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Educate Your Doctor

July 26, 2010 Written by JP    [Font too small?]

The quality of modern health care is frequently in the news. Health care professionals, insurance companies and politicians all have their own ideas about how patients can better be served for less money. There’s all this talk about reforming health care and yet very few of the “deal makers” actually consult patients like you and me. Am I right? Well, I for one have a strong sense about what I’d like to see change. On the top of my list is the need for a greater variety of treatment options. There are some obstacles to that but, surprisingly, the most significant among them have nothing to do with money. My Healthy Monday tip of the week is to educate your doctor about the value of alternative and complementary remedies.

Let’s say you walk into your doctor’s office and you’re told you have a certain health condition. What usually happens next? In many instances you’re given a prescription for an expensive and potentially dangerous medication. The easy or “polite” thing to do is to simply trust that your doctor knows what’s best for you, take your medication and hope that it agrees with you. But is this what you really want? If it is, fine. But if you’d like to know about alternative ways of managing your health issues then you should speak up. No doctor can hear the little voice inside of you that wonders about such things.

The sad truth is that many patients are afraid to disappoint or offend physicians by asking pertinent questions and practicing due diligence. They often fear being viewed as foolish or unqualified to express concerns and the desire to influence their own health care destiny. This is an unhealthy dynamic that needs to end. The tricky part is that it can only change at the will of patients themselves.

If we walked into the doctor’s office together, here’s what could happen. This time, you wouldn’t walk out of the office with a prescription in hand – at least, not immediately. Before even contemplating using the medication, we’d respectfully ask about any lifestyle interventions or natural remedies that might provide a viable alternative. Now the truth is that many allopathic physicians will essentially tell you that there is no such thing. At least nothing that has a reasonable amount of evidence to back it up. This presents a challenge. But it’s one that you can frequently overcome by becoming an expert about your own health care.

Here are 5 recent examples straight from the scientific literature that could be used to refute the claim that natural remedies have no scientific evidence in their favor. Any of these studies would be a good starting point for presenting your doctor with an alternative treatment plan.

  • The May 2010 issue of the journal Phytotherapy Research features a study on an herbal extract derived from Gymnema sylvestre – a plant that has been used for centuries in India for the natural management of diabetes. In this new trial, patients with type-2 diabetes (T2DM) were given 1 gram/day of Gymnema sylvestre for 60 days. Blood tests indicate a significant decline in fasting and post-meal blood sugar. An increase in C-peptide and insulin production is believed to be the mechanism by which this herbal extract successfully lowers blood sugar. The conclusion of the study states that Gymnema sylvestre “may provide a potential alternative therapy for the hyperglycemia associated with T2DM”. (1)
  • Another trial from May 2010 tested the effects of an “enteric-coated, delayed-release peppermint oil” vs. a placebo in 90 subjects with irritable bowel syndrome (IBS). The 8 week study measured IBS symptoms at baseline, the 4 week mark and at the completion of the intervention. In all, 14 of the 45 patients using the peppermint oil were “free from abdominal pain or discomfort” by the end of the trial. Only 6 members of the placebo group reported a similar improvement. In addition, the peppermint pills conferred significant improvements in quality of life measures and resulted in no serious side effects. (2)
  • A combination of 120 mg of Coenzyme Q10, 200 mcg of selenium, 1,000 mg of Vitamin C, 400 IUs of Vitamin E daily was recently shown to improve arterial elasticity in patients with “multiple cardiovascular risk factors”. The 6 month study enrolled 70 patients who were given the nutrient blend or a placebo. In addition to the benefits noted in arterial function, those receiving the nutritional supplement also registered a decline in blood pressure, C-reactive protein (an inflammatory marker), LDL (“bad”) cholesterol, long term blood sugar levels (HbA1C) and triglycerides. An increase in the protective HDL (“good”) cholesterol was also apparent. (3)
Umcka (EPs 7630) May Reduce Respiratory Infection Duration and Severity
Source: Acta Paediatr. 2010 April; 99(4): 537–543. (link)

In the June 2010 issue of the journal Nutritional Neuroscience, researchers from the University of Cincinnati, Ohio determined that chromium supplements can improve mild cognitive impairment in older adults. A placebo-controlled, double-blind trial assigned 26 older men and women to use chromium picolinate or a placebo for 12 weeks. Functional MRIs (magnetic resonance imaging) and various measures of memory and mood were evaluated just prior to the study and directly afterward. The volunteers supplementing with chromium “observed reduced semantic interference on learning, recall and recognition memory tasks”. The FMRIs further detected increased activity in key areas of the brain typically affected by Alzheimer’s disease such as the bifrontal, right posterior parietal, right temporal and right thalamic regions. In all, the conclusion was that chromium picolinate “can enhance inhibitory control and cerebral function in older adults at risk for neurodegeneration”. (4)

Millions upon millions of dollars have been spent to create medications and vaccines that limit the risk of respiratory viral infections. Much less attention has been paid to a specific extract taken from the root of Pelargonium sidoides, also known as Umcka or South African Geranium. This is a shame because this little known herbal medicine is clinically proven to reduce the incidence and severity of respiratory tract infections such as acute bronchitis. It’s even been documented as shortening the duration of such infections when they do take hold. The most recent examination of Umcka involved 400 study volunteers with ages ranging from 6-18 years. The optimal dosage was determined to be 90 mg per day. Side effects were considered minimal and comparable between the placebo and Umcka treatment groups. (5)

If you present your doctor with one positive study about a natural remedy, he’s unlikely to be swayed. That was never the point of today’s column. Rather, the evidence presented above is simply to show that many scientific studies on drug-alternatives do exist. But your doctor is unlikely to be the one to seek them out. Most physicians simply don’t have the time and, frankly, don’t care to use unconventional treatments that may court controversy. Now, you can either view this as a dead end or an opportunity. If you truly want more access and support in using alternative remedies, make it happen. Don’t accept the current tide or wait for someone else to enact some sort of systemic change. This is your health, not theirs. Stand up for it and be counted.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Children's Health, Diabetes, Mental Health

3 Comments & Updates to “Educate Your Doctor”

  1. JP Says:

    Update: The FODMAP diet and probiotic treatment are helpful for IBS patients …


    World J Gastroenterol. 2014 Nov 21;20(43):16215-26.

    Ehealth: low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome.

    AIM: To investigate the effects of a low fermentable, oligosaccharides, disaccharides, monosaccharides and polyols diet (LFD) and the probiotic Lactobacillus rhamnosus GG (LGG) in irritable bowel syndrome (IBS).

    METHODS: Randomised, unblinded controlled trial on the effect of 6-wk treatment with LFD, LGG or a normal Danish/Western diet (ND) in patients with IBS fulfilling Rome III diagnostic criteria, recruited between November 2009 and April 2013. Patients were required to complete on a weekly basis the IBS severity score system (IBS-SSS) and IBS quality of life (IBS-QOL) questionnaires in a specially developed IBS web self-monitoring application. We investigated whether LFD or LGG could reduce IBS-SSS and improve QOL in IBS patients.

    RESULTS: One hundred twenty-three patients (median age 37 years, range: 18-74 years), 90 (73%) females were randomised: 42 to LFD, 41 to LGG and 40 to ND. A significant reduction in mean ± SD of IBS-SSS from baseline to week 6 between LFD vs LGG vs ND was revealed: 133 ± 122 vs 68 ± 107, 133 ± 122 vs 34 ± 95, P < 0.01. Adjusted changes of IBS-SSS for baseline covariates showed statistically significant reduction of IBS-SSS in LFD group compared to ND (IBS-SSS score 75; 95%CI: 24-126, P < 0.01), but not in LGG compared to ND (IBS-SSS score 32; 95%CI: 18-80, P = 0.20). IBS-QOL was not altered significantly in any of the three groups: mean ± SD in LFD 8 ± 18 vs LGG 7 ± 17, LFD 8 ± 18 vs ND 0.1 ± 15, P = 0.13. CONCLUSION: Both LFD and LGG are efficatious in patients with IBS. Be well! JP

  2. JP Says:

    Updated 06/27/16:


    J Clin Gastroenterol. 2016 Jun 15.

    A Mixture of 3 Bifidobacteria Decreases Abdominal Pain and Improves the Quality of Life in Children With Irritable Bowel Syndrome: A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Crossover Trial.

    GOALS: We assessed the efficacy of a probiotic mixture of Bifidobacterium infantis M-63, breve M-16V, and longum BB536 in improving abdominal pain (AP) and quality of life (QoL) in children with irritable bowel syndrome (IBS) and functional dyspepsia (FD).

    BACKGROUND: AP-associated functional gastrointestinal disorders, particularly IBS and FD, are common in pediatrics, and no well-established treatment is currently available. Although probiotics have shown promising results in adults, data in children are heterogeneous.

    STUDY: Forty-eight children with IBS (median age, 11.2 y; range, 8 to 17.9 y) and 25 with FD (age, 11.6 y; range, 8 to 16.6 y) were randomized to receive either a mixture of 3 Bifidobacteria or a placebo for 6 weeks. After a 2-week “washout” period, each patient was switched to the other group and followed up for further 6 weeks. At baseline and follow-up, patients completed a symptom diary and a QoL questionnaire. AP resolution represented the primary outcome parameter.

    RESULTS: In IBS, but not in FD, Bifidobacteria determined a complete resolution of AP in a significantly higher proportion of children, when compared with placebo (P=0.006), and significantly improved AP frequency (P=0.02). The proportion of IBS children with an improvement in QoL was significantly higher after probiotics than after placebo (48% vs. 17%, P=0.001), but this finding was not confirmed in FD.

    CONCLUSIONS: In children with IBS a mixture of Bifidobacterium infantis M-63, breve M-16V, and longum BB536 is associated with improvement in AP and QoL. These findings were not confirmed in FD subjects.

    Be well!


  3. JP Says:

    Updated 11/28/18:


    Korean J Fam Med. 2018 Oct 26.

    A Randomized Clinical Trial of Synbiotics in Irritable Bowel Syndrome: Dose-Dependent Effects on Gastrointestinal Symptoms and Fatigue.

    Background: This double-blind, randomized controlled design study aimed to assess the dose-dependent effects of synbiotics on gastrointestinal symptoms of and fatigue in irritable bowel syndrome (IBS).

    Methods: Thirty subjects with IBS were randomly assigned into the following three groups and received 2 capsules a day for 8 weeks: (1) high-dose (2 capsules of synbiotics); (2) low-dose (1 capsule of synbiotics and 1 capsule of placebo); and (3) placebo (2 capsules of placebo). At baseline and 8 weeks, they completed the study questionnaires.

    Results: Two subjects in the high-dose group were lost to follow-up, leaving a total of 28 patients for the analysis. After 8 weeks, abdominal discomfort, abdominal bloating, frequency of formed stool, fatigue Visual Analog Scale (VAS), and Multidimensional Fatigue Inventory were significantly different among the groups (P=0.002, 0.006, 0.007, 0.028, and 0.041, respectively, by Kruskal-Wallis test). However, only abdominal discomfort, abdominal bloating, frequency of formed stool, and fatigue VAS were significantly improved in the high-dose group compared with those in the placebo group (P=0.002, 0.003, 0.002, and 0.013, respectively) by Mann-Whitney test with Bonferroni correction. No adverse drug reactions were reported.

    Conclusion: High-dose synbiotics were superior to placebo in improving bowel symptoms and fatigue of IBS patients, suggesting that synbiotic dosage plays an important role in the treatment of IBS.

    Be well!


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