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Why There is So Little Natural Medicine Research

Why There is So Little Natural Medicine Research
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Skeptics often dismiss and criticize natural approaches to healthcare, claiming that there isn’t evidence to support their effectiveness. Here’s why they’re both wrong and right (for the wrong reasons). Action Alert!

Mainstream critics have been calling natural medicine “snake oil” and “quackery” for years. The essence of this argument is that there isn’t any evidence that natural medicines are effective at preventing or treating illness. Distilled even further, the argument is that there isn’t enough of a specific kind of evidence, the so-called “gold standard”: randomized, placebo-controlled trials (RCTs). The argument is true in a specific sense: there are indeed major structural barriers to conducting this kind of research on non-patentable natural therapies because, unlike the case with drugs, the huge cost of this research cannot be recouped. More fundamentally, RCTs may be inappropriate to determine the effectiveness of vitamins and minerals because the effects are harder to isolate. The mainstream’s insistence on RCTs also ignores the mountains of clinical and other forms of evidence to support natural medicine’s effectiveness. All of this serves to keep natural medicine out of the standard of care, and to keep us, as a nation, hooked on prescription drugs.

One major barrier to studying nutrients and their effects on disease through RCTs is lack of funding. Within the National Institutes of Health (NIH) is the National Center for Complementary and Integrative Health (NCCIH). Out of NIH’s $43 billion budget in 2021, NCCIH received a whopping $154 million—0.3 percent. The situation is similar in other countries. For example, about 0.08 percent of the British National Health Service’s research budget went to integrative medicine.

RCTs cost an average of $600 million, and often much more. Clinical trials of integrative medicine can be even more expensive because effect sizes are often small, which requires large sample sizes, and therapeutic effects may appear only after long treatment periods—both of which add to the cost of conducting RCTs.

This brings us to a fundamental problem. Because nutrients (generally) and other integrative therapies cannot be patented, there isn’t a way for a commercial interest to recoup the astronomical costs of conducting RCTs. Only pharmaceutical companies making drugs, which can be strongly patented, can afford theses costs. This creates a vicious cycle: natural therapies are shut out of medical care because conventional “experts” claim there isn’t high-caliber evidence to support their effectiveness; drug companies can afford this research, and so become accepted as the “standard of care” for disease treatment. The irony is, of course, that drugs are still often quite ineffective and very dangerous, whereas supplements are both effective and extremely safe.

It should also be noted that RCTs are often inappropriate for studying food and nutrients. A new-to-nature drug molecule can be better isolated in its effects, although interactions with other drugs are inadequately studied. Foods and supplements often depend on co-factors. For example, supplemental calcium should not be taken without supplemental K2, D, and magnesium (especially the K2), but isolating it for an RCT would miss that.

Further, consider trying to study something like probiotics in an RCT. Probiotics interact with a person’s gut microbiome—the ecosystem of microorganisms residing in the intestinal tract—in infinitely complex ways. Further, the makeup of individuals’ gut microbiomes is highly variable, depending on one’s diet, environmental exposures, and other factors. Given the complexity of these factors, trying to isolate the specific impact of probiotics on health in an RCT may be extremely difficult.

Here’s another example. RCTs rely on the intervention and placebo being well-defined. This is easier to achieve in drug trials, since drugs are manufactured products—one Lipitor pill will be identical to another Lipitor pill. This is different for supplements. Studies on curcumin have shown that the addition of just 1 percent by weight of piperine can result in a 2,000 percent increase in curcumin’s bioavailability. Even tiny changes in product composition that are within manufacturing quality standards may yield very different effects. For herbal medicines, potency may vary based on variety, cultivation method, place of origin, or time of harvest.

Finally, the very nature of natural therapies is somewhat incompatible with standard approaches to research. The cornerstone of integrative medicine is that treatment is highly individualized and holistic, addressing root causes of health problems. This approach is inherently difficult to study in RCTs, which often require isolating a single variable and determining its effectiveness alone.

There is also a heavy dose of hypocrisy in the criticism that natural medicine is not backed by strong evidence. A few years ago, ProPublica published a report detailing how conventional doctors continue to use certain drugs and medical procedures long after their appropriateness has been contradicted by research. Heart stents are a prime example. Stents are small metal mesh tubes that are used to prop open an artery. Every year, more than 500,000 Americans undergo this procedure, called an angioplasty, but many patients—especially those with stable coronary artery disease—see little or no benefit.

Despite all of these barriers and hostility from the defenders of the status quo, there has been a lot of quality research done on natural medicines. This includes ANH Board of Directors President, Jeanne Drisko, MD, who spent years studying the therapeutic effects of intravenous vitamin C, chelation therapy, and many others. ANH’s Pulse of Natural Health newsletter has strived over the years to report on the important and impressive research demonstrating the therapeutic effects of humble vitamins and minerals—and we will continue to do so. 

The status quo that keeps us hooked on pharmaceutical drugs that treat the symptoms of preventable chronic illnesses must change. The proof of the failure of this paradigm is all around us. We can help change this if we demand that more money is made available for research on natural health modalities.

Action Alert! Write to Congress and urge them to force NIH to divert more money to support research on natural health modalities. Please send your message immediately.

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