“Natural medicine” non-starters
Followers of Intelligent Medicine are familiar with my frequent critiques of the excesses of orthodox medicine. Where appropriate, I favor natural solutions. But in the spirit of fair play, I’ll share that the world of natural medicine is not without its foibles. Here, at the risk of stepping on some toes, I take aim at some of the fads that haven’t stood the test of time or should be consigned to history’s dustbin.
Red yeast rice: It may disappoint some of you, but I’m not a fan of RYR for cholesterol management. RYR gives Peking Duck its unique flavor and taste. It is made by growing a red mold called Monascus purpureus on white rice. People in Asia have used this colored rice for cooking and healing since about 800 A.D.
The cholesterol lowering effects of certain fungal species were discovered by Japanese researchers in the 1960s. It turns out that the monacolin K found in RYR is identical to lovastatin (Mevacor), the first statin drug.
But here’s the thing: If you really need to lower your cholesterol—and not everybody does—why take an herb in lieu of a medication? The aura of “natural” makes RYR sound more wholesome, but since its active ingredient is a statin, it can produce the very side effects that refusers of statin drugs seek to avoid: depletion of Coenzyme Q10, muscle aches, liver problems, elevated blood sugar, and rarely, even cognitive problems.
Moreover, the actual statin content of different RYR supplements varies unpredictably. Mostly they’re weaker than prescription statins, lowering cholesterol by only around 10%, which may not be enough. At least with a drug you’re getting a standardized dose, which can be adjusted to reach a targeted reduction.
There’s also the threat of contamination of RYR with a harmful byproduct called citrinin, a mycotoxin that can damage the kidneys.
It makes no sense. These days, if you have headache, why strip white willow bark off a tree and laboriously boil it to make salicylic acid tea when you can simply take an aspirin? When needed for cholesterol management, why get a weak statin from a health food store instead of a potent and reliable one from a pharmacy?
Thyroid “glandulars”: I’m a big fan of natural thyroid derived from bovine or porcine sources—like Armour Thyroid, Natural Dessicated Thyroid (NDT), NP Thyroid—available by prescription under a doctor’s supervision.
By contrast, thyroid “glandulars” are sold over-the-counter, marketed for energy, weight loss, and “thyroid support”, even as a natural alternative to prescription thyroid medication.
Over the ages, people have taken animal extracts—organotherapy—to address organ dysfunction. One might turn to liver extract for a liver problem, or bull testicles to enhance virility. But there’s scant evidence that taking these supplements orally will help.
But prescription thyroid extract contains substantial amounts of thyroxin (T4) and liothyronine (T3), identical to what the thyroid produces naturally. When properly formulated and standardized, they offer significant advantages over synthetic thyroid medication containing T4 alone.
At least you know what you’re getting.
On the other hand, glandulars that you buy online or in a health food store are, per FDA requirements, supposed to be free of residues of T4 and T3. That’s because, if taken inappropriately, they could cause symptoms of hyperthyroidism like heart palpitations or even atrial fibrillation, bone loss, or agitation; alternatively, they might produce misleading blood test results if taken concurrently with prescription thyroid medication.
Contrary to regulations, these supplements contain detectable amounts of active thyroid hormone. A 2013 survey found:
“The majority of dietary thyroid supplements studied contained clinically relevant amounts of T4 and T3, some of which exceeded common treatment doses for hypothyroidism. These amounts of thyroid hormone, found in easily accessible dietary supplements, potentially expose patients to the risk of alterations in thyroid levels even to the point of developing iatrogenic thyrotoxicosis. The current study results emphasize the importance of patient and provider education regarding the use of dietary supplements and highlight the need for greater regulation of these products, which hold potential danger to public health”.
Other “thyroid support” supplements contain no glandular extract, but furnish iodine and/or selenium, teamed with adaptogenic herbs like ashwagandha. These are less dangerous, and may confer some modest benefits, but, if you’re really hypothyroid, they’re no substitute for prescription thyroid from an experienced health practitioner.
Why take a chance on sketchy thyroid supplements that may or may not contain active thyroid, at doses that vary all over the map, when rational options abound? For more advice see “Bovine Thyroid Glandular Supplements: A Real Hormone Hidden in a ‘Natural’ Label”
Transdermal vitamins: Tired of swallowing all those pills? No worries! Barrière and other slick start-ups have got you covered. Now you can get your supplements via transdermal patches:
“Wear your vitamins; self-care that sticks. With Barrière patches you simply peel, stick, and wear. A convenient and effective solution delivering vitamins directly through the skin.”
True, scopolamine patches work for sea sickness, and topical patches have proven a reliable delivery system for the heart med nitroglycerin. Estrogen patches and testosterone gels are readily absorbed and are preferable to oral formulations.
But when it comes to vitamins and minerals, the gut is uniquely adapted for absorption of critical nutrients. There’s scant evidence that most vitamins and minerals can traverse relatively impermeable skin barriers.
A 2017 study put that to the test. Gastric bypass patients offer a perfect challenge. They’re surgically modified to malabsorb nutrients—hence weight loss. They require careful supplementation to avoid critical deficiencies. 41% of orally-supplemented bypass patients were found to have at least one deficiency. But when treated with transdermal vitamins instead, 83% lacked sufficient levels of one or more vitamins.
Statistically significant lower postoperative serum concentrations of vitamin D, B1, and B12 were seen in the patch group.
The “evidence” touted by makers of these transdermal patches is not based on scientific studies; rather, it consists of anecdotal raves by users experiencing a subjective placebo effect—just wishful thinking.
EDTA suppositories: I’ve long been a big proponent of intravenous chelation therapy, using EDTA, for cardiovascular prevention and heavy metal detoxification. I’ve seen it help patients with blocked arteries in their legs (claudication) regain the ability to walk substantial distances pain-free.
But it’s an arduous treatment course. Chelation requires as many as 30 to 40 sessions of three hours or more, and insurance doesn’t cover it.
In the 90s, audacious claims were made that you could bypass all those IVs with rectal EDTA suppositories. Proponents professed that rectal EDTA could remove plaque from blocked arteries and even showed pre- and post- calcium scans as “proof”.
I was skeptical then, and my hesitation has been borne out, although EDTA suppositories are still hawked on the internet as a safe, non-invasive alternative to intravenous chelation.
There’s simply no evidence that rectal administration of EDTA can achieve blood levels comparable to those achieved when it’s given IV. And no studies confirm it can unblock arteries. Moreover, even were it well-absorbed—which it’s not—it should be administered under the guidance and monitoring of a physician trained to protect patients from harmful effects.
I should know—I taught doctors how to safely perform chelation for decades and even helped design NIH studies on the procedure.
BOTTOM LINE: Unscrupulous marketers keep taking advantage of credulous consumers to promote half-baked nostrums. Maintain your health literacy to avoid falling prey to dubious products.