never Existed,” but I did, and I found Dr. Tuteur to be all too frequently abrasive if not downright abusive to anyone who disagreed with her. Her stock response to any criticism of her style was/is “you’re just projecting your hostility on me.” I saw no evidence that she was interested in actually listening to those who disagreed with her, let alone entertaining the notion that anything she said might be wrong. As I looked at other posts of hers, I saw the same kind of exchanges, and I suspect this had something to do with her departure from the SBM site. Certainly it is not a quality I would want in a doctor that I was working with.

About prescription niacin–I have been taking 2100 mg a day for about a year now–my lipid levels dropped from dangerously high to barely above normal, and the last time I had a lipid panel was December–I will be checking again in August. I tried statins (hey, if they’re good enough for Andrew Weill who am I to turn my nose up at ’em?), but had a strong negative physical reaction to them–leg cramps, mostly–and my own research on them made me wonder if they had really been tested long enough to assure that there are not hidden, long-term side effects–plus, I don’t like being dependent on prescription drugs. Metaprolol and Warfarin and my glaucoma drops are bad enough. They told me I’d be taking furosemide for the rest of my life, but I managed to get off of that already–so I am hopeful about the future. Don’t like being dependent on complicated things–not that RX drugs are the only complicated things in my life…this computer, my pickup truck…..a teacher of mine said, “you have to eat, drink, sleep, breathe, poop, and piss–everything else should be optional.”

I also eat a lot of oyster mushrooms, a natural source of statins, in season. (They grow wild on our land.) Do not have a problem with statins in that form. More on that as an herb question in a bit.

As far as the purity of non-prescription supplements goes, the thing about niacin is, you know if you got some or not. (Temporary flushing while I go about my business during the day is a lot easier to handle than leg cramps when I’m trying to fall asleep at night!) The question is of concern to me,though, especially with so many things being made in China these days. They don’t seem to have much in the way of scruples over there. There is an independent test lab that some supplement makers use to verify that their products deliver as promised, and I buy most of my supplements from a brand that has itself tested.

Your comments about regular aspirin being a dangerously high dose are of great interest to me, as the cardiologist I saw after my heart attack is the one who told me to take one regular aspirin every day. I know there have been serious questions about daily aspirin use, and I will talk to my doctor about this when I see him next month.

The honesty of medical studies is a fairly hot topic. My perception is that there has been a lot of fraudulent claims. There is a lot of money at stake and it’s hard to contest a company’s claims if the company doesn’t want you to–as you say, most people don’t have a mass spectrometer sitting around the house. This link
http://corporatecrime.wordpress.com/2009/10/29/failing-the-drug-test-fraud-and-misconduct-in-corporate-clinical-trials/
is just one example of the stories about what goes on out there….I did a story on it myself a while back…
https://brothermartin.wordpress.com/2006/07/14/big-time-drug-dealers/

I think science’s tendency to look for one main “active ingredient” can lead it down the wrong path…examples are reservatrol, which appears to be much more effective when taken in a more natural way with other compounds from the plant, and marijauna, in which the THC is modulated by other “non-active” ingredients, and tests repeatedly show that patients prefer marijuana to marinol because of this.

Well, I’ve probably responded much more volubly than you expected. There’s a thunderstorm rolling in, and I think it’s time to shut the old computer down. Thanks for giving me some things to think about…hope I have been of similar service to you.

m

17 07 2010
brothermartin

just read this and i think it’s relevant to the topic:

“Healthy adults who reach for common painkillers to ease the twinges of everyday aches and pains could be setting themselves up for a heart attack or stroke, according to recent research.

“Past studies clearly showed that long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), including Advil, Motrin and Aleve, to relieve pain was linked to an increased risk of heart attack or stroke in those who already had heart disease.”

http://www.aarp.org/health/drugs-supplements/info-07-2010/common_painkillers_increase_heart_risks_in_healthy_people_.html?cmp=NLC-WBLTR-CTRL-71610-F1-1

the unintended consequences of modern medicine….

7 08 2010
BUILDING BRIDGES « DEEP GREEN PERSPECTIVE

[…] ice was broken.  “Clarance R” went several rounds with me on “SCIENCE-BASED MEDICINE” largely on the basis that plant medicines couldn’t possibly be as effective as […]

20 11 2010
brothermartin

Andrew Weil weighs in:

“Expensive as it is to the consumer, this faith in “single-agent” drugs would be acceptable if they actually yielded better results. But the fact is, the natural, whole plant often has both benefits and safety that put the isolated compounds to shame.

“Medicinal plants contain a wide array of chemical compounds. At first, this looks like chaos, but more investigation reveals a distinct order. Natural selection pressures push a plant to “try out” variations on molecules to enhance the plant’s odds of surviving stressful environments. So, often, one molecule is present in the greatest amount and has the most dramatic effect in a human body — but along with it are variations of that molecule in the same plant.

http://www.huffingtonpost.com/andrew-weil-md/why-plants-are-usually-be_b_785139.html

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