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By Dr. Joseph E. Pizzorno Jr.

Americans spend $88 billion a year on prescription and over-the-counter medicines, an amount that would feed twenty million Americans for a year. Were all of these drugs helpful, there would be no need for discussion. However, many of them not only don't cure the illness, they sometimes produce side effects more serious than the condition being treated.

    Most conventional drugs are intended to relieve pain and discomfort as quickly as possible. And they often do this. However, the problem with this approach is that these medications do not promote health. And worse,
they allow the underlying cause to remain and the illness to progress. If a person suffers recurrent colds, for example, taking cold medicines may unstop the stuffy nose and quiet the hacking cough, but the reasons for getting frequent colds are left unattended. Moreover, these medicines do nothing to encourage the body's natural healing ability, which a number of natural substances can do. We need to think about healthcare that promotes well-being instead of just treating the symptoms of disease.

    The following ten drugs most aptly demonstrate what I believe to be the fundamental error in our drug treatment approach to healthcare. Based on my review of the research literature and clinical observations, these are drugs that I personally would never take. In the case of some, I cannot justify the risks of taking them because I believe that safer, more effective, and less expensive solutions are available. In each case there is a natural alternative that helps to correct the underlying cause of the illness and promote wellness.

    I must add that answers to health problems seldom are found in any single remedy, whether natural or not. The conditions for the body to heal depend on healthy diet, exercise, and attitudes. Herbs, vitamins, and other substances often can stimulate healing, but unless the underlying reasons for the illness are corrected, improvement will be only temporary. Note: If you are under the care of a doctor or if you are taking medication prescribed by a doctor, you should consult with your doctor before beginning the therapies outlined below or before decreasing or discontinuing any medication. If any health condition persists, you should see your doctor.

1. Common Cold Medications

Many people freely take aspirin, acetaminophen, ibuprofen, and decongestants for conditions such as the common cold with little thought about possible toxicity. There could be real reason for concern, however, as these medicines can suppress immune function at a time when resistance to infection is most needed.

    For example, one group of researchers performed a double-blind, placebo-controlled trial on the effects of over-the-counter pain- and fever-relieving medications upon virus shedding (the expulsion of viruses through the skin), immune response, and common cold symptoms. In summary, the study showed that those using common cold medications suppressed their immune system's response to the virus, increased the amount of time during which they were infected, and experienced greater respiratory discomfort.

    Although not accepted by the mainstream medical profession, evidence exists that vitamin C helps prevent and decrease the duration of the common cold. This is not surprising because it is well known that blood levels of both white cells and vitamin C drop significantly during the common cold.

    Another nutrient, zinc, also helps the immune system and directly inhibits the growth of cold viruses. A double-blind study demonstrated that after seven days, 86 percent of thirty-seven zinc-treated subjects had no cold symptoms, compared with 46 percent of twenty-eight placebo-treated subjects whose symptoms persisted.

    The herbs Echinacea angustifolia and Echinacea purpurea also act against many infectious conditions, including influenza, the common cold, and upper respiratory infections.

    For patients, I have typically recommended, at the first sign of cold symptoms or when under unusual stress, one half teaspoon of echinacea root tincture three times per day or one teaspoon of juice of echinacea flower and stems three times per day; 500 mg. of vitamin C two times per day, and, for one day only, one zinc gluconate lozenge (containing 23 mg. of zinc) every two waking hours. I have recommended that patients take the echinacea and vitamin C for a maximum of seven days.

2. Antidepressants for Depression

Tricyclics (e.g., Sinequan, Tofranil, Aventyl, Vivactil, Surmontil) Heterocyclics (e.g., Asendin, Wellbutrin, Ludiomil [maprotiline], Desyrel, Effexor)

Selective serotonin re-uptake inhibitors (e.g., Prozac, Paxil, Zoloft) Monoamine oxidase inhibitors (e.g., Marplan, Nardil, Parnate)

Sympathomimetic stimulants (e.g., amphetamine, methylphenidate)

Antidepressants are among the most commonly prescribed drugs. Unfortunately, most of these drugs have significant side effects_headaches, drowsiness, dry mouth, sexual dysfunctions, and insomnia. Depression, it should be said, can be a complex problem involving various factors in a person's life, and people with serious depression should see a person trained to treat mental health problems. However, as people age, perhaps beginning in their thirties or forties, depression is often caused by (or can be worsened by) diminishing brain function. This condition responds well to nutrition and herbal improvement of blood flow to the brain.

    The herb Ginkgo biloba is especially useful for depression caused by poor circulatory flow to the brain. In one study, a group of sixty patients with both depression and a lack of adequate blood flow to the brain were given, once a day, 160 mg. of Ginkgo biloba extract and compared with a group given a placebo. Within two weeks, the ginkgo-treated group had less depression, irritability, memory loss, headaches, and concentration difficulties than the placebo group.

St. John's Wort 

    Another excellent herb for mood elevation is St.John's wort (Hypericum perforatum). In a representative study of St. John's wort, 105 patients with mild to moderate depression of short duration were given 300 mg. of St. John's wort or a placebo three times a day over a four-week period. Two-thirds of the St. John's wort group experienced alleviation of their symptoms (sadness, hopelessness, helplessness, worthlessness, exhaustion, headaches, and poor sleep) with no reported side effects.

    Hypericum extract has also been directly compared with the antidepressant drugs, such as maprotiline. In a study of 102 patients suffering from depression, 50 percent improvement was seen in body groups after four weeks. However, while the patients taking maprotiline suffered side effects such as tiredness, dry mouth, and heart problems, the St. John's wort patients reported no side effects.

    Finally, many people with mild depression report being helped by regular exercise, especially a combination of aerobic exercise (which increases the heart rate and increases blood flow to the brain) and yoga or stretching exercises (which improve circulation throughout the body, including the brain).

    For patients with mild depression, I generally recommend 40 mg. of standardized extract of ginkgo three times per day (containing a minimum 24 percent flavoglycosides, the active component). Also, I have suggested that they take 300 mg. of St. John's wort three times per day_ and exercise regularly.

3. Premarin (or Synthetic Estrogens) For Menopause

As women enter menopause and their estrogen output falls excessively, causing a number of menopausal symptoms, the conventional way to treat these symptoms is with an animal source estrogen or a synthetic estrogen. But this approach has many problems. Substantial research now documents the side effects (fluid retention, weight gain, irritability, postmenopausal bleeding, migraine headaches, and hypertension) and the possible increased risk of breast and uterine cancer. Nutrition and herbs can help to reestablish normal estrogen metabolism. Many women find special nutrients from plants (such as genistein from soybean products) a better choice than synthetic estrogens or the animal estrogen Premarin, which is extracted from the urine of pregnant mares.

Phytoestrogens ("phyto-" means plant) are chemicals (such as genistein) found in certain foods that normalize estrogen activity. Foods high in phytoestrogens include members of the umbelliferous plant family (fennel, celery, and parsley), the brassica family (cabbage, broccoli, and brussels sprouts), nuts, whole grains, apples, and alfalfa. Fennel and anise are particularly high in phystoestrogens, as are soy foods. One cup of soybeans provides the equivalent estrogen effect of one tablet of Premarin. (It is not necessary to eat this amount of soybeans, however, to produce beneficial effects. Only three ounces of soy a day yields positive results, and this could be obtained from a combination of soybean products, including soy beverages, tempeh, and tofu. The primary side effect is reduced risk of most cancers.)

    Perhaps the most research into herbs for menopausal symptoms has occurred with Vitex agnus-castus (chaste tree), which is used most often for menstrual disorders and PMS. A study in Europe of 153 gynecologists saw reduction in symptoms in 32 percent of patients within the first four weeks and 84 percent within twelve weeks. Twenty-nine percent became totally symptom-free while only a percent showed no response by the end of the study. About 5 percent reported side effects, all mild accept for one person who experienced heavy headaches requiring cessation of therapy.

    For patients who are experiencing menopausal symptoms, I usually recommend consuming ample amounts of foods that contain phytoestrogens and taking 40 drops per day of a 1:5 tincture (one part herb to five parts water/alcohol solvent) of Vitex agnus-castus.

4. Aspirin and other Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for Osteoarthritis

5. Aspirin and other NSAIDs for Rheumatoid Arthritis

NSAIDs now on the market include Ibuprofen, Diclofenac, Etodolac, Flurbiprofen, Indomethacin, Ketoprofen, Meclofenamate, Nabumetone, Naproxen and Fenoprofen, Oxaprozin, Phynylbutazone, Piroxicam, Sulindac, Tolmetin.

Aspirin has been the most widely used drug during the past one hundred years. One of its most common uses is for the relief of pain arising from both osteoarthritis and rheumatoid arthritis. Osteoarthritis is the more common of the two diseases. It strikes the joints and occurs mainly, although not solely, among the elderly. Rheumatoid arthritis affects the whole body and occurs mainly among younger people, especially women in the their twenties and thirties. Using aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) for either of these conditions can cause problems.

    The problem aspirin and other NSAIDs appear to cause in osteoarthritis is a good example of what can happen when therapy is limited to symptom relief rather than health promotion. By masking pain, these drugs may allow ongoing damage to the joints and hinder the body's normal repair function (the manufacture of collagen to replace lost cartilage).

    An alternative approach is, first, to decrease the damage to the cartilage. This usually calls for rebalancing the musculoskeletal system, which can be done with the help of a chiropractor, osteopathic or naturopathic doctor, or other practitioner skilled in establishing proper alignment of the spine and other joints. The next thing to do is to increase the rate of repair of damaged cartilage. Several nutrients appear to help speed the repair process, especially glucosamine sulfate, a naturally occurring substance found in joint structures.

    One double-blind study of forty patients with osteoarthritis of the knee compared the efficacy of 1.5 grams daily of glucosamine sulfate with 1.2 grams of ibuprofen daily. By week eight, the patients treated with glucosamine reported a lower pain score. Other studies have shown that the pain relief continues for weeks after the glucosamine sulfate supplementation is discontinued and that adverse reactions are rare.

    For patients who suffer from rheumatoid osteoarthritis, I have recommended three 500 mg. capsules of glucosamine sulfate per day. Patients usually see results in several weeks.

    When aspirin and other NSAIDs are used in the treatment of rheumatoid arthritis, these drugs do decrease symptoms. But once again, they actually contribute to the progression of the disease since they damage the lining of the intestines and permit toxins that damage the joint cartilage to more easily enter the body. A better approach in the case of rheumatoid arthritis is to use fish oils. For example, a double-blind study of patients with rheumatoid arthritis demonstrated that daily supplementation with 1.8 gm of eicosapentaenoic acid (a fish oil concentrate referred to as EPA) brought about significant improvement. A very early study performed almost 40 years ago found that supplementation with the much less expensive cod liver oil also resulted in significant clinical improvement.

    For patients who suffer from rheumatoid arthritis, I typically recommend 1.8 gm of EPA per day.

6. Sumatriptan and Ergotamine for Migraines

Headaches are one of the ten most common complaints that send people to a doctor. The standard medical approach to migraine headaches is to relieve the symptoms through the use of drugs such as sumatriptan and ergotamine. Sumatriptan works well, reducing symptoms in 70 percent of cases, with most side effects being mild except in the 5 percent who suffer chest pain. It has no impact on the frequency of attacks, however, and is expensive ($75 a dose). Ergotamine is effective in about 60 percent of cases, but 40 percent of these experience such side effects as drowsiness, diarrhea, nausea, and vomiting. Again, the better approach may be
to treat the underlying cause, which often appears to be food allergies.

    In a controlled trial of eighty-eight children with severe, frequent migraines, 93 percent recovered when their food allergies were controlled. In a study of adult patients with migraines, 66 percent had complete relief within two weeks when the offending foods (an average of five different foods and one food additive in each person) were eliminated. The most common allergenic foods were cow's milk, wheat, chocolate, eggs, and oranges, and the most common food additive was benzoic acid, which appears in many packaged and processed foods.

    People who suffer from migraines might first want to try eliminating the above mentioned offending foods and the food additive. If this eliminates the migraines, then add the foods one by one back to the diet to see which were the offending foods. If elimination of these foods does not stop the migraines, then consult a nutritionally oriented doctor for more extensive testing.

7. Weight Loss Products

In the past decade, the weight of the average American adult has increased ten pounds. While hundreds of diet plans and schemes are widely touted, the $6 billion a year people spend on these products is wasted. Both nonprescription drugs (such as phenylpropanolamine and benzocaine) and prescription drugs (such as amphetamines) promote weight loss, but typically the weight is rapidly regained because the underlying causes of the condition are not addressed.

    My clinical experience and study of the research convince me that the only successful weight loss program is one that includes all of the following: (1) an unprocessed, whole foods diet, (2) regular significant exercise, (3) support for the thyroid, and (4) psychological counseling.

    Here are some points of interest. Although appetite regulation is a complex process, research suggests that at least some of our appetite is controlled by how many trace minerals we get in our diet. In other words, we eat until our trace mineral levels get high enough. This is why whole, organically grown foods are important_these foods have been tested and found to be higher in trace minerals.

    Thyroid deficiency is a far more common problem than most people recognize. Low thyroid levels yield a lower rate of calorie burning. Depending on the test used, 10 to 30 percent of the population suffer from low thyroid function.

    Much of the increase in weight that is seen among Americans can be connected to a decrease in exercise. The number of sedentary adults is high, and it increases with age, from 55 percent among those who are aged 18 to 34 years old, to 59 percent of those who are aged 35 to 54, to 62 percent of those who are aged 55 or older.

    And finally, stress is found in studies to increase appetite. Factors in one's life that worsen stress need to be controlled.

    For weight loss, I suggest a program that includes the four recommendations outlined above. A doctor can tell you whether your thyroid output is low, and if it is, there are natural thyroid substitutes that a naturopathic or holistic doctor can recommend.

8. Antibiotics for Acne

While antibiotics are very useful when the body's immune system is overwhelmed, their overuse may cause health problems.

    Candida fungus overgrowth can be one of the more pernicious outcomes of antibiotic overuse. When patients receive antibiotics, it appears that the level of candida in their intestines can increase so much and the intestines can become so damaged, that some of the candida leak into their blood and inhibit the function of the immune system.

    New evidence now suggests that antibiotics alter some forms of bacteria and fungi in such a way that the immune system cannot detect them. These altered forms of bacteria can quickly proliferate and cause full-blown infections. They have been tentatively implicated in urinary tract infections, heart valve infection, rheumatic fever, Crohns disease (inflammation of the small intestine), and additional chronic health problems.

    A new twentieth-century problem is the growing number of bacteria that are resistant to the available antibiotics. For example, it is increasingly difficult to find antibiotics that are effective against pneumococcal infections of the ear and respiratory tract, or ones that are able to combat coccal infections of the genitals.

    The bottom line is that while antibiotics can be lifesaving when used appropriately such as for bacterial pneumonia, overuse and inappropriate use cause serious and potentially widespread health problems. Doctors in recent decades have overprescribed antibiotics for such conditions as colds caused by viruses (which antibiotics don't kill) and other infection could be treated without these drugs. Antibiotic overuse has been most evident when these drugs are routinely prescribed for acne.

    Once again, it is better to search causes. Acne appears to be a combination of a hormonal imbalance, a local diabetes-like condition in the skin, a excessive inflammatory reaction to the bacteria in the skin. Several natural medicine treatments can help reverse these problems. The first step is to eat a healthy diet. A diet high in animal or saturated fats will worsen the inflammatory activity in acne, especially the more severe cystic form of it.

    Zinc is one of the most important nutrients for acne treatment. Zinc helps correct the underlying hormonal problem (by detoxifying testosterone), decreases the inflammatory reaction (by synthesizing antiinflammatory prostaglandins), and directly kills some bacteria growing in the skin. In a double-blind study of sixty-six patients with inflammatory acne (a more severe form), those taking 30 mg per day of zinc (in the gluconate form) showed significant improvement over a control group.

    Chromium is another useful nutrient for controlling acne. It helps by moderating the levels of sugar in the blood; sugar depresses white blood cell activity necessary for control of the bacteria that cause acne. Supplying chromium (200 micrograms per day) in the form of brewer's yeast results in an improvement in acne.

    For patients suffering from acne, I have most often recommended one tablespoon of brewer's yeast and 30 mg of zinc gluconate per day and a reduction in the consumption of animal fats.

9. Cortisone Cream for Eczema

Eczema (also known as atopic dermatitis) is a common skin flare-up, affecting about 5 percent of the population. The usual medical treatment is cortisone cream (either taken in stronger form as a prescription drug or found in weaker concentrations in over- the-counter products), which alleviates the intense itching. However, because this approach only treats symptoms, the eczema returns as soon as the cortisone is stopped. In addition, long-term use of cortisone causes several side effects, from local thinning of the skin and increased susceptibility to infection to suppression of the adrenal glands.

    A far better approach is to treat what appears to be the underlying causes of the disease: a lack of hydrochloric acid (HCI) in the stomach, the presence of food allergies, and probably most importantly, a tendency to excessive inflammatory reactions. This latter problem occurs due to an imbalance in the ratio of inflammatory to anti-inflammatory prostaglandins (hormonelike chemicals that control our inflammatory reactions). The antiinflammatory prostaglandins are made from the essential fatty acids (which come from nut, seed, and fish oils) while the inflammatory prostaglandins are made from arachidonic acid (which comes primarily from animal fats).

    Since 1933, researchers have known that children with eczema have lower levels of essential fatty acids in their blood. Supplementation of either eicosapentaenoic acid from fish oils or gamma-linolenic acid from evening primrose oil (and presumably from borage and black currant seed oils) markedly improves eczema. Clinical improvement typically takes from six to eight weeks.

    For patients with eczema, I have typically recommended the following: (1) get adequate essential fatty acids, as outlined above, (2) increase HCI secretions in the stomach by taking herbal bitters (available at health foods stores) before meals or by taking supplemental HCI in the form of betaine HCI, plus 30 mg of zinc, which is needed by the body to synthesize HCI; and (3) determine if you are allergic to foods through tests done by a doctor.

10. Antacids

Aluminum-containing antacids: Alternagel, Amphojel, Gelusil, Maalox, Mylanta

H₂-blockers: Cimetidine (Tagamet), Famotidine (Pepcid), Nizatidine (Axid), Ranitidine (Zantac)

Millions of Americans who suffer "heartburn" or acid indigestion seek relief by regularly taking acid-neutralizing pills bought over the counter. Until recently, antacids (such as Maalox or Mylanta) were the drug of choice for this condition. Now, a new category of drug has been introduced into the market: the H₂-blockers, which block the release of acid in the stomach. The H₂-blockers, such as Tagamet and Zantac, were formerly prescription-only drugs used against ulcers and are now sold over the counter for acid indigestion and ulcer symptoms. In my opinion, both the antacids and the H₂-blockers pose health risks, some potentially serious.

    The basic problem with these medicines is that they interfere with the stomach's normal production of acid, which plays an important role in digestion and in the prevention of intestinal infections. Stomach acid secretions are crucial to proper digestion and assimilation of food, particularly the digestion of proteins and minerals. They not only start the breakdown of foods in the stomach, but also, when these acids are dumped from the stomach into the small intestine, they signal the pancreas to release its digestive enzymes. If there is a deficiency of stomach acids, which can happen to people who frequently take over-the-counter antacids and H₂-blockers, the likelihood of a wide range of diseases and illnesses can increase. Asthma gallbladder disease, hepatitis, and osteoporosis are a few of the diseases associated with low gastric acidity, while some of the signs revealing this condition include indigestion, cracked fingernails, postadolescent acne, and yeast infections.

    There are other problems with over-the-counter antacids. Many contain aluminum salts, which neutralize the stomach acid. Although the evidence is not conclusive, there is a chance that aluminum in the blood in some way contributes to Alzheimer's disease. Biopsies demonstrate that people with Alzheimer's have high levels of this toxic mineral in their brains. Whether aluminum initiates the disease or simply concentrates in the brain in response to the disease process is not known. However, removing aluminum from the blood of Alzheimer's patients appears to slow the rate of deterioration (although it appears to be too late to effect a cure).

    People who take aluminum-containing antacids get markedly more aluminum than an average daily intake. They consume between 100 and 1,000 mg a day, as opposed to the 10 mg that people normally get from food and water.

    It is better to take care of the underlying problem rather than trying simply to relieve the symptoms. Stomach ulcers and acid indigestion are caused by damage to the stomach cells. Scientists today believe that the primary source of damage is from infection with a bacterium, Helicobacterpylori (H. pylori), for which antibiotics have become the popular treatment.

    However, a closer look at the population of ulcer victims calls this theory into question. It is true that virtually all patients with ulcers are infected with H. pylori. However, 30 percent of people without ulcers are also infected with H. pylori, and only 5 to 10 percent of the general population have ulcers. In other words, only one-third (at most) of those infected with H. pylori have ulcers. This means that, like other infectious agents, H. pylori only produces ulcers in those who are susceptible. To avoid any infectious illness, it helps if the body's immune system is in peak order, and this state of health is largely achieved through proper diet, exercise, and mental outlook.

    Once someone has ulcers or acid indigestion, raw cabbage juice is a well-documented treatment. Studies have shown that drinking 1 liter per day of the fresh juice, taken throughout the day, results in total ulcer healing (confirmed by X rays) in an average of only ten days. For some people, this can be an inconvenient therapy (cabbage juice is definitely an acquired taste). For such people, glutamine may be an effective therapy. (Glutamine appears to be the component in cabbage juice responsible for the efficacy.)

    The herb Glycyrrhiza glabra (licorice root) also has a long history as an excellent natural medicine for stomach ulcers. However, one of licorice root's constituents, glycyrrhizinic acid (GA), can increase blood pressure in susceptible individuals. These people may take deglycyrrhizinated licorice (DGL), which has the GA removed. DGL is so safe and effective that it has been shown to be far superior to the drug that for years was the primary medical treatment for ulcers: cimetidine. DGL has been shown to increase the blood supply to the damaged mucosa, increase the number of cells producing the mucus that protects the stomach, and increase the amount of mucus the cells produce.

    For patients with acid indigestion or ulcers, I have recommended a regimen of cabbage juice (1 liter throughout the day)_ or 1.5 grams of glutamine per day_and 500 mg. of DGL before each meal.

Joseph E. Pizorno, MD., is the president of Bastyr University in Seattle and author of The Encyclopedia of Natural Medicine (1991) and the forthcoming Total Wellness, both published by Prima.

Reprinted with permission from Natural Health, September-October 1996. For a trial issue of Natural Health, call 1-800-526-8440.