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Aging Begins at 30

Intelligent Choices in Medicine

Ian Maclean Smith, M.D.
Emeritus Professor
Department of Internal Medicine
University of Iowa Hospitals and Clinics

Creation Date: 1996
Last Revision Date: 1996
Peer Review Status: Internally Peer Reviewed

Alternative medicine costs more than $10 billion yearly and more than $3 billion is spent on unnecessary vitamins. Proposers of unproven remedies often present themselves as ill used underdogs, which appeals to the media. Misinformation abounds. Can we control this misinformation in the media?

Licensure of practitioners of various pseudosciences is often treated as endorsement and as a gateway to greater privileges.

If something sounds "too good to be true." it probably is. Be prudent. Be a discerning customer. Don't lose critical time away from scientifically proven treatments. The time you lose may kill you.

If these various "alternative" medicines are to go the way of the unicorn horn, purging, bleeding, leeching, cupping, colon cleansing and so many other fantasies, banalities and exaggerations, then medical pratitioners must speak out. If the 14,000 homeopaths of 1900 now reduced to 350 are to be eliminated with their medicines with non-existent molecules and rational treatment is to succeed, then rational thinking and the evaluation of truth in advertising and in medical care must be taught in high school. Where is the university course, "A Guide to Intelligent Decisions."

The cost of obtaining FDA approval is high. I know, I have pre-market tested 23 antibiotics. If lives are to be saved and treatments are to be rational, it must be done. The FDA was established in part because of tape worm eggs sold as slimming pills. "Alternative" medicines will survive if we don't learn how to recognize truth. The gold standard is the double-blinded (patient and doctor don't know if it's active medicine or placebo) controlled clinical trial.

Herbal medicine has contributed aspirin from willow bark, reserpine from snakeroot, taxol from the yew tree, but "natural" is not automatically safe. Doses must be standardized and the herbs have to be accurately identified. Drug companies have made an enormous effort to identify active compounds in herbs. Randomly gathered herbs are often more toxic than magical. Thirty ingredients of herbal teas are toxic and some are potentially lethal. A number of proponents of unconventional medicine have died of conventionally treatable diseases.

An office to study unconventional medical practices has been established at the National Institutes of Health with an initial budget of $2 million (out of a total of $10 billion). This will be headed by Dr. Joseph Jacobs, MD, MBA, educated at Yale and Dartmouth who describes himself as a "Preppie (Mohawk) Indian." he will encourage comparative studies of traditional and untraditional medicine with strict controls and statistical analysis of the results. We hope he and the grant applicants will be left free of political pressure. It has been very expensive, for example, to prove that sugar is not a cause of hyperactivity.

We must learn to discard inferior treatments when proved useless. Modern medicine has been doing that for many years. Remember truth is a direction not a destination. Be open minded about changing directions when proven wrong.

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