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Friday, 15 October 2010

Acedemic Arrogance in the Matter of CAM.

In the matter of Complimentary and Alternative Medicines (CAM), much has been said by both medical bloggers, Doctors and Clinicians. Such words as 'wibble', 'mumbo-jumbo' and other derogatories, have been usefully employed to deride CAM. And, sections of the protocols employed within CAM, have been highlighted to prove the point. Homeopathy and Acupuncture particularly, have been held up to the light of day, and pronounced as worthless, and without any scientific proof of efficacy. I heartily agree with this view, and would apply it to quite a few other aspects of CAM. But, I do think, that to classify everything outside of mainstream drug protocols and the medical 'mainstream' as useless, is nonsensical, counter productive and further, it is arrogant in the extreme.In many ways, it also flies in the face of a number of treatments already adopted by many Clinicians.

Physiotherapy has become an essential part of recovery protocols, or even primary interventions for many, both in Hospital and in the Community. Yet, it is, in strict terms 'complimentary', to Medicine and Surgery. So get your terms right Doc'. If the use of specific vitamin supplements by Medics is invoked, again you are venturing down this road again. Some will recommend or even prescribe fish oil concentrates, to certain patients (Amcor). This is of course despite the fact, that the NHS will be paying through the nose for an expensive version, of that which can be obtained, 'over the counter' from quality sources. But that's the problem we have with NICE; they often recommend (or don't) the use of particular products based upon flawed or skewed evidence, or simply price.

In the matter of evidence, a lot outside of the 'mainstream', is viewed as being without any evidence of efficacy or safety, when the truth is that there is wealth of well constructed trials, just as good, if not better than those conducted by, or paid for by 'Big Pharma'. It's just that Clinicians pronounce judgement without even bothering to look for them. It used to be a widely used protocol in coronary heart disease, to utilise magnesium both in IV form as well as orally. It is also viewed as a major deficiency, especially in the elderly, and with the concentration in the diet, of 'industrial foods', is also becoming a deficiency in the wider populace. Supplementation, is now the only way to ensure an adequate intake due to it's depletion in the soil and consequently the food grown, and animals who live on it. It is essential for human metabolism and a deficiency, is linked to many diseases as well as CHD. But prescribing it, and taking it is CAM. Yet it is embraced by many, both within and without Medicine. It is also the subject of much research as shown here and and here too.

Moving onto drugs; there are number currently in use that owe their existence to CAM, which of course embraces herbs, vitamins and supplements. Metformin, the drug almost of first use, for Diabetics, is the synthetic form of French Lilac. Statin's, for what use they are, are the result of a poison found in China called Red Yeast Rice, and of course many, if not most of the older drugs in use, especially analgesics, are all based on, or made from natural sources (Opiates). In fact in the early days of medicine there was nothing else, as anyone who has studied its history can attest. In many ways, some herbs can afford results to patients, that are better, or as good as drugs, and usually (but not always) with fewer or no side effects. The problem arises, that treatments, based on this type of medicine, yields little or no benefit to the Drugs Industry.' They' love to 'patent' everything, so as to make money; lots of money. It seems in fact that 'Big Pharma' and some Doctors view disease as an income stream, rather than something to cure, and patients as a means to a handsome livelihood.

Doctors also advocate diets. Diets are part of CAM. Most of that, which they tell the patient, is counterproductive, because they do not keep up to date with research, or slavishly follow the advice of vested interests of the Drugs Industry, which requires dietary input to legitimise its drug protocols. This often flies in the face of common sense (high carb diets for Diabetics) or legitimises heavily flawed, or unproven hypotheses such as 'fat causes heart disease' (see last post), but diets however, are part of CAM, so curb the hypocrisy, Doc' you recommend diet all the time! Just because it's the wrong one does not change this.

There is much within CAM that is wrong, so wrong it boggles the mind. It is full of 'snake oil salesmen', some legitimised (they think) by being actual Doctors, MD's that is, not simply graduates of some obscure institute on the 'net. Some will flog you a pendant, that will change your life, or a bracelet to cure your arthritis. Others will promise you explosive sex if you take their herbal concoction. But beneath it all are some good and honest practitioners, who utilise the best of both schools of thought and will resort to drugs when needed. One particular area dear to my heart, as a Diabetic carer, is the reckless use of antibiotics for Urinary Tract Infections.

A simple treatment with a sugar derivative, called D-Mannose, cures the bulk of UTI's that stem from E-Coli, but by a different mechanism. It simply attaches to the bacteria preventing it adhering to the bladder wall and is flushed out. It cures about 80% of common UTI's

Closed minds. Hubris. They all contribute to the arrogance displayed by many in Medicine. The dismissing of everything outwith drug protocols peddled by 'Big Pharma', or the politicised advocacy of useless or even harmful diets, displays the lack of any real pragmatism in Healthcare. There is some light; some are now looking to supplements such as Vitamin D3 and CoQ10 as a means of supporting patients immune systems. Some will even advocate lifestyle changes as a means of curing rather than simply treating symptoms with spurious drugs that prove to be more dangerous to the patient than the ailment with which they present. More power to them.

There is a place in Medicine for all that is science based, but sometimes a gamble has to made. You can't do a double blind placebo trial in humans for UTI's with D-Mannose. It would be unethical. But I can attest to it working. And I became very seriously ill with it, and had three courses of antibiotics and was diagnosed with possible cancer. It wasn't I'm pleased to say, but I and many others (not all) could be spared that and the NHS much cost if this simple protocol was invoked. There are many others; most inherently benign. Is it not time at least to try a middle road?

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