I started my career in health care as a young grocery store-based pharmacist in 1984.  My experiences there along with some personal health issues changed the course of my career, primarily because I was very disturbed by the disparity I saw between people's grocery cart and the drugs they were picking up at my counter.  I saw many people experience side effects from drugs, and they were taking these drugs for conditions that better nutrition and lifestyle could help address. It didn't take me long to figure out that I wanted to help people live healthier lives with lifestyle changes and the smart use of natural therapeutics, along with guiding people on the intelligent use of drug therapies, when needed.

While the pursuit of this career path hasn't always been easy, I was able to build a very successful career in integrative medicine (nutritional-based care that can work along with conventional medical care as needed) as well as a consulting and lecturing business.  20 some years later I am still thrilled when we at LMI can help patients achieve better health and better management of their health issues.  There is nothing like hearing our patients report how they have their vitality back, that symptoms of a condition are leaving them, or that their doctor has just taken them off medications for a particular problem. 

This field has exploded, primarily because consumers strongly desire health and wellness versus disease care.  One of the reasons is because it is much more personalized care.  A Price Waterhouse report showed that consumer demand for personalized care would generate in excess of 300 billion dollars in revenue by 2014, primarily in foods and the dietary supplement category.  While all complimentary and alternative health care modalities are enjoying tremendous sales due to consumer demand for these products and services, in some circles they are still extremely controversial.  There are severe critics of naturopathic medicine, yet nearly 50% of the 120 medical schools in the U.S. now have integrative medicine departments or programs.  

As I look back upon my career, I marvel at just how far things have come. In many ways there has been a lot of progress, yet there is so far to go. I hope you enjoy the main article this month where I reflect on the changes I have seen take place in the natural therapeutics arena of health care and my speculation on its future.

*Note in the article "we" refers to all of us who were interested in natural medicine.   CMP's refer to conventional medical practitioners. Natural medicine goes by many names:  naturopathic medicine, functional medicine, complementary and alternative medicine and integrative medicine. I prefer to call it metabolic medicine, because a skilled practitioner can use different nutritional products to positively shift the metabolic pathways of the body.  For ease of wording, I will simply refer to it throughout this article as natural medicine.

When I first started practicing as a health and wellness-consulting pharmacist, the people who sought out my services were usually just passed off as "health nuts."  I think many people thought that natural medicine was probably a passing phase, thinking surely the use of vitamins and minerals, herbal products, other nutraceuticals, homeopathy, and a diet based on whole unprocessed foods would be disproved eventually.  For example, CMP's told us that enriched white bread was just as good as whole grain and that taking vitamins just gave people "expensive urine."  Now whole grains are routinely recommended over refined flours, and several studies have found benefits from taking multivitamins (though there is still some controversy over them.)

But natural therapeutics was not a passing phase.  As more and more people were helped with nutrition and other natural products, the popularity of dietary supplements has grown every year, along with all other categories of alternative care like acupuncture.  According to a 2008 survey and analysis conducted by the Natural Marketing Institute, total sales in the health and wellness industry in just the U.S. alone was $112.3 BILLION dollars.  While some CMP's have contended that these are billion of dollars wasted, I have always asserted that people generally aren't in a hurry to waste their money.  In other words, if the products and services didn't help them, consumers would not keep spending their money.  And of course in clinical practice we can measure the results via labs and other clinical measures such as body fat and blood pressure.   More importantly we can track via questionnaires how a person feels and the changes they experience in their symptoms over time.  This style of tracking outcomes is becoming very relevant in medical circles today.

When I first started in this business well designed studies on nutritional therapies were sparse.  Today, countless thousands of studies are proving the roles that many vitamins and minerals and naturally-derived agents can play in health and disease management.  Just look at the list - fish oil, folic acid, and vitamin D are all now regularly recommended by most doctors. In addition many doctors use niacin for dyslipidemia and B vitamins in the prescription form called Foltex for lowering homocysteine.  Some of you may not remember it, but I remember when any nutritional supplement was decried as "snake oil."  But over time research found elucidated their benefits, ie fish oil helps reduce risk of heart disease, helps mood, and can help relieve joint pain.

Another issue of contention in the field of nutrition has been the RDA's.  Many in nutritional practice consider them to be low for optimal health.  Upon further review over the years many of the RDA's for vitamins and minerals have been changed. In the 1980's vitamin D was considered to be one of the riskiest fat soluble vitamins and we were taught that it could be toxic at as little as 4 x the RDA.  Today we know that vitamin D levels are very low in most people possibly due to spending most of our time indoors, applying sunscreen when we are in the sun, and maybe even due to the cultural practice of daily bathing, which washes off the skin oils that contain vitamin D. Low levels are associated with increased risk for breast cancer, MS, and insulin resistance.  Vitamin D supplementation is also being shown to protect people from the flu.  Many MD's are now testing their patients vitamin D levels and giving them vitamin D as necessary to restore them to more optimal levels.  These are a just a few examples of nutritional therapies being integrated into conventional medicine. 

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