“Evidence-Based Medicine”: Do we need research to support our use of supplements?
The practice of Naturopathic Medicine relies on the use of natural materials for health and healing. Many of our vitamins, herbs and supplements have been in use for years, some for hundreds of years. In the mainstream medical world, research is required for a pharmaceutical medication to be approved by the FDA. Naturopaths rarely have the support of this type of research in choosing which products to use, so we often rely on our own experiences -and the experiences of those who practiced before us- when we choose our treatment methods.
However there is now a growing body of research looking at the efficacy of many naturally-derived materials in the treatment of a broad variety of conditions. Incorporating research outcomes into the way we practice is called “evidence-based medicine.” Though this research has barely begun to scratch the surface of all the tools that we use as naturopaths, it is fascinating to see a body of information begin to develop. It is even more fascinating to see how these studies are portrayed in the mainstream media. More often than not, research studies make news when they do NOT support the use of a particular supplement, rather than when they do. I have often heard medical experts on the news conclude that a particular substance is not effective because of the results of one single study. More often than not, it is a substance that I use frequently and with very positive results in my practice. A perfect example of this is the use of glucosamine in the treatment of joint issues including arthritis.
So this leads me to wonder: do we need research to prove that our treatments are effective? How important is it that Naturopathic Medicine is “evidence-based”?
I can only answer this question for myself and possibly on behalf of my patients, who might benefit from the choices that I make as a physician. It is important to remember that many of the research-backed medications that have been on the market in heavy use by physicians have turned out to have extremely dangerous side effects. These side-effects were sometimes omitted from the study results published as a requirement for FDA approval, and subsequently caused the medications to be pulled from pharmacy shelves. Technically the approved use of these medications, some of which caused death, was “evidence-based.”
Research includes human error, and when I read the studies that support the use of a particular substance, it is often not difficult to see how the conclusions of the study have been somewhat biased. All research is not corrupt, but it is very important to not rely on one study to draw a conclusion. I get excited when I see a study published that supports the use of a material that I already am using in my practice with success, because it encourages me and provides me with some evidence to share with my patients. But I must confess that if a study is published that “disproves” the efficacy of something that I know to work in treatment, I don’t have a problem putting it aside and waiting for more studies to be performed. I realize that this might sound biased, but the knowledge of the Naturopaths who practiced for years before me is more applicable to my choice of treatment than any research published. I look forward to seeing the results from studies being performed today, but I will wait a few years before I definitively change my practice habits until I feel certain that the results are truly representative of the efficacy of a product.