Mainstream Medicine vs. the Wellness Industry (Part II)

Last week I introduced some of the issues implicit in the century-old conflict between mainstream allopathic medicine and the wellness industry. The fundamental issue concerns the profit motive. In the 1800s, allopathic, homeopathic, osteopathic, and herbalist physicians were all peers who together served the population; each differed in the types of medicines used and in the theoretical basis for practice. However, all of the medicines used by any practitioners originated in botanical chemistry and science. The use of herbs in medicine goes back thousands of years to the ancient Egyptians, Chinese, and Indians.

In the 20th century, perhaps due to the rise of Bayer and pharmaceutical companies, allopathic medicine began to dominate the medical world. The American Medical Association fought very hard to establish what is now mainstream medicine, excluding other forms of therapeutics.

Today herbal medicine, homeopathy, and naturopathy are considered “alternative” medicine, despite being mainstream in the world for centuries. Because of the enormous financial profits in the pharmaceutical industry, a great amount of money goes into research and clinical trials (although most goes into advertising and marketing). The FDA regulates all products put on the market by the pharmaceutical industry, and does not regulate the products of the wellness industry, since nutriceuticals and micronutrient supplements are “natural substances.” So the net result is that we have large clinical trials substantiating the use of medicines such as aspirin, beta-blockers, etc., but smaller studies evaluating the use of natural medicines.

However we do have plenty of evidence supporting the use of certain micronutrients in the treatment strategies for particular illnesses. This body of evidence is the basis for the claims made by proponents of the wellness industry. A simple Google scholar or PubMed search can bring these studies to the attention of the reader. Review articles are an excellent source of information. For example Drain et al in 2007 published a review article in the American Journal of Clinical Nutrition (Am J Clin Nutr February 2007 vol. 85 no. 2 333-345) which explores potential positive and negative effects of vitamin/mineral supplementation for patients with HIV receiving anti-retroviral therapy. Also Andersen et al in 2001 published a review article in Medscape’s Advanced Practice Nursing E-Journal; a review of micronutrient supplementation in the treatment of ischemic heart disease.

Allopathic commentators on this topic often claim that vitamin and mineral supplementation is not necessary if such substances can be ingested via food intake. Such a claim is testament to the lack of inter-disciplinary communication and collaboration between mainstream medicine and agricultural scientists. That modern farming techniques led to micronutrient-depleted soil and that food processing procedures led to micronutrient-depleted foods is well known to scientists who study farming and agriculture. In fact, Turkey has instituted a campaign to use zinc-enriched fertilizers to combat widespread zinc-deficiency in their population. The reality is that unless measures such as these are taken, food typically consumed by people in our country will not provide the essential micronutrients to sustain cellular health. This in part explains the extraordinary finding of almost universal Vitamin D deficiency in the American population.

With such a complicated, multi-faceted situation involving multiple industries with competing financial interests, how does the clinician or practice manager effectively and safely address possible micronutrient deficiency in their patients? There must be a systematic methodology, after all. If there is a measurable deficiency, then logically supplementation should be provided, with future follow up to ensure resolution of the deficiency. The answer I believe is hair analysis testing. Blood levels may not reflect actual tissue/cellular levels, but hair levels of micronutrients reflect health at the cellular level. I understand that this is not standard of care in mainstream medicine, but likely it will be essential in the diagnostic practices of chronic disease management in the near future.

My parents, both in their 70s, are in excellent health. Both have undetectable levels of biomarkers of inflammation. They both have significant family history of disease, but all of that is offset by living “the healthy lifestyle” (which I will explore in next week’s column). In addition to their excellent pattern of living, they have a physician who performs annual hair analysis testing of micronutrients as well as heavy metal toxicity and radiation. Both toxic and deficient levels of micronutrients are detected, and measures can be taken to normalize the levels. I believe this is an excellent way to scientifically address the clinical benefit of vitamin/mineral supplementation, and is a far less spurious way of addressing the issue as compared to the scientifically dubious and careless manner espoused by researchers mentioned in the Archives of Internal Medicine article cited in last week’s column.

Find out more about Dushyant Viswanathan and our other Practice Notes bloggers.