Why I am qualified to comment on alternative therapies

To get the answer, skip to the penultimate paragraph. The rest is preamble.

Patronising and paternalistic doctors; bossy, unsympathetic nurses; hours spent in dingy waiting rooms. That’s what I remember most about my experiences of the British National Health Service when I was growing up in the 1960s and 1970s. Which might explain why, by the late 1970s when I was active in various socialist/feminist drinking circles in London, I had developed a deep antipathy towards the medical establishment. What I discovered, in those circles of journalists, social workers, teachers who were my fellow middle-class humanities graduates, was that my experiences of the NHS were not atypical. It seemed as if almost everybody I talked to felt the same.

We were the post-war baby boom generation, who couldn’t begin to imagine what life been had like before our publicly-funded health service made health care provided by qualified medical practitioners available to all, regardless of their ability to pay. Health insurance was something people in less advanced countries like the USA did (and still do). We didn’t need it. There was no question in our minds that the NHS, funded by the taxpayer — whether we counted amongst them or not — was our right, was everybody’s right. I still believe this. The only question was whether the service it provided was good enough and most of us were sure about the answer. It wasn’t.

Some of us were ripe for the alternative therapies revival that would let us cock a snook at all the conservatism and pomposity of traditional medicine. ‘Alternative Medicine’ sounded exciting and rebellious, like Alternative Comedy. We would learn from the ‘ancient wisdom’ of our ancestors and use remedies that were ‘natural’. We would learn to heal ourselves.

I’ve no idea how much money I wasted over the next couple of years, nor what a silly little twit I must have looked, sitting at my desk sucking on a ginseng root and drinking some odious tea brewed from raspberry leaves in an effort to keep my ‘wellness’ at optimum level. I was a relative latecomer to homeopathy because the ‘treating like with like’ stuff had always sounded like crap, even to me – and I didn’t even know then about the dilutions and succussion, which surely make homeopathy one of the nuttiest therapies out there.

But I was suffering from two chronic conditions: insomnia and the tendency for even the smallest accidental knock on my arm or leg to come up as a huge ugly bruise. So out of desperation, I bought homeopathic remedies off the shelves of Britain’s biggest chemist. They were coffea pills for the insomnia and Nelson’s Arnica cream for the bruises. Did they work? Of course not. I didn’t really believe they would, so they didn’t. If I’d believed in their power, maybe they would have worked, at least for the insomnia. I don’t know.

After abandoning homeopathy, I tried a few more experiments. One was with the Bach Flower remedy, after someone whose judgment I respected at the time swore on the life of her children that it worked brilliantly for keeping one calm on nerve-wracking occasions. I tried it and it didn’t. Luckily, her children survived, so far as I know. I also tried valerian root for insomnia. I could have danced all night.

My point here is that I have tried ‘alternative medicines’. I have tried herbal, homeopathic and various other ‘remedies’. I therefore do not need to be told to try them. I don’t claim to be an expert but I do speak as a former user. As the supporters of this nonsense are fond of citing anecdotal evidence in its favour (because that’s the only evidence they have) I expect them to give my own anecdotal evidence against it due respect.

My other point is to try to explore a bit about why so many people – even we privileged Brits with our NHS – turn to alternative therapies in the first place. More of that in my next post.

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12 thoughts on “Why I am qualified to comment on alternative therapies”

  1. Your piece about House of Commons Science and Technology sub-Committee’s ‘evidence check’ on homeopathy was one of the best I’ve seen. Strength to your elbow.

    Your discontent with the NHS was understandable but is not shared in quite the same degree by those who could compare it with what we had before.

    The first paragraph of this illustrates what I mean.

    All good wishes

  2. Wondering who you went to who advised you to suck on a ginseng root….I am training to be a medical Herbalist I am in my second year of what will be a 4 year gruelling degree course. I used to be a registered health professional before I saw with my own eyes herbal medicine working time and time again. I wonder if you have ever browsed PubMed or ScienceDirect at the multitude of studies done on herbal medicines? I wonder if you realise that atleast 50% of all allopathic medicine is plant derived? A large portion of antibiotics are soil derived or indeed that the leading allopathic treatments for e.g. malaria come directly from plant sources? I too share your disbelief of homeopathy however, and I believe it is the liquid equivalent of a sugar pill placebo. However in herbal medicine the chemical content derived from plants are both potent and tangible if used correctly. The Eu directive plans to ban herbal medicine for all this April – Pharmaceuticals will take the products which have been used SAFELY by QUALIFIED herbalists(and I use that word pointedly) for many years. In Germany, Doctors regularly prescribe a mix of both herbal and allopathic drugs. I urge you to think about what can and may well be lost this year. Herbal medicine has a place alongside allopathic medicine with clear communication needed between the two. It can and does help people who quite often have no allopathic treatments left available to help them. Best Wishes

  3. Thank you for comment, Sara.

    I’ve no idea where I got the idea of sucking on a ginseng root from – it was over 30 years ago – I just recall it was quite a popular idea at the time amongst altmed devotees and Cliff Richard, no less, was said to swear by it. LOL!

    Yes, of course I know that plants contain chemical compounds and that conventional medicines contain plant extracts but I think the figure as far as 21st century medicines are concerned is more like 25%.

    I’m also well aware that there is some positive scientific evidence for some herbal remedies and that, unlike homeopathy (which also comes as sugar pillules by the way), herbs can have a physiological effect on the body and this effect can be beneficial or it can be harmful as the many stories on link illustrate:

    http://whatstheharm.net/herbalremedies.html

    I’m afraid if you use quackspeak like “allopathy” and say things like, “I saw with my own eyes herbal medicine working time and time again,” you undermine your own credibility in many people’s eyes. Having read extensively on the subject of what constitutes evidence, I am satisfied that there is only one way to determine whether any therapy is effective or not and that is with high quality clinical trials.

    I am very open-minded about herbal remedies and, up to a few years ago, I still tried them on word-of-mouth recommendations but they never worked. Nowadays, when I get a word of mouth recommendation, I go to pubmed instead. There I find most of remedies recommended to me have been trialled and the results have been disappointing. I am certainly not against research into herbalism and wouldn’t be interested in reading any good quality trials that you can reference.

    Kind regards

  4. Sara

    Would you agree in general with David Colquhoun, Professor of Pharmacology at UCL, who said:

    Herbal medicine: giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety.

  5. Hi,
    Firstly, thank you for taking the time to reply to the post – I am not quite sure why the word allopath is ‘quack speak’ though.
    “Allopathy: The system of medical practice which treats disease by the use of remedies which produce effects different from those produced by the disease under treatment. Medical Doctors practice allopathic medicine.”
    I will not practice allopathy when I qualify as I am not training to be a medical doctor.
    I take your comment however, that seeing herbal medicine working is a very subjective statement- I was simply vocalising why I had switched careers. I think that being naturally skeptical of ‘alternatives’ can be a healthy trait – I was myself for some years until my mind was changed by the facts before me. Indeed I would not waste my valuable time retraining to do something that ultimately would not work or indeed benefit those dearest to me, and others in general. Financially I will earn less than I did as an NHS employee (which is no mean feat lol). I have always needed to satisfy my own naturally skeptical nature and never take anything at face value.
    Many people hear word of mouth ‘treatments’ for their conditions and I must reiterate that only someone who has substantial training in the field is really qualified to say with any credence if, how and why a product works or does not or indeed and more importantly, that treatment is appropriate for that particular patient based on a full medical history,current medications – consent always given by patient for herbalist to consult with MD if and when necessary. The practitioner should also have solid evidence to underpin the herbal actions and be acutely aware of any contraindications and side effects. The quality of the product, its production,its extraction, its standardisation, unadulteration are all matters which are paramount in its ability to deliver.
    I am very happy to provide a couple of links to articles referencing the efficacy of herbal compounds and I wholeheartedly agree with you when you say that high quality clinical trial are the standard by which to practice – I think that you will be pleasantly surprised by what is available. I do also agree that more are needed to build the foundations of proving that what has always been anecdotally known to work and should be explained comprehensively. As you know, this is not to say however that EVERY trial double blind/randomised etc is a GOOD piece of research ofcourse.
    Articles whether purporting to be a new allopathic medicine or herbal can be flawed. As I’m certain you are aware, it is prudent to be informed of the potential problems that can occur with any of them for instance who funded the trial its methodology and execution, control etc.
    There are as in all professions, competent and incompetent practitioners – the best way to find one who has the training behind them is to visit the websites of the self -regulatory bodies whereby only individuals who have completed an accredited degree course to a suitable standard are allowed to join. It is a sad fact however, that currently anyone can legally call themselves a herbalist with little to no training at all. The name is not protected so it is the public who suffer at the expense of charlatans. Schedule 3 herbal drugs covered in 1968 Medicines Act are (thankfully) not accessible by students or unqualified practitioners. Qualified practitioners are prohibited from treating certain conditions and are legally bound to report those that are notifiable. They are trained to be aware of the areas that can benefit a person most and to also be aware of the limitations. As I said in my last post the best case scenario for the patient (who is ultimately the most important person in all of this) would be their ability to access safe high quality herbal medicines provided by state regulated practitioners. Patients therby enjoying the liberty to reap the joint benefits of both allopathic and herbal medicines and being able to use the extensive knowledge of both treatments to promote the best health outcome for that person.
    I have provided some random article links you requested below for your perusal – I am aware that you may or may not have an Athens or similar institutional account and that you may only be able to access the abstracts – apologies if this is the case. I am happy to mail them via an alternative route if you so would like. Below are some articles but there is a plethora of other articles available if you search.

    best wishes

    1. http://www.ncbi.nlm.nih.gov/pubmed/8974970
    Weikl A, Assmus KD, Neukum-Schmidt A, et al. Crataegus Special Extract WS1442. Assessment of objective effectiveness in patients with heart failure (NYHA 2) Forschritte der Medizin 1996 Aug 30;114(24):291-6

    2. http://www.ajhp.org/cgi/content/abstract/59/5/417
    Rigelsky JM, Sweet BV.Hawthorn:Pharmacology and therapeutic uses. American Journal of Health-System Pharmacy 2002 Mar 1;59(5):417-22

    3.http://www.ncbi.nlm.nih.gov/pubmed/18667054
    A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee.

    Sengupta K, Alluri KV, Satish AR, Mishra S, Golakoti T, Sarma KV, Dey D, Raychaudhuri SP.
    Cellular and Molecular Biology Division, Laila Impex R&D Center, Jawahar Autonagar, Vijayawada, India.

  6. P.S.
    An important point I failed to mention – herbal products available to the general public in certain high street chemists and certain health food shops are not manufactured to anywhere near the same strength, standard and quality as those available to a practitioner – who primarily obtains pharmaceutical grade products form specialist provider companies.

  7. Reply to Zeno
    Hi there,

    unknown dose – untrue the doses are done according to strength of tincture frequently active ingredients are standardised to accord efficacy

    unknown effectiveness – untrue sadly just like allopathic medicine copious herbal medicines have been tested on animals. Anecdotally obviously they have been used ny humans in some form or other for millenia around the globe

    unknown safety – refer to unknown effectiveness above – side effects/contrindications with other meds are documented just as in allopathic practice

    a thought for anyone to ponder -why do you think they want to ban herbal medicine something that in the right hands has helped the human race for centuries- is it because they want to protect the public? no because you just register the bonefide ones and the remainder cant practice. Or is it because the list that exists in the EU directive coincides with the most studied and the most effective herbs that the pharmaceuticals want to take and manipulate as their own a pharmaceutical company tried to patent the plant fenugreek recently – they failed mercifully. Herbs are much much cheaper than pharmaceutical drugs and on the whole have much fewer side effects. Some and I hasten to repeat some doctors dislike herbalists because they are legally allowed to diagnose under the 1968 Medicines Act. Good herbal practitioners can compliment the work that the doctor does; bad ones can disgrace the whole profession.
    We want regulation.

  8. Hi Sara

    That definition of allopathy is exactly what makes it quackspeak. What a ridiculous way to define 21st century medicine! The longer definition from the same source (medterms.net) goes on to say:

    “The term “allopathy” was coined in 1842 by C.F.S. Hahnemann to designate the usual practice of medicine (allopathy) as opposed to homeopathy…”

    The absurdity of thinking that using a definition coined by the founder of homeopathy to define whatever passed for medicine in the mid-19th century is an appropriate way to define the medicine of today is the reason that nobody except altmed practitioners use this term and why its usage helps to undermine their credibility and flags them up as quacks.

    “I was myself for some years until my mind was changed by the facts before me.” This is a repetition of what you said in your first post, “I saw with my own eyes herbal medicine working time and time again.”

    What it doesn’t tell us is what made you think the herbal medicine was working? How do you know that any improvement you saw was because of the herbal medicine and not because of some other reason? It’s to establish whether there is in fact a causal link between remedy and perceived improvement that they have controlled trials rather than relying on personal interpretation of what they see before their eyes. But then you already know this.

    That said, I do want to be on your side. Unlike so many ‘therapies’, herbalism is scientifically plausible and it would be fantastic if sufficient scientific support could be gathered to legitimise its use as a complementary therapy. But I think that in order to gain wider public sympathy for the idea of herbalism as one of the useful therapies, herbalists need to disassociate themselves from the culture of the quack loonies like homeopaths, reflexologists and ear candlers because these people are already on their way down as they are subjected to increasing public scrutiny. That culture includes the unprofessional vocabulary and the fallacious arguments – especially the anecdotal evidence. Anecdotes as an explanation of what inspired you to take it up are fair enough but, as I’m sure you realise, they won’t impress the sceptical reader as evidence of efficacy. What you may not realise is that, in the sceptical reader they bring on a weary sense of deja vu because we know that anecdotes are scientifically worthless yet so many altmed practitioners rely on them because that’s all they have.

    I take on board what you say about the herbal stuff sold on the high street. I’m sure you’re right. Thanks for those links. I’ve had a quick look at the abstract of the first onet one and I agree it seems encouraging. I know next to nothing about the EU directive. Apart from a mention or two in a few of these early posts, I’ve not taken any interest in herbalism, preferring to focus instead on the therapies I consider to be nonsense. However, I note what you say with interest and hope to find some time to research it further.

    Best wishes

  9. Sara

    Thanks for your reply.

    You said:

    unknown dose – untrue the doses are done according to strength of tincture frequently active ingredients are standardised to accord efficacy

    That just raises the question of what the ‘strength of the tincture’ is. It may well be that these tinctures are ‘standardised’ in some way and that the same plant species, grown in the same soil, same conditions, with the same nutrients, etc is always used so that there is consistency of chemical composition between different batches of tincture, but there is also the question of how it is known that the ‘active ingredients’ are indeed the constituents that are providing the expected pharmacological effect and how it is known what the dose responses are for individuals of such a cocktail of chemicals.

    unknown effectiveness – untrue sadly just like allopathic medicine copious herbal medicines have been tested on animals. Anecdotally obviously they have been used ny humans in some form or other for millenia around the globe

    Of course, many things have been used for millennia – including blood letting – but that says nothing about the efficacy of it.

    It would take a lot of work to look closely at the references you cite, but I’ll say a few things about the first one. It concerns the effect of Crataegus Special Extract WS 1442 (hawthorn leaves and flowers) on heart failure and is in German. I note it is dated 1996. In 2008, this study was published, concluding:

    [Crataegus Special Extract WS 1442] does not reduce heart failure progression in patients who have HF. CSE appears to increase the early risk of [heart failure] progression.

    As an aside, although I can’t read the full study, I’d be intrigued as to why the study you cite was placebo controlled and didn’t use a best treatment option, particularly when the abstract says:

    …while the condition of the placebo group progressively worsened

    That sounds somewhat ethically dubious.

    I’m not sure what your intention was in telling us that ‘copious herbal medicines have been tested on [non-human?] animals’. That is certainly a vital part of the testing of any conventional medicine (I agree with Skepticat on the use of the pejorative term ‘allopathy’), but only part. Testing on humans to determine dose-response and safety is also vital. Would you agree?

    unknown safety – refer to unknown effectiveness above – side effects/contrindications with other meds are documented just as in allopathic practice

    You talk about side effects and contraindications after they’ve been given to people and it is certainly very important, but these people should not be the subjects in the experiment — what’s the evidence from clinical trials?

    Another study of this same hawthorn product concluded:

    Theoretic interactions exist with antiarrhythmics, antihypertensives, digoxin, and antihyperlipidemic agents. Proven conventional therapies for heart failure are still recommended until the safety and effectiveness of hawthorn has been proven in long-term studies.

    Can you confirm whether your herbal products are covered by the Yellow Card ADR Scheme?

    Before we start trading papers, are you aware of a meta-analysis or systematic review of CSE for heart failure?

    You said:

    why do you think they want to ban herbal medicine something that in the right hands has helped the human race for centuries

    It is incontrovertible that some herbal potions have benefited some humans. However, the real question that has to be asked is whether any whole plant-based product is better than the current best treatment and resorting to unevidenced conspiracy theories doesn’t help your case.

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