Is Modern Medicine Killing You? – Episode 5

By Michael Edmonds 14/11/2012 25


What I have learnt from the episodes so far

  • Many New Zealanders (or at least many of those appearing on this TV show) appear to have poor diets
  • If it a condition is even vaguely muscular then give them magnesium
  • Many people ignore, or at least don’t fully follow the advice of doctors

In episode 5 we met Ben, a 24 year old athlete who has had to restrict his activity due to back pain. Having previously consulted several chiropractors (with no benefits), a physiotherapist (some relief) and using the anti-inflammatory, Voltaran (little effect) he came to Dr Pitsilis for advice. During the consultation it came out that a previous physiotherapist had identified issues with his hip flexors and weak abdominal muscles, though it is not clear whether this was followed up with a suitable exercise programme. His diet was identified as high in starch and sugar and too low in protein, something I found quite surprising for someone who had been a high achieving athlete. Dr Pitsilis also identified that his testosterone levels were lower than expected. After prescribing Ben “anti-stress” herbs (winter cherry, ginseng and rhodiola and having him consult a sports physiotherapist for strengthening exercises as well as improving his diet, Ben felt better but was still experiencing the same level of pain. Dr Pitsilis then prescribed testosterone cream, and after a few more weeks the pain had cleared.

So a conventional medical approach (physiotherapy) plus a drug (testosterone), plus patience dealt to the pain, while an improvement in diet improved his sense of wellbeing (I’ll come back to the “anti-stress” herbs later).

Sara, 42 had for many years suffered from painful endoemetrisosis, which hadn’t been helped by a botched surgery to help it, where the bowel was nicked and major surgery was required to save her life. In consulting Dr Pitsilis, Sara did not want to use drugs, so “bio-identical” progesterone was suggested, alongside dietary changes including fish oil, a gluten and dairy free diet, and various “herbs” – boswellia, ginger, curcumin and quercetin (note – the last two “herbs” are not herbs but specific compounds extracted from herbs).

After making these changes, Sara experienced an increase in pain and sensitivity which was put down to the progesterone. This is not surprising as whether or not it is “bio-identical” progesterone is a drug. Dr Pitsilis responded to this change by pointing out that “even a so-called natural therapy can upset people” and suggested the use of the contraceptive pill instead. However, Sara found that just the changes in diet and supplements were enough to improve her quality of life – a good result.

In each case I have seen in this programme, the “integrative” doctor prescribes multiple changes making it difficult to pinpoint which components are having an effect on the patients health.

Herbal mixtures are made up of hundreds of different compounds, of which only a small minority will have a beneficial effect. The amount of these compounds can vary from batch to batch which, in my opinion, makes herbs a potentially less reliable approach. However, there is some evidence that synergistic effects of compounds in some herbal remedies might have benefits. At the moment there is some evidence for the successful use of herbs such as ginseng in treating specific conditions such as diabetes but there is no scientific evidence I can find that some of the herbal mixtures listed above are effective for treating “stress”, a condition which could be readily influenced by both the placebo effect and improvements in diet and exercise.

*Apologies for missing episode 4, work has been hectic the last couple of weeks.

 

 

 


25 Responses to “Is Modern Medicine Killing You? – Episode 5”

    • Possum,
      Thats a good question, Drug tests certainly can’t distinguish between “natural” testosterone and “synthetic” testosterone (seeing they are identical).

      Jean,
      yes it worries me too. On line there are a lot of people who feel that (bio-identical) progesterone has benefits, but because it is marketed as “natural” the assumption is that it is safe. If I remember correctly the use of hormones can raise the risk of some cancers. Such things need to be taken into account so that the risks and benefits of any drug can be weighed up and the patient monitored for side effects where appropriate.

      Also, another issue with herbal medicines is that some do interact with drugs and this needs to be taken into account. I have no problem with the use of herbal medicines for which benefits have been shown, and which are produced in a reliable fashion, however they need to be treated like drugs in that they may interact with other drugs a patient is taking and that needs to be taken into account.

      Overall, while I have some minor concerns about how some treatments are presented in this programme, I do think the programme is doing a good job in terms of showing how important diet, exercise and sleep is, and also note that they have stayed away from many of the unproven alternative “medicines” such as homeopathy, reikki etc

  • Totally agree Michael – who is sponsoring this programme? The use of steroids, sometimes under a different, natural name, worries me.

  • Micheal – drug testing can, and does, determine the difference between synthetic and natural testosterone.

    Synthetic comes from C3 plants such as yams, and a good mass-spec can sort the carbon isotopes. From memory, Floyd Landis was caught because of his isotopic ratio. It is complicated because our diets include both C3 an C4 plants, but the doping agencies apparently have that covered.

    • Bruce,

      You are of course correct, drug testing can tell the difference between synthetic and natural by looking at the isotope ratios, however this has very little effect on the chemical properties of the drug, and certainly doesn’t support the argument that naturally sourced molecules are better than synthetically produced molecules.

  • Maybe Ben’s back pain resolved due to
    ‘Tincture of Time’? In other words, it would have gone away anyway if nothing had been done? Who can say? Crediting the recovery to the testosterone cream seems to be a classic case of post hoc ergo propter hoc fallacy.

  • Michael, you say, “however they need to be treated like drugs in that they may interact with other drugs a patient is taking and that needs to be taken into account.”

    Are you aware that many foods interact with pharmaceutical products? Grapefruit juice, for example, can raise some lipostatin blood levels x15. Who are the biggest consumers of grapefruit juice? Older people who are more likely to be prescribed lipostatins. Alcohol, brocolli and dozens of other foods affect metabolism of pharmaceutical drugs. Should they be treated like drugs? Ginger eaten in food is no different to ginger eaten as a herbal remedy. Are you suggesting they should be regulated as drugs? What about garlic?

    • Paul, the full quote was “I have no problem with the use of herbal medicines for which benefits have been shown, and which are produced in a reliable fashion, however they need to be treated like drugs in that they may interact with other drugs a patient is taking and that needs to be taken into account.”
      If herbal remedies are having an beneficial effect, like drugs (i.e.they contain an active component) then I think the only safe thing is to treat them like drugs.
      Your point about foods which interact with drugs is a very thoughtful, one I had not considered. Patients should certainly be aware of them, but as they are not typically claimed to have a druglike effect themselves I think this is where the difference lies. Certainly something to think about further though – where do we draw the line between what should be treated like drugs and what is not?

  • ” but as they are not typically claimed to have a druglike effect themselves I think this is where the difference lies. ”

    Bioactive ingredients in foods are the same as those in supplements.

    http://www.nlm.nih.gov/medlineplus/druginfo/natural/300.html
    “Garlic is an herb. It is best known as a flavoring for food. But over the years, garlic has been used as a medicine to prevent or treat a wide range of diseases…”

    The body doesn’t know political distinctions between food, herb, supplement. or drug when the same substance can be all three. A capsule is simply a small convenient container. It doesn’t define what is or isn’t a food or drug. The European Courts have ruled that to define a substance as a drug because of the way it is presented is illegal [In Europe].

  • The same website you link to, Paul, describes garlic-used-as-medicine as ‘possibly effective’, ‘possibily ineffective’, and ‘insufficient information available’. It also says that ‘some’ uses may be supported by science. In other words, the phrase ‘used as a medicine’ is fairly loose.

    One of the differences between ‘food’/’herb’ & drug is surely that in the latter, the dose provided is known & should not vary between one capsule & the next. Another is that ‘food’ is not a single chemical but a range of complex molecules (where it can be rather difficult to tease out which one is having a particular effect), whereas ‘drug’ is a pure form.

  • “The body doesn’t know political distinctions between food, herb, supplement. or drug when the same substance can be all three”

    Assuming this statement is true, that we cannot distinguish between drugs, herbal supplements or food, then that would suggest to be consistent we much either 1) regulate all groups or 2) deregulate all groups. Given the potential dangers of the second option it would be sensible to regulate all three.

    However, I think we can differentiate, because whether something is a drug, herbal medicine or food with bioactive properties, these properties come from one (or in some cases a small number of) bioactive compounds.
    In some respects it seems more sensible to regulate any substance with enough of a bioactive compound to have a significant effect on the body if it is possible to take large enough doses that could be harmful. This is not usually a problem with foods, is almost always a potential problem with drugs, with herbal medicines, in my opinion, sitting in the middle.
    SOme herbal medicines will not contain enough bioactive substance to have any useful effect in which case one might ask what is the point in taking them. WIth those herbal medicines that do have a (beneficial) biological effect then typically an excessive dose is most likely to be harmful. Thus, it would seem sensible to treat them as a drug.

  • Alison, I agree “‘drug’ is a pure form”. Michael, the statement was that ““The body doesn’t know political distinctions between……” not “that we cannot distinguish between…….”

    You say “that would suggest to be consistent we much either 1) regulate all groups or 2) deregulate all groups.” Why? Shouldn’t the need for regulation be based on risk? From what I’ve seen the risks from consuming a supplement are less than from consuming a food and far far less than from consuming a drug. Do we regulate prams, push bike, cars and trucks in the same way?

  • PaulS

    Indeed, basing regulation partially on risk would be a good approach, however, I’m not sure how you justify the statement that “the risks of consuming a supplement are less than consuming a food”
    As well as basing regulation on risk, it would also make sense to base it on efficacy as well – taking a supplement with little risk but no efficacy would be like buying a car without an engine – low risk of having an accident but no use at all for getting anywhere.
    There are certainly supplements that are important for our health, however, these often have risks associated with them if taken in excess (the difference between a benefit and a poison is down to the dose).
    Also it would be a mistake to assume that supplements are all we need for good health – as the programme has very clearly demonstrated diet, exercise and sleep all contribute to good health but at times drugs are needed to deal with some health conditions. (note – this is not a view you have suggested but is certainly one which is sometimes encountered amongst some supplement advocates)

  • PaulS

    Your pram, push bike, car and truck analogy is a good one. While we do not regulate them all according to the same rules, they are all regulated in relation to what they are used for. A analogous approach certainly would be appropriate for foods, supplements and drugs. If supplements are used to TREAT disease then similar regulations as apply to drugs would seem to be appropriate don’t you think? (e.g. a study of potential toxic effects, efficacy etc)

  • ‘PaulS’ wrote: ‘Do we regulate prams, push bike, cars and trucks in the same way?’ All of these are regulated. Of course, they’re regulated in different ways – they’re different things.* But they’re all quite strongly regulated in their different ways. Same for supplements, food and drugs, or should be.

  • Grant, they are different things just like food, supplements, and drugs are different things. However, they are all transport devices.

    You don’t need a license to sell a pram. A pram doesn’t need a WOF. Neither does a push bike. I agree with you that supplements, foods and drugs should be regulated in different ways with different mindsets.

  • PaulS

    You wrote: ‘You don’t need a license to sell a pram. A pram doesn’t need a WOF. Neither does a push bike.’

    You originally wrote about safety regulation, not licenses to sell or WOFs: I responded to that. I wasn’t talking about what bits of paper declare them ‘done’, but that they have standards to meet for safety. I’d have thought was the point at hand not the particular paperwork/certification scheme used.

    You wrote: ‘I agree with you that supplements, foods and drugs should be regulated in different ways with different mindsets.’

    Sorry, but this has you ‘agreeing’ with something I didn’t write. Scratch the ‘should’ and ‘with different mindsets’. ‘Mindsets’ adds a spin to it, one not coming from me! It would seem to be want you think/want. (If anything, what I wrote had one ‘mindset’ – safety.)

  • I would agree with Paul. In practical terms, regulating curcumin under the same act as propranolol would simply make it impossible to regulate either properly.

    Anyway, magnesium deficiency; psychiatrist Dr Emily Deans has referenced the clinical evidence here: http://www.psychologytoday.com/blog/evolutionary-psychiatry/201106/magnesium-and-the-brain-the-original-chill-pill

    to quote Dr Deans:

    “As I mentioned before, there are only a few controlled trials of magnesium supplementation and psychiatric disorders. A couple covered premenstrual dysphoria, cravings, and other symptoms (8)(9). Another small study showed some improvement with magnesium supplementation in chronic fatigue syndrome (10). Two open-label studies showed some benefit in mania (11)(12). There is another paper that postulates that magnesium deficiency could exacerbate the symptoms of schizophrenia. However, there is nothing definitive. Which is, of course, quite troubling. How many billions of dollars have we spent on drug research for depression, bipolar disorder, and schizophrenia, when here is a cheap and plausibly helpful natural remedy that hasn’t been properly studied?

    So everyone get out there and take some magnesium already! Whew. Well, just a few more things to keep in mind before you jump in.

    There are some safety considerations with respect to magnesium supplementation. If you have normal kidney function, you do not have myasthenia gravis, bowel obstruction, or bradycardia, you should be able to supplement without too many worries. In addition, magnesium interferes with the absorption of certain pharmaceuticals, including dixogin, nitrofurantoin, bisphosphanates, and some antimalaria drugs. Magnesium can reduce the efficacy of chloropromazine, oral anticoagnulants, and the quinolone and tetracycline classes of antibiotics.”

  • George, thank you for the interesting link to Dr Emily Deans, though the information looks tentative – anecdotal plus medical hypotheses publication suggests early work exploring magnesium.
    I’m also not sure if NZ water treatment is likely to remove magnesium.
    It is a very intriguing idea. It is a pity the TV programme wasn’t more explicit in why Mg was being prescribed

  • In lab tests, curcumin seems to block the growth of certain kinds of tumors. One study showed that turmeric extract containing curcumin could — in some cases — stabilize colorectal cancer that wasn’t helped by other treatments. But more research is needed.:*:,

    Please do go look at this useful blog http://caramoanpackage.com

  • First, 15 to 20 mins with my gp doesn’t cut it now, it’s an official 15 min appointment, and that means his computer starts making a noise at the 8 min mark, 30 secs more and the bill is printed and he’s standing at the open door, bill in hand.. You can be still seated discussing what you went to see him for, doesn’t matter!

    On another note, the western delivery of “modern medicine” means that if a guy gets infection established in the prostate, it’s virtually impossible to dislodge with oral drugs. The mention of local injections to effect a prostatitis cure, for example, brings a look of total disgust, read ignorance, from every urologist I’ve been to. Yet in China it’s commonplace and works. Check this site out for prostatitis treatment: https://www.sexualhealthclinics.org/prostatitis-pid-treatment-clinics.html
    In my experience so far, medicine in NZ is an “old-boy” system, if you’ve got a problem that requires persistent investigation, forget it.

    • Sean,

      If my GP’s computer started making noises 8 minutes into an appoint I would be switching my GP asap.
      My GP is excellent as are most of the locums I’ve ever had to use.
      With regards to an “old boys network” I’ve met quite a few female GP’s who are excellent, and my GP is extremely good and always discusses my health so I can understand it.

      I think the poor behaviour of some GPs should not lead one to assume all of them are poor.

  • Michael, the key is finding one of those “GP’s”, and one that is prepared to catch up on all the history. I’ve been in China for 7 years and the change here is an enormous shock. In China you pay and you expect quality and there’s hell to pay if you don’t get it, as well as plenty of alternatives. Capitalism trumps the old boy network every time, but not in a system that feeds off “free” care. Not easy to explain unless you’ve lived in China for a while and got past all the Western media “myths” (polite).
    I found your series of writings here because I was researching Dr Twentyman. I’m going to see him next week, not because of “alternative medicine”, but rather someone who will listen and discuss my health. Neither of those two subjects have fared well with anyone I’ve seen so far.
    My comment re. the state of medicine in NZ is directed largely at Specialists, and I can only go on my experience so far, incompetence, arrogance, the old boy network and inflated egos figure highly in the lineup. Like all professional sectors, finding a good person can be hard (lawyers also come to mind) but I certainly haven’t given up yet. Glad to hear you’ve got a very good GP.

    • Sean,

      I hope you find what you are looking for with Dr Twentyman, my impression from TV is that he is very attentive and knowledgeable, which bodes well.

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