“Julie, do you recall the ‘Tylenol murders’ in 1982? Seven people died after taking Tylenol
capsules laced with potassium cyanide.
As a result, over-the-counter meds now come in tamper-proof bottles.”
“That was before my time, Curmudge, but now when I open a
bottle of Bayer aspirin from Walgreen’s I can be confident that each tablet
contains 81 mg of 2-acetoxybenzoic acid plus an enteric coating. However, I would be assuming a bit more
risk if I were opening a package of a multi-component mixture of exotic Chinese
herbs from an unfamiliar vendor.”
“That’s the point, Julie. There is the possibility of contamination or adulteration at
each step in the product’s chain-of-custody—from picking the herbs to drying, grinding,
compounding, bottling, labeling, and selling to the consumer. These are minimally regulated dietary
supplements, and the consumers’ main protection is to buy from trustworthy
vendors who, in turn, buy from trustworthy suppliers. Problems like contamination and mislabeling are apt to get
past the cautions that we mentioned in Alternative Medicine 2.”
“In Alternative Medicine 3 we promised to talk about the use
of alternative meds by people with a disease or who are likely to contract a
disease. Here is how I see that
our discussion above relates to the use of alternative meds and their inherent
risks: As the risk of one’s contracting a disease goes up, so does one’s
willingness to accept greater risk in avoiding the disease. Consider these examples: If a woman’s
mother died of breast cancer, the woman may regard herself to be at risk. If a man’s father has prostate cancer,
the younger man may consider himself at a higher-than-normal risk of prostate cancer. In both examples, the younger persons
might consider the prophylactic use—and attendant risks—of alternative
medications.”
“Wow, Julie!
How perceptive! That’s our
story, so let’s develop it. The
best way to ward off disease, including cancer, is proper diet and a healthy
lifestyle including adequate rest and exercise and no tobacco. Of these, a healthy diet may be the
most difficult to achieve unilaterally.
Consider these obstacles: living with a spouse who is an intractable
meat-and-potatoes person, living at home with Mom whose cooking is
irresistible, or living alone and unwilling to devote more than seven minutes
to preparing dinner. The last
example leaves one with a diet high in all the bad stuff in processed food.”
“Other than divorce to solve the intractable spouse problem,
dietary supplements may need to be considered for filling the nutrition gaps in
one’s current régime. One could
take the supplements when Mom isn’t looking. Based on your well-known lack of expertise, Curmudge, how
would you recommend that one proceed in selecting dietary supplements?”
“You seem to have forgotten, Dear Colleague, that the making
of recommendations is above our salary grade (which is zero) as well as our
knowledge grade. My perception, however, is that one should
simply compare his diet with those we have referenced, take out the bad stuff
if Mom will allow it, and fill in the blanks with over–the-counter multivitamin
and multimineral supplements. Add
fruit and fiber at breakfast and raw vegetables and more fruit at lunch. Up to this point, we have stayed with
safe and reliable products from the neighborhood pharmacy and food market and
avoided exotic herbal concoctions.”
“Next, Old Guy, what about the person who is fearful that
his ancestors have left him with the propensity for contracting a horrible
disease? We assume that this
person is already following the dietary program noted above.”
“If this person is really serious, his best move is to find
a health care provider with knowledge of integrative, alternative, or holistic
medicine or herbalism. However,
those people are pretty scarce, so Plan B is to ask around and read the right
literature. In addition to reading the
books on nutrition that we have already cited, become an ‘information hound’ on
the issue or ailment of your concern.
If you wonder about something, Google it and you will be amazed at the
response (sometimes mostly ads).
If the person’s fear is hereditary cancer, Yance and Blaylock
(references in preceding posting) discuss the biochemical pathways involved in
carcinogenesis; learn from them what substances have been found to derail those
processes. Some of these
substances may have strange-sounding names and come from strange-sounding
places. With these, the risk of
adulteration or contamination goes up, especially with multi-component
mixtures. So if one is
self-medicating, keep it simple and conservative.”
“That sounds like good advice, Curmudge, especially coming
from someone who doesn’t give advice.
I presume that you also have some non-advice for someone who already has cancer?”
“Jaded Julie, the literature on alternative medicine and
cancer is metastasizing. Come back
next week and we’ll learn more.”
Kaizen Curmudgeon
Link to posting from blog archives: Patient Safety—Human Factors 2/19/09
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