Working with Your Doctor

  • 23 Jan 2003
  • Reading time 7 mins
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Despite all the publicity about the importance of tackling obesity, encouraging people to exercise and the benefits of five to six servings of fruit and vegetables a day, the chances are that your doctor will be at best mildly sceptical about the effectiveness of the non-drug nutritional approach. And that’s not just an off-the-cuff opinion.

In the book we give examples of studies showing just how bad doctors usually are at getting people to make life style changes, even for patients who have just come out of hospital after a heart attack. We also show how influenced they are by medical education paid for by the drug companies and how they are likely to have heard a lot about negative trials of vitamins, several of which are badly flawed, as we show.

So if you want to make use of non-drug treatments but stay with your doctor – and providing he/she is reasonably sympathetic we recommend that you do – you may have to start by politely and diplomatically countering some of the misinformation about the nutritional approach that he/she have probably absorbed.

Here are the top five objections that doctors are likely to raise when you tell them about such lifestyle changes as going on the low-GL diet or cutting out certain foods that you have already made or plan to make, and how to answer them.

Objection 1: The diet seems reasonably sensible but you don’t need supplements and you need to keep taking the drugs. Any improvement you report is really just a ‘one-off’ apparent success. It’s probably got more to do with the placebo effect than your new regime.

Response: Ask your doctor what are his/her criteria for lowering or stopping medication? Is it being symptom-free, having a normal blood sugar level or blood pressure? Try to make sure such markers are measured before you start to objectively evaluate your new treatment. If this has been done already and you’ve got the measured proof of change, then insist, firmly but not evangelically, that this approach, diet, supplements or lifestyle change, has made a big difference and suggest they recommend it to others. Give them the details of the practitioner you saw or the book you read.

Objection 2: There is no evidence these treatments work.

Response: This is a common one but once you have read through Part 3 of the book you’ll see that it is just not true. Any properly trained nutritional therapist will be just as keen on basing treatment on the evidence as a doctor. In fact, you might argue that the diet and exercise approach is more firmly based in the evidence.

Not only have we seen that a high proportion of drugs, such as SSRIs for children, are prescribed ‘off-label’ – meaning that the trial evidence for the effectiveness is simply not there – but the evidence upon which doctors have based their prescribing often turns out to be faulty. Of course, your doctor is not going to take kindly to this kind of comment from you, but you could show them this book, including the list of references, or even offer to lend it to them and ask for their opinion about the non-drug alternatives that you’d be interested in trying.

But it’s still open to the sceptical doctor to ask for more evidence, and this is where you encounter one of the major blocks to getting nutritional medicine properly established. The amount of money available for testing non-drug therapies in tiny compared with the billions lavished on new pharmacological fixes and tracking down fresh genetic targets.

As a result, one of the things we are calling for is some sort of proper funding for non-commercial treatments. And we are not the only ones; a number of reports including ones funded by the government as well as several leading medical figures (details in the book) have recommended the same thing. It’s only common sense really. Rather than just testing a new anti-inflammatory drug to treat arthritis against a placebo, money should be available to try it out against omega-3 oil or even against a diet that reduces allergic reactions.

After all, what patients actually want to know from research is what the best treatment is, not whether this drug is better than nothing. Your doctor is quite likely to agree with that and that in most cases the chances of harm coming from an untested non-drug approach is likely to far lower than being put on an untested drug – something that happens far more often than most people realise, as the book shows.

Objection 3: Non-drug therapies are supposed to be very safe but supplements can have serious side effects. You should stop taking them except, perhaps, an RDA-type multivitamin.

Response: A recent survey found that 29 per cent of people overall, and 37 per cent of people in the Southeast of England take supplements – and that the percentage of people taking supplements, and the amount of supplements that they take, is increasing.  So, despite all the negative hype, people are perceiving, and probably experiencing, benefits. Against this backdrop of almost 20 million people in Britain taking supplements, critics have a hard time coming up with any more examples of damage than maybe a few cases of diarrhoea as a result of taking high doses of vitamin C.

That doesn’t even begin to compare with over 2,500 people killed by gastrointestinal damage from aspirin-type drugs in the UK every year and the ten of thousand patients who are estimated to die from the unexpected side-effects of prescription drugs.

Ask your doctor what their specific concern is in the context of your health problem. Is it the B vitamins, the vitamin A, E or C? Ask them how much they consider safe and on what evidence. Go armed with the evidence of the benefit of the supplements we recommend in the book, complete with the list of references. Too often doctors buy into an anti-supplement stance without ever having really examined the evidence. Ask them to come back to you with their opinion and of course show them Chapter 18 which details the bad science behind the main vitamin scares

Objection 4: Proper medicines go through stringent testing and so should any alternatives. I can’t prescribe alternatives without this evidence.

Response: It is hard to understand how anyone who knows anything about the way research trials are funded can say this with a straight face. Most non-drug practitioners would love to have a proper test of their treatment as compared with a drug. But drug companies pay for most of the trials and the higher the hoops (large-scale, randomised double-blind trials), the harder it is for non-patented medicines to do the same. What’s more we would like to see the testing of non-drug treatments done in a way that does not conceal inconvenient data or downplay side effects.  However, the fact is that there’s a lot of positive research already and the downsides are minimal.

Ask your doctor if their concern is primarily about side effects. How confident are they that drug treatments are less likely to produce side effects than non-drug approaches? Ask them what you have to lose by exploring this option of your own free will, under their supervision.

Objection 5: Health care involves wanting to get as near to the truth as possible and not giving vulnerable individuals false hope.

Response: Absolutely. As the recent report by the Parliamentary Health Committee found, doctors are being denied proper information about the drugs they are prescribing by drug companies’ spinning of the data. A lot of false hope must have been generated as a result. Sleeping pills are still prescribed in their millions even though studies have shown they are not as effective as psychotherapy.  What we need is doctors and patients working together with access to reliable information on both drug and non-drug medicine – and it starts with you giving this kind of information to your doctor.

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