Posted tagged ‘complementary medicine’

Do natural remedies work?

January 23, 2017

The Pediatric Insider

© 2017 Roy Benaroch, MD

Last post, I gave Rachel’s questions about “natural remedies” a hard time. They’re not, usually, natural at all. And whether they’re natural or not doesn’t imply that they’re good for you or bad for you. The label “natural” is an irrelevant marketing gimmick slapped on products to get you to buy them.

Still: Rachel had a fair question, and I really haven’t answered it yet:

My daughter and I were talking the other day and saying we would like to ask a doctor what his thoughts are about all these ‘natural’ remedies that are available. Recently a friend made the remark, ‘I do everything I can to avoid a doctor.’ I lean more toward the medical system and the knowledge they have acquired over the years rather than relying on these home remedies.

OK, for the sake of answering the question, let’s just accept that “natural” means “seems natural” or “marketed as natural” or whatever you want it to mean. I think we know what Rachel’s talking about here – home remedies, or alternative medicine things, or things you can do yourself without relying on a physician. Do these kinds of things “work”?

Yes. They do. Most of the time, for most people with most problems that come to the doctor, “natural remedies” will indeed work. Usually, you will feel better, and indeed you will get better, after taking them.

(I’m not talking about a placebo effect here—though that’s an interesting subject we can talk about another time. And I’m not saying that these natural remedies “trick” you into feeling better, or that you only feel better because you spent money on something and you expect to feel better. I’m talking 100%, honest-to-goodness, my rash went away and I am better-better!)

Here’s the scoop, the insider secret you all have been waiting for: most concerns that most people bring to the doctor, most of the time, are things that will get better on their own. Your cough will get better, your fever will get better, your sprained ankle will get better. Your rash will improve, you’ll have fewer belly aches, and that weird foot odor will probably improve, too. The fact is, and doctors and alternative-health practitioners know this, that your body will heal, and your symptoms will improve, and — if what you want to do is play the odds – whatever is on your mind the day you go to a medical practitioner is probably going to get better on its own.

There’s two reasons for this, depending on the nature of the problem. For acute things (like a common cold, or the flu, or a twisted ankle), your body will probably do a pretty good job healing itself if you get out of the way and let it get better. For longstanding sorts of things, like headaches or back pain, you’ll get better, too—if only because you usually go see your healer when these symptoms are at their peak. Think about it – you’ve got backaches, or stomach pains, or whatever. From day to day or week to week the symptoms go up and down. Your symptoms are sometimes worse, or sometimes better. You don’t go to your doctor (or naturopath) when the symptoms are minimal or improved. You go when you feel bad. And—guess what?—the symptoms continue to go up and down. Only now, you think it’s going down because of the medicine, or because of the herb or the magic potion. But: in truth, the “treatment” probably doesn’t matter. All that matters is that most problems get better.

Of course, “most problems” isn’t all problems. Your child’s asthma, leukemia, or iron deficiency anemia isn’t likely to go away on its own, and if you’ve had a heart attack you’d better get thee to a hospital, pronto. Some things will get better faster with appropriate treatment. I am not suggesting that no one needs a medical evaluation. But the main point of almost any doctor visit is to get advice from someone with both the expertise and experience to tell the very-many-who-will-get-better from the few-who-really-need-therapy.

And the few who truly need therapy probably don’t need what naturopaths have to offer.


Ric Flair

Most natural remedies aren’t

January 17, 2017

The Pediatric Insider

© 2017 Roy Benaroch, MD

Rachel wrote:

My daughter and I were talking the other day and saying we would like to ask a doctor what his thoughts are about all these ‘natural’ remedies that are available. Recently a friend made the remark, ‘I do everything I can to avoid a doctor.’ I lean more toward the medical system and the knowledge they have acquired over the years rather than relying on these home remedies. What are your thoughts?

A great question, Rachel. It turns out that many of these “natural” remedies aren’t very natural at all. Something should be considered “natural” if it exists in the world around us – if it’s a part of the observable, real world we live in – and a part of our world that we didn’t create or imagine. Trees and rocks and wind are natural. Ghosts and voodoo curses are not (they only exist in our imagination). Bridges, ovens, clothing, and books are not (we made those things.)

When you think about it, a lot of what passes for “natural” remedies are not natural. Homeopathic remedies rely on an entirely imagined mechanism of chemistry invented by Samuel Hahnemann around 1796. He thought that by diluting and shaking substances, a vital essence of their properties could be captured, which upon further dilution could alleviate the symptoms that were caused by ingesting that same substance. Acupuncture relies on changing the flow of a life-energy, Qi, through channels in the body that do not, objectively, exist. Chiropractic (invented by DD Palmer in 1895) relies on identifying and treating “subluxations” that do not exist on x-rays or any other objective test. Modern chiropractors have acknowledged that their subluxations are more of an idea than a real thing, but most of them insist that treating these nonexisting things is helpful. (Not all chiropractors subscribe to this belief – a small group is trying to distance themselves from the dogmatic belief in Palmer’s subluxations. I wish them well.)

Many other kinds of healing supported by “naturopathic doctors” are not at all natural. Reiki, Ayurveda, “detoxification”, iridology, reflexology, kinesiology, and many other ideas are like homeopathy, chiropractic, and acupuncture. They all  “supernatural”, like ghosts and voodoo and magic.

What about herbal medicine? Herbs, themselves, are natural (and, often, tasty!) But what’s sold at drug and what used to be called “health food” stores is not. Many herbal supplements do not in fact contain the labeled herbs. The herbs are imaginary and un-natural. Even if the herbs are indeed contained in the supplement, by the time they’ve been processed and turned into capsules, are they any more natural than the “medications” on the shelf nearby?

I think the wisest way to think about Rachel’s question is to reject the false dichotomy between what’s “natural” and what’s not. There’s nothing inherently safer or better about natural things. Smallpox is natural, earthquakes are natural, heart attacks and strokes and cerebral palsy are all natural. Poisons from pufferfish and venoms from rattlesnakes are natural. On the other plenty of good and necessary things are “unnatural.” The food we eat has been grown with fertilizers and pesticides (including organic foods, which use all kinds of substances you wouldn’t consider “natural” at all), brought to stores by trucks on roads driven by people wearing wristwatches and clothes. None of these things are natural. And that’s OK.


Coming up next post: OK, fine, natural remedies aren’t natural. But do they work?

Who you gonna call?

The poisonous homeopathic pill

October 30, 2010

The Pediatric Insider

© 2010 Roy Benaroch, MD

The FDA has announced a recall of Hyland’s Teething Tablets, because some lots contain poisonous amounts of belladonna. What was a potentially deadly extract from the nightshade plant doing in the tablets it the first place? Well, it was supposed to be there—but not really, not in the sense of any actual molecules of belladonna actually being in the tablets. No, no. Just kind of the “energy” of the belladonna, the unmeasurable-magical-it’s-there-but-it’s-not part, definitely not the kill-you-dead part. Got it? No?

Hyland’s Teething Tablets are marketed as a “homeopathic” product. From talking with parents, there seems to be a misconception that homeopathy is a kind of natural, herbal medicine that’s been around since ancient times. Nothing could be farther from the truth. Homeopathy is about as super-natural as the tooth fairy, and was invented (that is, “made up”) by a retired physician, writer, and translator, Samuel Hahnemann, around 1800.

I don’t blame Hahnemann. Put yourself in his shoes: “medicine”, as practiced at that time, was still largely based on Galen’s ideas of the four humors. Purging and bleeding being were the main therapeutic options. What Hahnemann realized was that Galen’s approach  was completely wrong. It was killing more people than it helped. What Hahnmann was looking for was a complete departure from the medical philosophy of the day, and what he invented was homeopathy.

The central foundation of his new “medicine” was the concept that “like cures like”, sometimes called “the law of similars.” He and his students would take a bit of an herb or bark or other substance, and see what kind of symptoms it seemed to cause. For instance, just a little bit of nightshade would cause (among many other symptoms) a belly ache. So Hahnemann figured that if the belladonna were diluted, and diluted again, and maybe diluted again a zillion times, the resulting solution would then cure belly aches.

(Not just diluted. The solutions had to be shaken and stirred in a specific way, called “succession.” This released the “vital energy” of the substance, and involved specific sorts of tubes and things to strike them with a certain number of times. I suppose a genuine homeopathic factory would look like it was designed by Willy Wonka.)

“A zillion times” was kind of an unfair term—I don’t know what a zillion is, but Hahnemann’s idea was that the more diluted the substance was, the stronger the cure became. His dilutions went far, far beyond the zillions, often using products diluted to 10-60 as a cure. Ten to the minus 60, that’s a fraction that looks like 1/1000… (ßput 57 more zeroes there.) That’s not “strong” enough for you? From 10/30/2010, “Homeopathy”:

A popular homeopathic treatment for the flu is a 200C dilution of duck liver, marketed under the name Oscillococcinum. As there are only about 1080 atoms in the entire observable universe, a dilution of one molecule in the observable universe would be about 40C. Oscillococcinum would thus require 10320 more universes to simply have one molecule in the final substance.[74]

Homeopathy is entirely supernatural, relying on concepts of power and dilution and “vital energy” that have no basis whatsoever in what we understand of the natural world. Still, it did have one important advantage: in the 1800s, it probably killed far fewer patients than what a lot of other doctors were doing. No purges, no bleeding—just a solution so fabulously diluted that really, you’re just drinking a little water, or taking a little pill of sugar. Harmless fun.

But apparently the makers of Hyland’s Teething Tablets forgot about the “homeopathic” part, and started making tablets out of genuine, measurable, and poisonous amounts of belladonna. Babies have been developing symptoms of belladonna toxicity, and measured amounts of poison in the pills have varied considerably. Since they’re “homepathic” (that is, they ought to contain essentially nothing), products like these do not have childproof packaging, and cases of “overdose” of a genuinely toxic amount of belladonna have apparently occurred.

The FDA has no authority to require testing homeopathic products for safety or effectiveness; they were (and new ones continue to be) essentially “grandfathered” in. Only when harm has already occurred (as in the case with these Hyland’s products) can the FDA step in and test the products to see if they contain poison.

If you have some of these tablets in your home, throw them out. In the future, if you’d like to save some money, I suggest you obtain your homeopathic remedies in an easy, safe, and economical way: just fill a vial with tap water. You can bet that somewhere, someone flushed down the toilet some kind of something that would have made your child sick on some way. By now, that substance has been diluted through all of the lakes and tanks and streams and aquifers in your water system, so it’s released all of Hahnemann’s vital curing properties. That tap water, if Hahnemann was right, ought to cure everything.

If you want to make it stronger, just dilute it with more tap water.