Dear Dr. Jahn: I have noticed that many of my singer friends do not trust conventional medicine; myself included! We need good health to perform
and we are willing to do about anythingo get it! You are an open-minded medical doctor; what do you think of all this?
As the millennium closes, we find ourselves in the midst of an alter- native medicine renaissance. There are many reasons for this, both positive and negative, including an ever-increasing access to information about other cultures and the wisdom of the past, as well as advancing research in neuropsychology, cellular biology and the mind-body connection. The computer has greatly empowered healthcare “consumers” to take an active role in their well-being. These factors, along with smoldering dissatisfaction with the cost and quality of conventional care provided by HMO-suffocated physicians has, for better or worse, led to bold and unconventional new directions in self-treatment. Driven by a welter of “feel-good” literature, we are today uncritically and indiscriminately ingesting a huge pharmacopoeia of plant and animal extracts in hopes of a healthier life.
Since singers are particularly interested in alternative medicine, this column will cover some of the potential advantages and disadvantages from my personal point of view.
There are many pitfalls as we enter these uncharted waters. One is the semantic confusion between medications, drugs, and dietary supplements. Since these self-administered formulations are not prescribed for an illness, somehow they are seen as “natural,” “herbal” or “organic,” without the negative connotation of prescribed drugs. Just because a substance is plant-derived does not mean that it is invariably beneficial. In reality, many of these substances are potent, and potentially harmful. It is important to remember that many of the most powerful prescription drugs (such as digitalis and some chemotherapy agents) are derived directly from plants, and are anything but “gentle.”
Another general problem with over-the-counter (OTC) formulations is that they are not standardized industry-wide for activity, bioavailability and consistency. Higher price does not guarantee greater potency. For example, a Consumer Reports article on calcium supplements a few years ago found that one of the most effective supplements was the cheapest.
Although the legitimate drug market is partly driven by the pharmaceutical industry, there are some scientific controls, such as the need to provide proof of efficacy through rigorous double-blind studies. The “dietary supplement” industry is driven for the most part by consumer whim. Although many supplements have an impressive pedigree, including references in old Asian medical writings, you must remember that current methods of diagnosis are much more specific. Therefore, therapy originally recommended for symptoms such as “phlegm” or “fatigue” may not be effective for specific diseases such as acid reflux or anemia.
A final warning concerns how the body handles these supplements. I have studied several texts on Chinese medicine, and have found nothing on the topic of drug toxicity or overdose. Some supplements are stored in the body, and may accumulate to toxic levels. The commonest examples are Vitamin E or Vitamin A. Since most of us take these without a prescription, and proceed on the premise that if a little is good, a lot is better, we may be harming ourselves.
How should alternative medicine be used, then? I see three general benefits, which may not be as readily available through conventional medical measures.
The first is to use any method to improve your immune defenses. This may include dietary manipulation (dark leafy vegetables, decrease simple carbohydrates), dietary supplements ( judicious use of vitamins), and methods for stress dissipation (meditation, yoga). As antibiotics become more and more ineffective, improving our general immunity may become more important.
Second, look at methods to improve your circulation. The blood carries nutrients, eliminates wastes, and conveys immune cells to every part of your body. Methods include exercise (conventional and traditional, such as chi-gung), dietary supplements that thin the blood (Chinese herbs such as tree-ear mushroom, as well as plain old aspirin), and massage.
Third, make use of the mind-body connection. The “placebo effect” so maligned in conventional medicine is nothing less than the mind-body connection. It is the extremely important work the body does to heal itself. For some, this healing involves certain rituals such as religious rites or crystals, for others the ingestion of certain harmless supplements. Do not minimize the power of the mind over the body. The connection, through the brain, neurotransmitters and hormones, is well-known and important.
As a last note, keep in mind that if you are chronically, seriously ill, you should see a physician. He or she can help you make a diagnosis and make sure you are not harming yourself with self-treatment.
