Firstly, I must commend the September 1999 Midland Renal Service Nephrology newsletter. It warned that anyone presenting with unexplained or worsening kidney disease should be questioned about their use of “natural” remedies.

Herbalists are at pains to point out that plants are good for you because they are “natural”. However, many plants produce powerful poisons – often to defend themselves from being eaten!

The newsletter said the worldwide availability of “natural” remedies without rigorous safety checks places people at risk. The kidneys are vulnerable to natural poisons, as it’s their job to remove them from the body. They quoted some examples:

  • Chinese Herb Nephropathy
    Over 100 women in Belgium using a slimming remedy containing antocholia fungi, developed life-threatening kidney disease, requiring transplant or dialysis treatment (Am J Kid Disease 1998 32 (3) i-ii, Lancet 199 354 481-2).
  • Ephedrine Nephrolithiasis
    The Chinese herb Ma-huang from Ephedra species often lurks in food supplements and body building mixtures; and has caused deaths from cardiac effects. Regular use can cause kidney stones (Am J Kid Disease (1998) 32 153-9).
  • Potential Fatal Kidney Damage
    After mixed Chinese herbs (Renal Failure (1999) 21:(2) 227-30).
  • Hypokalaemic Alkylosis
    Which can lead to kidney failure, because of liquorice in several remedies for stomach problems. Other herbs damaging the kidneys include juniper, grindelia, aloli, ginseng and cat’s claw. You have been warned!

Bring Back The Stake

The final year of the millennium was a successful one for alternative health (Liam is in Mexico as I write). Its protagonists world wide received more than twice the income of their evidence-based counterparts. Some signs are beginning to appear however, that the public’s eagerness to choose magic over science may be on the wane. Ignorance is rarely overcome by logic or reason, but by that more persuasive force in human nature – dollars.

Alternative medicines’ safety and efficacy, and their ease of marketing is being questioned. For example, cholestin, found in red yeast rice and used as a colouring and flavour for centuries, and which is presently marketed by Pharmenex as a cholesterol lowerer, is now under threat. The American FDA has concluded that it is an unapproved drug, not a dietary supplement. The case is still under litigation, but has huge implications for the alternative health industry who usually market their produce under the “food supplement” label.

Those who control the health industry are at least expecting their members (especially doctors) to be more accountable. “Prove it works before you ask us to fund it,” they are saying.

GPs are being bullied into increasing their skills in prevention instead of handing out more pills. Time after time research is showing that not enough doctors believe in their ability to change patients’ courses of self-destruction. Seventy per cent of illnesses need never occur, and if GPs were more aggressive in their efforts to get their patients to give up smoking and alcohol, reduce weight, increase exercise and eat healthy foods, then the health bill would be a tiny fraction of what it is.

Herbs, homeopathy, most “natural” remedies are merely cop-outs by people to avoid the honest self-responsibility health solutions. “Civilisation” has brought with it a basic unfitness not seen in nature except in domestic animals. The fact that so many of us are alive is a tribute to the incredible powers of the human body to defeat the awful way we live. We wouldn’t need all those expensive investigations and treatment however, if we got rid of our bad habits.

The courts and professional bodies will make a difference, as the manufacturers of alcohol and cigarettes will find out in the next decade, but we still need a change of direction, especially from our leaders. It is splendid to see more doctors who practise alternative health to the detriment of their training, getting their comeuppance these days. For instance, one such cowboy has just been successfully censured for failing to convince his patient of the power of prayer. He said he practised complementary medicine, which included traditional GP services, homeopathy, muscular and skeletal medicine and prayer.

The Health and Disability commissioner unsympathetically said that his attempt to use prayer as a form of treatment amounted to coercion. The patient, an atheist, didn’t want it.

So my message for the coming decade, never mind the next millennium, is: Let’s have no more truck with witch doctors.

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