How to know whether alternative medicine is safe

Recently a patient of mine brought in a bottle given to her by her acupuncturist. She had turned to acupuncture with my encouragement after traditional medicine fell short at addressing her chronic pain. Indeed, there is data to support the efficacy of acupuncture in the management of chronic pain. I was encouraged to hear that this treatment, often labeled as “alternative,” seemed to be helping her substantially.

However, my patient’s questions had to do with the ingredients of the herbal medication she was given to help with weight loss and phlegm: a potpourri of botanicals translated from Chinese to English. She asked for my assessment and blessing, reminding me that I was a self-proclaimed “holistic” doctor.

Quickly I scanned the product’s label. It contained, among other things, raphanus semen, something I immediately felt that I personally would not care to ingest. Despite my initial concern, I promised to research the herbal supplement to the best of my ability.  Later, I discovered that raphanus semen was radish seed, which at least seemed less disgusting than what I had imagined.

This patient interaction brought to light two topics worth discussing:

  1. What is meant by holistic medicine?
  2. How does one assess the safety of complementary and alternative therapy, and more specifically, of botanicals and natural supplements?

I am fairly certain that holistic does not carry the same meaning to me as it does to many Americans.  In my view, holism in medicine implies having a whole person view.  That is, seeing each patient, not just as a constellation of physical symptoms to diagnose and treat, but also within their psychosocial context.

After all, a person’s unique psychology and cultural background determine how he or she reacts to physical illness, diagnosis, medical advice, and treatment prescribed.  A doctor who makes attempt to understand these parts of his or her patients is apt to be more successful at treating them. However, most Americans tend to think of a holistic doctor as one who is well-versed in alternative therapies and who bucks standardized approaches endorsed by the medical establishment, including the pharmaceutical industry and the FDA.   This is not true of my practice, though I am aware of the existence of bias and limitation within the scientific process.

As of late, the term holistic medicine has actually become antiquated and has been replaced by the contemporary field of integrative medicine. As defined by the wise Dr. Andrew Weil, one of its best known proponents:

Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.

By this description I am an advocate of integrative medicine, though, the key point here is “use of all appropriate therapies.” The unfortunate truth is that many physicians who profess to practice integrative medicine treat multiple diagnoses that are not at all well-established by science, for example, “adrenal fatigue.”

In addition, many advocate use of products that lack sufficient evidence for safety and efficacy, for example DHEA or bio-identical hormones, and disavow standard FDA approved drugs for unclear reasons.  This business too can be a money-making operation, as some of these physicians do not bill health insurance for their services, run a multitude of diagnostic lab tests of uncertain significance, and may even sell their non-approved natural” products for significant profit.

Which complementary and alternative therapies are safe and reasonable to try? There are a number of resources that can help to guide both doctors and patients, such as NIH’s National Center for Complementary and Alternative Therapy page on Herbs at a Glance.

Unlike prescription drugs, the manufacturers of medicinal herbs and botanicals are not required to prove the safety and efficacy of their products prior to marketing them.  In addition to the definite possibility that these substances might be ineffective, there are two major safety considerations–their potential for causing drug interactions and the risk of product contamination. If you are researching for negative reports on a particular substance you may find the NIH’s index “How Safe is this Product or Practice?” to be useful.

In the case of my patient, she is on a fairly long list of medications for several serious health conditions.  For example, she has a history of pulmonary embolus and also has an inherited condition that makes her prone to clotting. For this she takes a blood thinner. Her other drugs include strong pain medications and several psychotropic drugs with narrow therapeutic indices. My immediate concern was for the possibility of botanical-drug interactions, which might increase or decrease levels of her prescription drugs and cause toxicity or adverse medical events.

It turns out that my research was unable to shed light on any reliable information whatsoever about raphanus semen, nor the remaining six ingredients of the herbal medication that she showed me. I was left to shrug my shoulders and advise her, in this case, probably not a good idea.

On the other hand, I support the use of acupuncture for chronic pain and have been known to advise melatonin for sleep, probiotics for various digestive ails, and even strontium for osteoporosis.

Juliet K. Mavromatis is an internal medicine physician who blogs at Dr Dialogue.

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  • buzzkillerjsmith

    Good post, especially the NIH resources.

    Many people don’t have a good understanding of how modern medicine works. We are generally unwilling to accept a treatment until its safety and efficacy have been proven in scientific studies. Of course there are exceptions to this, and I would submit that some drugs we use now have not been definitively been shown to decrease suffering and death. We sometimes use surrogate outcomes, and all the doctors at this blog know that practice is suboptimal.

    Nevertheless, we try to limit our treatments to what make physiological sense if don’t have definitive proof of efficacy. Not perfect, but better than recommending treatments whose effects on the body are unknown. I would submit that much of alternative medicine falls into this category.

    What is known is a subset of what is true, so we should all keep an open mind, but I myself am leery of alternative medicine and tell this to my pts.

    • Chiked

      I disagree. Understand that big pharma only researches drugs that are patentable. That means that most natural supplements will never be scientifically tested. Luckily many of us are smart enough to see through all of that and have been on supplements for decades without one problem.

      While we do not know completely know all of their actions, I can definitely say that most of them are safe even if you took 10 to 15 of them daily. Can you say the same about big pharma drugs?

      • buzzkillerjsmith

        We docs agree that BP’s studies are not adequate. I implied that in my comment. RCTs and meta-analyses are the standards. The Cochrane Collaboration is a good source.

        You say most of them are safe. You don’t know that. You might think you know, but you don’t. And even if they are safe, they might not be effective.

        • Chiked

          “You say most of them are safe. You don’t know that. You might think you know, but you don’t. And even if they are safe, they might not be effective.”

          Why? Because there aren’t any randomized controlled double blind studies.

          Yep. Therein lies the problem with medicine today. Choosing to rely on big pharma’s arsenal when we all know that many of their published studies are cherry picked and even the published ones are comparing their drugs against a placebo.

          Why won’t they go head to head with these “dangerous” supplements. They won’t because it will be a disaster for their blockbuster drugs. So all they do is keep telling the uninformed (doctors included) that we should be wary of supplements.

          Like I said before, people are beginning to see through the smoke screen.

      • http://www.twitter.com/alicearobertson Alice Robertson

        Aren’t more people per year harmed, and many more die with pharmaceuticals than alternatives? I remember when Steve Jobs died and doctors rushed to write about his harmful karma crap:) They left out vital facts and didn’t mention just how much he used doctors. He was given less than two years to live, but through wise choices and a way of using both spheres of medicine he lived 8 years.

        Ben Goldacre (author of Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients) shares this example (but the cracker is the one Dr. Steve Nissan from Cleveland Clinic shares from the documentary Escape Fire and his taping of pharmaceutical company reps and the good that Elliott Spitzer did as Attorney General when he sued the drug company and instead of cash took the information that allowed a team to sort through the data and show just how many people had died from missing data in clinical trials. It’s all online, so I won’t bore you, but it’s fascinating to see that some clinical trials are ghostwritten and we are only reading the flattering stuff.

        Oh yes, that example that sums up BigPharma’s purposefully leaving us in the dark which means many doctors have good intentions but get suckered too: During an 18 year period the FDA tracked antidepressant trials
        showing 38 positive outcomes and 37 negative outcomes, but once
        published in literature only three negative trials showed up and 48 were
        portrayed as positive. And so it is with vaccines (with FDA doctors
        approving them then heading over to work for the same pharmaceutical
        company making millions).

    • http://www.twitter.com/alicearobertson Alice Robertson

      And let’s add that patients like their drugs! You know I have homeschooled for 25 years and sometimes teach. I have seen such a change in this movement….and so it is with alternative medicine. I remember years ago they wanted to legislate against it until a Congressman stood up and asked why they were worried…there weren’t enough mothers willing to give up their lives to do homeschooling. He was right….and so it is with alternative medicine. It’s limited….people like their prescriptions. It’s usually their first line of defense.

  • mmer

    There is no such thing as “alternative medicine” – there is medicine that is supported by varying degrees of evidence and medicine that is not.

    The distinction is, more often than not, used to draw a distinction for marketing purposes (the ominous “Western medicine” versus the “holistic” and pure “alternative medicine”).

    Something like melatonin for sleep, I would qualify as evidence based; it makes sense physiologically, strong prior plausibility, good and corroborating evidence in human and animal models.

    • PollyPocket

      Exactly what I was about to post! There is no complimentary and alternative medicine. There is evidence based medicine and there is voodoo and there are grey areas in between. (ie therapies with questionable evidence of efficacy).

      • http://www.twitter.com/alicearobertson Alice Robertson

        Oh please! Cleveland Clinic highly recommends CoEnzyme 10 now and “alternative” medicine users knew about it 20 years ago. Look at fish oil. There are studies telling us it isn’t it and a bit, but it is! And on and on and on.

        This looks too Paul Offitish:) His new book is a bit of a yawn and pretty self-serving considering who his adversaries are.

        When the money becomes available via the NIH or elsewhere there will be efficacy. In the meantime anecdotal speaks pretty clearly…like Prozac who cares if it’s a placebo effect…if it works. And the damage from alternative isn’t the same as pharmaceutical in numbers.

        Bottomline…the better doctors learn quickly and learn that patients who try to help themselves are also better patients. Some of the top 100 doctors in this country steer their patients towards probiotics (sharing they are the new antibiotics), coenzyme, fish oil, resversatol, etc. If they change their diet (oh yes, doctors are only just now coming around to just how much diet can not only help us lose weight, but by eating less sugar and more vegetables we do our bodies a real service….I remember some of their comments from years ago about diet too).

        • mmer

          //that patients who try to help themselves are also better patients//

          If by helping themselves, you mean taking supplements, then I beg to differ. If you mean by replacing screen time with exercise or reducing their vices, then I agree.

          The supplement industry is entirely unregulated. 85% of Americans are confident in the safety, quality, and effectiveness of supplements yet half of the FDA Class I drug recalls between
          2004 and 2012 were due to supplements (Class I means that the supplements contained ingredients with a reasonable probability of causing “serious adverse health consequences or death”).

          Doctors who steer patients towards things like resveratrol, which “At present, research…is still in its infancy and the long-term effects of supplementation in humans are not known” are steering patients towards a substance whose efficacy in humans is nebulous. Fish oil is a different story and CoQ10, most people will not see a benefit from and will be a waste of money. We can’t just lump all these things into one category, each has to be investigated on its own merits, nor will all patient populations necessarily benefit if one does.

          Remember, as much as you want to heap the criticism on “big pharma” the supplement industry is $30 billion dollars large in the US and regulation is entirely absent in some cases. They thrive on the narratives that they are part of something “alternative” when in many cases, their claims simply do not hold up to scientific scrutiny.

          Some general tips: Look where the study funding comes from (usually this is disclosed), see if they study has been peer reviewed (and preferably repeated), remember that isolated substances may not have the same effect as when they are found in their associate whole-food (ie. resveratrol and red wine), just because something has been found to be “good” doesn’t mean that taking more is better, our levels are maintained through homeostatic mechanisms that in many cases will degrade excesses to be excreted (you are literally pissing away your hard-earned money).

          //doctors are only just now coming around to just how much diet can not only help us lose weight..//

          That is a wholly unsubstantiated claim.

          • http://www.twitter.com/alicearobertson Alice Robertson

            So doctors aren’t coming around to just how much diet can help a person? Even trials with stage 4 cancer patients responding to diet? Your last sentence sounds a bit silly, but you made some other statements that are worth discussing. I am glad you brought them up.

            Why do doctors want regulation on an industry that isn’t causing harm without stopping for a moment and wondering if their very source of information (the very information they treat patients with) is only half a picture? We already know half of most clinical trials are left off the radar (non-disclosure…even with regulation…we know it’s overall unobtainable and trials are often fixed by selection of participants). We know pharmaceuticals can help, and they can kill and guess whose scripting them? Right, doctors. Doctors who are often left in the dark because they rely so heavily on tainted medicine. That’s why I recommended Ben Goldacre’s book. He gives a lot of facts and some opinions that should be discussed and on the table, but the fact is doctors are sometimes scripting in the dark.

            So why don’t doctors just concentrate on cleaning up the industry that can help mankind in a huge way and get full disclosure. Why aren’t you here demanding a type of Wikileaks on that industry instead of trying to demean patients who are very proactive in their own care?

            Alternative medicine means that doctors have to do more homework. If a doctor can study and educate a patient and not just fluff it off they will do a lot more good.

            But here you are sounding a trumpet call in the wrong direction. So what if it’s unregulated. It isn’t doing the harm the regulated pharmaceutical companies are.

            If you would stop balking and think for a moment about why patients like Dr. Oz so much (no I don’t watch TV). It’s because he is informed and tries to help them help themselves and he listens. Instead of rolling their eyes at him they should take some clues about what patients want. They watch him because in many cases their own doctors simply won’t listen.

          • mmer

            I just cited the fact (not my opinion) that, “half of the FDA Class I drug recalls between 2004 and 2012 were due
            to supplements (Class I means that the supplements contained ingredients
            with a reasonable probability of causing “serious adverse health consequences or death”), yet you say they aren’t doing harm? How can you say such a thing? Ridiculous.

          • http://www.twitter.com/alicearobertson Alice Robertson

            Okay, fair enough. I am a conservative who reads her Slate daily (often rolling her eyes, at their dramatics but entertained none-the-less. It’s a good balancer, and plus I sure do miss bad boy Hitchens:) I did read that article, but will reread it. I think even the best doctors mess up…it’s in the odds….who won’t? Don’t doctors overall make about 20% error? It’s why they rarely rat on each other because to rat on a colleague means your own errors will be divulged? It’s why peer reviews are often futile?

            I know Dr. Oz does a show each year where he shows clips of where he was wrong or his staff. It’s humbling for him and extremely informative for his readers (I don’t watch it, but read the recap newsletter at times). I admire that he goes public with his errors, and wish more doctors would admit that (this is usually a segue for a doctor to say they can’t…lawsuits, etc….but they usually can). Now if we could just get Slate to do this, huh? :)

          • mmer

            Depends if we’re talking diagnostic or procedural errors and which procedure and (correct) diagnosis we are talking about.

            I think the more important number is that about 90% of all hospital mistakes go unreported (The study was co-authored by Dr. David Classen, a professor at the medical school of the University of Utah).

            The “transparency wave” has only just begun to reach healthcare – it will benefit in the long run and repair some of the trust that has been eroded between doctor and patient. By publishing things such as individual error rates compared to peers, it will cause physicians to strive to be better. I am all for the transparency you want, hospital, physician, and pharma included, but may have some disagreements on the nitty-gritty issues of what constitutes proper healthcare and evidence-based medicine.

          • http://www.twitter.com/alicearobertson Alice Robertson

            I agree and this is where the NIH is coming in handy dandy:) They forced Cleveland Clinic to cough up their infection rates, etc. (I watch this stuff because my daughter gets cancer treatment there).

            I guess ultimately my beef is that doctors often prefer patients who are in the dark because it makes treatment so much easier when a type of “Yes” man patient sits there with a willingness to just be subservant. Our one doctor will actually ask me, “So you want to debate?” We both laugh and go at it in a good natured debate about something I care about more than anything else in the world (my daughter and her treatment). My other two favorite doctors say the magic words, “I don’t know.” I wish they did know but I admire their strength to say so.

            Another doctor has supplements right in the office and goes over it what she recommends (she scripts and uses a compounding pharmacy on campus, and does whatever it takes to help the patients a type of all-inclusive doctor who is in the top 100 in the country).

            I really think there is a place for alternatives in medicine, and think doctors have been very resistant to it. I tend to think they should embrace it and educate themselves on it more than the just the capitalistic side and while they are at it campaign more loudly to get the truth out about what they scripting. And I do believe we are moving in that direction. Now all that said I have a Rheumy who is so ultra cautious you end up suffering a bit too much. Sometimes getting what you want isn’t easy either:)

          • http://www.twitter.com/alicearobertson Alice Robertson

            Okay….reread it….so he recommended a natural diet product? If that’s the worst Slate can get on him he is doing spectacularly well!:) If you were on TV daily you would probably be relieved if that’s all they could get on you. I know I would be.

            But you mentioned science. Where would the money come to do studies that you want on these products? And if we are going to get into natural products getting studied (or regulated) where does that go? Will we have to go down to only organics (and that’s tricky) to eat? Should we ban all processed food? Seriously, where does the regulation of natural products end? Will we be forced to grow it and eat the roots? Ha! Sorry, but if you like Slate I thought you would find that statement funny:) People wonder will hair dye be gone (and cosmetics)? Can you imagine the repercussions from that decision? Okay…you get the picture and I am just having fun with a serious topic and trying to make you smile.

    • LIS92

      My doctor has prescribed a medication for me off-label. I take it because it makes me feel better. My doctor has admitted he doesn’t understand the underlying mechanism of why it works. There are no studies to show it works for someone with my condition. So prescribing medications off-label is not medicine?

      I also use massage therapy because it make me feel better. Is this medicine or not? What’s the difference between the unproven massage therapy and the unproven off-label medication?

      • PollyPocket

        Placebo?

        • LIS92

          So is your reply evidence bases or voodoo?

      • mmer

        //I take it because it makes me feel better.//

        Your personal anecdotes do not constitute as scientific evidence. We shouldn’t be prescribiing things because “they make us feel better,” but because they have a demonstrated efficacy in treating a certain condition, preferably in a relevant patient population – feeling better will be a corrollary of this. A doc doesn’t necessarily have to know how something works for it to constitute as medicine (although he probably should). Is the off-label use of your particular medication supported by any studies for your condition – maybe it is.

        I regularly get massages and they make me feel good, but massages have not been shown to effectively treat any clinical conditions, with a big maybe surrounding lower back pain.

        The litmus test for the question “is it medicine” is not “does it make me feel good.” An IV of morphine will make you feel very good too.

        • LIS92

          I have symptoms and the medication takes care of those symptoms. It doesn’t save my life or get rid of the disease, it makes me feel better. If I didn’t take this medication, I don’t know if my disease will get worse. It’s really all about the symptoms. Taking the medication makes me feel better.

          There

          I trip to the physical therapist usually results in a localized massage. Are you saying PT is alternative therapy?

          Extra vitamin D has not been shown to treat any disease…or prevent it yet my doctor insists that I take large doses. And then there was vitamin E…

        • anon3

          In that case they should stop doling out antidepressants not just for depression, but for everything. They prescribe them for anything. INCLUDING things where antidepressants can or will make the person WORSE. Notably they are using antidepressants off label for many physical problems. However the both of you are arguing things that are flawed logically, so I can’t really go into that much detail. I will just say, massage gets rid of tight muscles, it is used in sport, it is a THERAPY, it can drain lymph… it makes you feel good for more than one reason, and there is evidence for it. Some people don’t like being half-naked and or rubbed by a stranger but cannot deny it helped their injury! Lots of successes in medicine are related to the placebo effect and I know doctors also do this with patients, pretending to do something or exaggerating things, knowing that the care and reassurance might help the patient.

          • mmer

            //They prescribe them for anything..Notably they are using antidepressants off label for many physical problems//

            Your hyperbole makes the rest of your comment look silly.

            First off, antidepressents are not a monolithic entity, there are many classes (ie. TCAs, SNRIs, SSRIs…). Cymbalta (an SNRI), for example, is approved by the Food and Drug Administration for chronic musculoskeletal pain – but, if your doc prescribed an SSRI for chronic pain, I would definitely question that call. The evidence supporting the treatment of some physical problems by certain classes of antidepressents is there, and for others, it’s not.

            //lots of successes in medicine are related to the placebo effect and I
            know doctors also do this with patients, pretending to do something or exaggerating things, knowing that the care and reassurance might help
            the patient.//

            When did I claim the contrary? These things are important in the healing process, and in some cases are validated by evidence in improved outcome (ie. the study “Pediatric clinicians’ support for parents makes a difference: an outcome-based analysis of clinician-parent interaction”).

          • http://www.twitter.com/alicearobertson Alice Robertson

            Rheumy’s prescribe that stuff for pain all the time. Elavil and Cymbalta (which I know is an SNRI and as you stated approved for plural problems…but an FDA approval doesn’t rock my world. Yes, they are useful at times, and harmful at times. The drugs didn’t work for me for my pain from RA, but other patients like it).The drug classifications you mentioned are all sorta trial and error….just like alternatives (that are safer because we know there can be huge problems with Cymbalta. I think crazymeds (dot) com does the best plain language summations of any site, or any doctor. I have seen). That’s just an FYI for others who read these threads.

            If you believe in the placebo effect (and I agree with you on this) then there is no beef with homeopathy or alternatives. We know there is placebo effect with scripts too (I think there was a clinical trial on Prozac proving that). If the patient thinks they are better….let it be!:) The only problem is scripts as placebos may mean some very real problems that aren’t imaginary.

            Could you or any dissenter just tell us the data on who died from alternatives? Then we can discuss who died from scripts (that are heavily regulated).

  • Medical Revolt

    I am an internal Medicine physician and my wife is a naturopathic
    physician so I see both sides. The problem is that what is called
    “alternative medicine” is often nontoxic vitamins, minerals, foods, or
    herbs that hundreds of years of observation have shown to be effective
    but are never studied or used by traditional medicine because there is
    no profit to be made. There is preliminary research showing promise for
    vitamin D for seizures, turmeric for arthritis, vitamin A for
    alzheimers, horse chestnut seed extract for venous insufficency but it
    is never followed up with any good randomized trials because there is no
    money in it. And therefore it is forever damned to the category of
    “alternative” because it is “not evidenced based.” The statement that it
    is not evidenced based is true but not because it was studied and
    failed but because it never has been and in our current system never
    will be looked at because there is not profit to be made. I have devoted
    my entire blog to this issue and I hope as many physicians as possible
    will visit it and have their eyes opened as mine were by my wonderful
    wife.

    • Chiked

      “…but it is never followed up with any good randomized trials because there is no money in it”

      I will also add that if big pharma did any randomized trials comparing their drugs with herbal remedies, we would finally see how worthless some of their blockbuster drugs are. They simply will not take that risk.

      • Medical Revolt

        Absolutely. Good point. Not only is there no money to be made. There is a lot of money to be lost. If IV Vitamin C is found to treat cancer better than chemotherapy for instance that could be billions of dollars lost.

        • Roy Benaroch MD

          There are billions of dollars to be made– and billions are being made, now, by the many manufacturers and sellers of alt-med products. The alt-med community has a booming, money-making industry of its own, with their own biases and agendas (as much as with traditional medicine. Smaller, but still huge.)

          “There’s no money to be made” is a flimsy excuse. The alt med industry could do these studies, and, yes, perhaps show that some of their products are superior to those of the pharmaceutical companies. That would be great, and would benefit all of us. Will they take up the challenge to start studying their products critically? I suspect they would, but only if their customers expected it.

          • Chiked

            You are a doctor so I am sure you understand the side effects of many of these drugs. Why would the alt med industry ethically subject anyone or any animal to a drug that could destroy your liver for instance (statins0 just to prove what has been known for thousands of years.

            I say whoever wants to sell a $10 a pill drug prove that it is worth it.

    • http://www.twitter.com/alicearobertson Alice Robertson

      Is your blog URL listed here somewhere? Or if the link won’t load can you give the full name of your blog?

  • Medical Revolt

    I agree lots of money is being made with alternative meds. Billions in fact. When I say there is no money to be made I am referring in doing the studies. Clearly there is lots of money to be made by selling herbs and vitamins. Look at Herbalife. However, there is no money to be gained by doing studies of vitamins or herbs because they cannot be patented. When a pharmaceutical industry patents a drug and does the studies necessary to get it through the FDA they have the potential to make financial windfall as the only allowed retailer of that medication. However, if some altruistic company decided to start doing the studies necessary on herbs and vitamins, they gain no benefit after they have spent all that money to do so. If their study shows that Woojoo weed (made up name) cures cancer they cannot patent it. Therefore anyone who wants to sell woojoo weed can do so and the company that spent the money to do the study has no market advantage.

    And lets face, no corporation (be it in the alternative or traditional medicine field) is going to spend money they don’t have to and that they won’t gain from.

    Personally I see no other way than for the government to step into this role. Let the NIH start looking into promising treatments that have no free market incentive to be investigated. The government may very well make back the money it invests and then some in Medicare savings.

    • http://www.twitter.com/alicearobertson Alice Robertson

      I read a Cardiologist sharing that statins were formed upon the basis of how red yeast helps lower cholesterol. But as you stated the money wasn’t there so they added a bit of this or that and wallah….a pharmaceutical is born and statins made tons of money (while doing more harm than red yeast because of this or that they added). But it’s the this or that added that has made statins a problem with diabetes and memory and muscle problems (which Coenzyme helps solve. I can imagine they would like to script that too).

      Yet, they will scream about the money and safety of alternatives and I think we may see more of this.. Take something natural and add a compound then sell it for ten times more to the public. Ultimately, they will add something and get it regulated to make tons of money while the public has not been served well. It’s the same reason they triple the price of a drug right before it goes generic. Greed!

      The whole debate feels more like a profits pull than a safety issue.

      From Wikipedia on Red Yeast Rice: snippet: Different strains of Monascus fungus will produce different amounts of monacolins. The ‘Went’ strain of Monascus purpureus
      (purpureus = dark red in Latin), when properly fermented and processed,
      will yield a dried red yeast rice powder that is approximately 0.4%
      monacolins, of which roughly half will be monacolin K (identical to
      lovastatin). Monacolin content of a red yeast rice product is described
      in a 2008 clinical trial report.[7]

  • usvietnamvet

    She might want to try using Olive leaf. It’s helped my excess phlegm tremendously with no side effects (what a change). As for weight loss the best thing is to learn to listen to your body and eat only when you’re hungry and only enough to make you un-hungry. I’ve lost over 100 lbs this way. This after seeing a diet specialist who told me all my dieting had screwed up my metabolism.