| ...1... | Arthritis Patients Seek Relief With Word-of-Mouth Treatment Health: Cure du jour involves over-the-counter nutritional supplements. But most physicians remain skeptical, urging caution and reputable research. | |
| ...2... | Supplement Offers Hope to Arthritis Sufferers | |
| ...3... | SILVER BULLET STALLED A DIET CAN INDEED EASE ARTHRITIS ACHES--IF ITS AIM IS TO REDUCE WEIGHT | |
| ...4... | What's the
alternative? Hazel Courteney 12/28/97 Sunday Times - London |
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| ...5... | ||
| ...6... | ||
| ...7... | ||
Arthritis Patients
Seek Relief With Word-of-Mouth Treatment Health: Cure du jour involves
over-the-counter nutritional supplements. But most physicians remain skeptical,
urging caution and reputable research.
DANIEL Q. HANEY
06/14/98
Los Angeles Times
Bulldog Edition
Page A-2
Copyright 1998 / The Times Mirror Company
BOSTON -- Suddenly hundreds of thousands, maybe even millions, of Americans with arthritis are taking a combination of obscure nutritional supplements. Whatever made these pills the cure du jour, it's certainly not the way their names roll off the tongue.
Glucosamine sulfate and chondroitin sulfate. Hard to imagine marketing whizzes brainstorming that, isn't it?
It's also not because a lot of arthritis specialists are pushing them on their patients. Mention health store pills to most doctors, and the response is likely to fall somewhere between a blank look and a condescending smile.
The real reasons, it seems, are a cleverly titled book, a hard-to-treat disease that afflicts 16 million Americans and that most elusive and powerful of marketing forces, a good buzz on the street. Or the golf course. Or wherever else men and women of a certain age gather and talk about what's aching them.
Across the country, folks have seized on these over-the-counter pills as a new way to ease throbbing knees and hands, although the opinion of the medical establishment is, to put it politely, skeptical. Just how many of these people are truly finding relief is impossible to say, but clearly the experience has made believers of some.
Among them is Ralph Cushman, 49, a real estate lawyer in Anchorage, Alaska. Cushman is the kind of guy who lives to hike and fish. Those pleasures gradually grew difficult as old injuries stiffened his knees with arthritis, making walking painful. On a hunting trip two years ago, he got 500 feet up a mountain and could go no farther.
"It was heartbreaking," he recalled. "Suddenly, I couldn't deer hunt anymore. All the things I lived for were slipping away."
His doctor told him nothing could be done. Take pain pills and live with it. Cushman limped to a bookstore. There he found something that, in his mind, changed his life.
"The Arthritis Cure," written by Dr. Jason Theodosakis, lays out a program of exercise, diet and glucosamine and chondroitin. The book has sold more than 1.4 million copies since it came out last year.
Cushman followed its directions. "Within days, I realized it was making a tremendous difference," he said. "Suddenly I could out-hike my boys rather than hollering for them to wait. There was just no question this was working. I assure you, you cannot make that kind of pain go away with a placebo."
"Placebo" is just one of the words that comes up when arthritis doctors get onto this subject. They correctly point out that a belief something will work is often powerful medicine in itself. Indeed, when researchers test possible arthritis drugs, about 30% of the subjects feel better even when they are in the comparison group getting sugar pills. Some doctors suspect this may at least partly explain why people find relief from glucosamine and chondroitin.
"Patients invest time and money in them and they want them to work, so they are more likely to see a positive effect than a negative one," said Dr. Jonathan Kay of the Lahey Clinic in Burlington, Mass.
Osteoarthritis, by far the most common form of the disease, develops when the cartilage that covers the ends of the bones in the joints begins to break down. Eventually, bone rubs against bone, causing pain and loss of movement.
Doctors' usual advice is exercise to strengthen the muscles around the joints and weight loss to reduce some of the stress. Mainstream practitioners also usually recommend anti-inflammatory drugs. Among these are aspirin, Motrin and other over-the-counter painkillers and a variety of prescription medicines.
But many patients suffer despite these pills, and steady use can have serious side effects, such as stomach ulcers and liver damage. According to one estimate, anti-inflammatory drugs contribute to more than 7,000 deaths in the United States annually. Furthermore, the medicines do nothing to slow the progression of arthritis.
Unlike these drugs, glucosamine (pronounced glue-COSE-uh-mean) and chondroitin (conn-DROY-tin) are already present in the body as building material of cartilage.
Proponents theorize that taking extra glucosamine stimulates new cartilage production, while chondroitin slows its destruction. To hear them tell it, these supplements not only relieve or eliminate the pain, they can also stop and even reverse the disease. And they do all this with no side effects.
To which many arthritis experts reply: Show us the proof.
Most studies of glucosamine and chondroitin were done several years ago in Europe. In general, they suggest that the supplements work about as well as over-the-counter painkillers in easing the ache. In the test tube, they appear to stimulate and preserve cartilage.
However, skeptics note these studies were small, not particularly well done and didn't combine glucosamine and chondroitin, which is the way most people now take them.
Dr. Doyt Conn, medical director of the Arthritis Foundation, said the supplements appear to be safe, and they may indeed do some good for some people, but his organization cannot recommend them until there are better scientific data.
"We have to be responsible to the public and give them what reliable information there is to make a judgment," Conn said. "Right now, I don't think that information is out there."
Several U.S. studies are under way, sponsored by companies that make the supplements. The National Institutes of Health is also underwriting one, with results expected in about five years.
Even without the kind of evidence that doctors demand, many hurting people seem willing to try anything that sounds reasonable.
"Pain is a motivator for desperate measures," said Dr. Bobo Tanner, a rheumatologist at Vanderbilt University.
The combination pills, which are widely available in drug and health food stores, typically cost about $40 a month--a lot for someone on Social Security, perhaps, but not an unusual expense for arthritis sufferers. Tanner said his osteoarthritis patients often spent $1,000 a year on unproven remedies. About 10% of them acknowledge taking glucosamine and chondroitin, and at least half have asked about them.
Theodosakis, a sports medicine physician at the University of Arizona who started the craze, estimates that 5 million Americans are taking the supplements. He came across them while trying to relieve his own arthritis, which resulted from sports injuries.
"I needed this stuff, because I was in a wheelchair," he said. "I wasn't helped by anything."
Theodosakis felt a big improvement after two weeks on the supplements. He believes 30% of users will see their arthritis resolve completely, and 80% to 90% will get at least partial relief.
Furthermore, he says, many people find they can reduce their doses over time, and some stop taking the pills entirely without a return of their symptoms.
The most common cause of failure, he says, is brands that contain little or no actual chondroitin and glucosamine . Because the U.S. Food and Drug Administration considers these to be food supplements, not drugs, they escape the kind of scrutiny for purity and effectiveness that medicines receive.
Some arthritis experts are coming around to Theodosakis' view, in part because they have seen remarkable effects in their patients or even in themselves.
Dr. David Hungerford, head of arthritis surgery at Johns Hopkins University, has been taking glucosamine and chondroitin for two years for a bad knee and fingers.
Hungerford is such a believer that he is one of the rare doctors who offers the supplements as first-line osteoarthritis therapy, ahead of anti-inflammatory drugs.
"It's made a dramatic difference for me," he said. "My fingers and joints were swollen and sore. I couldn't use my index finger. Now I have no symptoms at all."
Still, many physicians would probably agree with Dr. Ralph Marcus of Hackensack University Medical Center in New Jersey, who has several hundred patients on glucosamine and chondroitin.
"I can tell you that a very small percentage of patients say they feel better," he said. "My feeling is that somebody's making a lot of money on a product that is probably ineffective."
Supplement Offers Hope to Arthritis
Sufferers
Lisa Lytle
06/09/98
KRTBN Knight-Ridder Tribune
Business News: The Orange County (Calif.) Register
Copyright (C) 1998 KRTBN
Knight Ridder Tribune Business News; Source: World Reporter (TM)
Jun. 9--Cradling an infant gently. Swinging a tennis racket for a mean serve. Walking briskly with the dog around the neighborhood.
People with osteoarthritis know it's tough to do these without discomfort and pain. No wonder droves of sufferers are turning to glucosamine -chondroitin, a nonprescription pill that promises to relieve pain without the side effects typical in many prescription drugs.
Some doctors are approving it for their patients.
The supplement is doing brisk business in drug stores.
But the hype over glucosamine -chondroitin is premature, according to the Arthritis Foundation. The group says we need to wait until we get concrete evidence in the United States that it works.
A synthetic version of naturally occurring substances in our bodies, glucosamine -chondroitin owes much of its popularity to last year's publication of bestselling "The Arthritis Cure: The Medical Miracle That Can Halt, Reverse, and May Even Cure Osteoarthritis" (St. Martin, $11.95) by Dr. Jason Theodosakis, Brenda Adderly and Barry Fox.
The claims in the book are rooted in European research and have yet to be verified by U.S.-published medical studies. Definitive answers may be coming from at least two U.S. studies that are awaiting review from medical experts and publication in medical journals.
Since the book, glucosamine -chondroitin has become the top-selling supplement. Two brands of glucosamine -chondroitin landed the No. 1 and No. 9 position in an A.C. Neilsen report that, since last year, tracked sales of nondrug dietary supplements -- sometimes called "nutraceuticals" -- including St. John's Wort, chromium picolinate and melatonin. The report did not include vitamins and minerals.
Clearly, some of the 16 million American osteoarthritis sufferers -- and some doctors -- aren't waiting until U.S. evidence is published.
They are hoping glucosamine -chondroitin is a potent alternative to current treatments -- drugs that can cause side effects ranging from nausea to ulcers to high blood pressure.
"I think glucosamine -chondroitin has helped with some of the symptoms of my osteoarthritis," said Howard Caplan, 63, who has mild osteoarthritis. "I've been taking them periodically, not on a regular basis, for several months. I have stiffness in my hands and soreness in the morning, which is typical."
Caplan said he takes them after he gets out of bed in the morning.
Before he tried glucosamine -chondroitin, he took Tylenol.
Caplan is not only an osteoarthritis sufferer, he also is a physician specializing in geriatrics at Leisure World in Seal Beach. And he has recommended glucosamine -chondroitin for his patients who have osteoarthritis.
"I've had mixed reviews from my patients," he said. "I don't think it will be much help to people with severe symptoms."
At that same retirement community, director of pharmacy Aniko Lengyel said she and her staff have been getting a lot of questions about glucosamine -chondroitin and people have been buying it in the last six months.
"Several people have come back saying it's helping them cut back on anti-inflammatory medications for their arthritis," she said.
Gary Tekely, 57, of Cypress, recently started giving glucosamine -chondroitin a second chance after it did nothing to relieve his minor knee pain the first time. Tekely took glucosamine for 30 straight days several months ago, but stopped after seeing no results.
A football injury in his younger years damaged Tekely's left knee, and many years later, the bum knee "locked up," forcing him to undergo surgery that removed cartilage from that knee.
Following surgery, the joint started hurting occasionally as though little men were pounding tiny hammers on his knee. One night, the pain was bad enough to wake him.
Tekely has been diagnosed with mild osteoarthritis and plans to take glucosamine -chondroitin for two to four months. If nothing happens afterward, he's dropping it.
U.S. EVIDENCE OF EFFICACY IS IMMINENT:Is glucosamine -chondroitin a cure for Tekely's pain?
Theodosakis and colleagues believes it could be.
They define "cure" as the partial or complete relief of symptoms. It's only a matter of time before American studies end up confirming the benefits European studies have shown for several years, Theodosakis said.
But the Arthritis Foundation says claims of a cure are premature at best, exaggerated at worst.
The organization has adopted a buyer-beware, wait-and-see stance, citing the lack of solid evidence of the supplement's effectiveness in treating pain from osteoarthritis in American medical publications.
The European studies have appeared as abstracts and not yet as papers in peer-reviewed journals, according to the foundation's official statement.
"The studies that have been conducted in the U.S. on glucosamine have been very small -- one had only about 30 people in it," said Dr. Robin Dore, a spokeswoman for the Orange County/Long Beach chapter of the Arthritis Foundation. "That study didn't find it to be any better than Tylenol.
"A lot of my patients started taking it," Dore said. "They felt better after the first month, but they didn't feel any better after that. I've found that after some of my patients took glucosamine , their blood sugar levels were raised."
Dore stopped short of establishing glucosamine as the direct cause of increased blood sugar.
A couple of U.S. studies may provide some concrete answers.
Preliminary findings from a six-month double-blind placebo-controlled study of about 100 patients conducted by Dr. Amal K. Das, an orthopedic surgeon in Hendersonville, N.C., show that glucosamine -chondroitin was effective in reducing pain in mild to moderate cases of osteoarthritis after patients took it for at least four months.
All participants in the study had osteoarthritis confirmed by X-rays. They took a daily dosage of 2,000 milligrams of glucosamine and 1,600 milligrams of chondroitin sulfate under the brand Cosamin, the manufacturers of which partially funded the study.
Das also asked patients to report side effects. The incidence of side effects such as gastrointestinal problems was no different from that of the placebo group, he said. He found no contraindications with other medications.
A 16-week double-blind, placebo-controlled study by Dr. Alan Philippi and Dr. Christopher Leffler of 34 Navy Seals and divers at Portsmouth Naval Medical Center in Virginia showed that the participants experienced significant relief from knee pain after taking glucosamine and chondroitin.
Neither study has been published or completed review by independent medical experts yet.
Despite his study findings, Das recommends that other physicians hold off prescribing the supplement to their patients until his findings and those of other studies are published in respected U.S. medical journals.
Because his study deems them effective, however, Das said he already is prescribing it for some of his patients.
GLUCOSAMINE -CHONDROITIN WORKS ON CARTILAGE: One reason glucosamine -chondroitin is becoming a popular alternative to typical medicine is the public perception that it is natural and therefore probably not harmful, Dore said.
Glucosamine is a substance derived from, among other sources, crab shells. It is naturally found in our cartilage, the rubbery, gelatinous tissue that cushions the hard ends of our bones. Think of the soft, goopy stuff at the end of a chicken drumstick.
Chondroitins are found in most animal tissues, especially the gristle around the joints, Theodosakis and colleagues wrote. Our bodies get it from some of the food we eat.
Synthetic chondroitin usually comes from cartilage in cows and is sold as a sulfate.
Neither is classified by the Food and Drug Administration as a drug nor requires a prescription. Glucosamine and chondroitin also are sold separately.
But they're more powerful when they're combined, Theodosakis said.
In osteoarthritis, cartilage disintegrates. Think of glucosamine -chondroitin as a gardener who feeds plants fertilizer and nutrients and keeps the weeds from wreaking havoc. Glucosamine -chondroitin does the same for cartilage: It stimulates the growth of new cartilage and keeps the enzymes that chew cartilage under control.
NOT ALL BRANDS DELIVER: It's important to pick a reliable brand, Theodosakis said. There is a possibility that a brand that contains glucosamine -chondroitin may not have enough amounts of the active ingredients to work.
Theodosakis suggests looking for brands that have received the stamp of quality assurance from an impartial and reputable testing lab or organization. He said that after sending several to independent labs such as Pharmacokinetics-Biopharmaceutics Laboratory of the University of Maryland at Baltimore, he found some brands were not consistent or did not have enough of the right ingredients to be effective.
Dore, who does not recommend glucosamine -chondroitin, said that those who insist on taking it should keep in mind that insurance does not cover it and it can be more expensive than over-the-counter medications for pain such as Tylenol.
Glucosamine -chondroitin typically costs $57-$78 for 30 capsules or tablets. Tekely, for example, paid $60 for a 30-day supply of twice-a-day pills.
Theodosakis recommends a daily dosage of 1,000-2,000 milligrams of glucosamine sulfate or glucosamine hydrochloride and 800-1,600 milligrams of chondroitin sulfate, depending on your body weight.
"I tell my patients not to be too disappointed if it doesn't work and to keep their expectations low," Dore said. She also advises patients to take it separately from oral medications to decrease the possibility of interactions with drugs.
Pregnant women should not take glucosamine -chondroitin because there are no studies that have examined its safety during pregnancy. People with other medical conditions such as diabetes and high blood pressure should check with their doctor before taking the supplement.
GOOD EATING
HEALTH WATCH.
SILVER BULLET STALLED A DIET CAN INDEED EASE ARTHRITIS ACHES--IF ITS
AIM IS TO REDUCE WEIGHT
Steven Pratt. Special to the Tribune.
01/13/99
Chicago Tribune
NORTH SPORTS FINAL; N
Page 3
(Copyright 1999)
The key to preventing, or at least controlling, the pain of 40 million Americans afflicted by osteoarthritis may lie with the food they eat. But so far researchers haven't been able to get more specific than the suggestion that arthritis sufferers lose weight and pursue a healthful diet. If there is a solution to be found in food, it probably won't resemble the "miracle diets" ballyhooed in vitamin stores, books, magazines and supermarket tabloids.
When patients ask rheumatologist Dr. Richard S. Panush whether a specific diet or food is good for arthritis, "My simplistic answer is `no.' Especially for osteoarthritis," he said.
"Right now there isn't a set of meaningful dietary recommendations, other than to eat healthfully. There are no magic foods, no diet, no book," said Panush, chairman of the department of medicine at St. Barnabas Medical Center in Livingston, N.J. He also works with the National Institutes of Health's Office of Alternative Medicine.
There is an indirect relationship between food and arthritis, though. Arthritis sufferers still need to be aware of what they are eating.
Weight loss probably is the most important prescription for people with osteoarthritis pain, said Dr. David Pitsetsky, chief of rheumatology at Durham Veteran's Hospital in North Carolina. He wrote "The Duke University Medical Center Book of Arthritis."
Obesity, especially over many years, stresses joints and so speeds the development of osteoarthritis.
The most common form of arthritis, osteoarthritis is caused by damage to the cartilage that cushions bones at the joints, especially weight-bearing joints such as the knee and hip. Deteriorated cartilage can become inflamed, compressed and irregular, allowing joint surfaces to rub directly against one another, which is what causes the stiffness and pain. (The less common but more severe rheumatoid arthritis is an immune system disease.)
"A rule of thumb is that a 10 percent reduction in weight results in a 50 percent reduction in suffering," Pitsetsky said.
Once an advocate of the low-fat, high-carbohydrate weight-loss diet so frequently recommended for controlling heart disease and cancer, Pitsetsky is having second thoughts about that prescription.
"I'm not sure that kind of diet works for everybody," he said. "There may be other diets that are more effective in keeping weight down, so I am becoming more open-minded. Weight reduction is the main objective. If there is another diet that will do it, then why not try it, as long as it is not harmful?"
Panush, who has studied the diet/arthritis question, is very wary about directly linking what people eat to osteoarthritis. But he does acknowledge a few pieces of promising evidence.
Limited research, he says, suggests that antioxidant compounds- those oft-mentioned substances that fix the damage done by free radicals in the body-may reduce cartilage loss and slow progression of the disease. Other studies link inadequate vitamin D intake, essential for bone density, with susceptibility to the disease.
For several years it has been known that omega-3 fatty acids, abundant in cold-water fish and some plants, mimic the effects of aspirinlike compounds and help reduce inflammation, Panush said: "Occasionally for patients with a sensitivity to certain arthritis drugs, diets high in omega-3 can be useful."
A few other arthritis experts venture further into the food- arthritis connection.
"I feel diet does play a role," said Dr. James McKoy, who specializes in treating arthritis at the Kaiser Permanente Medical Center in Honolulu. Although he said it is "ludicrous" to promote any one diet as an arthritis cure, McKoy is "a firm believer in food as the drug of the future."
"We still don't know why people get arthritis," he said. "I ask why it can't be multi-factorial: a product of diet, stress and pollutants."
McKoy, who sometimes lectures other physicians on alternative medicine, said he often recommends that arthritis patients eliminate processed and refined foods and red meats in favor of fresh fruits, vegetables and fish with high amounts of omega-3s.
"Most every fresh fruit or vegetable has certain phytochemicals that will help protect against cancer, arthritis, heart disease-even cataracts-by enhancing the immune system," he said. "Some, such as broccoli, kale, radishes, garlic, onion, ginger and green tea, are especially rich in antioxidants."
Though they are not really foods, many purported arthritis cures are being sold as dietary supplements, a designation that frees them from the government scrutiny required for drugs. Most of these compounds-sold in vitamin stores, some drugstores and on the Internet-have little scientific research to back their claims.
Even the heavily advertised Knox NutraJoint is based mostly on the theory that gelatin helps build joint cartilage.
"NutraJoint is simply un-gelled Knox gelatin, to which additional calcium and vitamin C have been added," says Patrick J. Bird, dean of the University of Florida's College of Health and Human Performance in Gainesville.
Gelatin has been around for years. Its main ingredient is collagen and it is a good source of protein, he says. "But as far as we know, the protein in collagen contributes no more to the cells involved in joint functioning than protein from other sources."
Calcium long has been known to be essential to good bones. And some strong, if preliminary, research supports the role of vitamin C in offering arthritis relief. But calcium and vitamin C supplements are inexpensive compared to NutraJoint, which runs about $16 for a month's supply-on sale.
"When you have chronic ailments and are willing to spend money for relief, there always is somebody waiting to take the money," McKoy said. "In 1997 about $8 billion was spent on nutritional supplements. People are looking for a miracle, so there's a lot of junk out there."
Among the most popular supplements promoted for arthritis relief is a combination of glucosamine sulfate and chondroitin sulfate. Glucosamine sulfate is a synthesized salt of glucosamine , which occurs naturally in the body and plays an important role in the repair and maintenance of cartilage. Chondroitin sulfate is made up of glucosamine and sugar molecules.
Some research shows short-term benefits from these compounds, Pitsetsky said, but there haven't been any long-range controlled studies.
"The research on glucosamine and chondroitin is interesting, even hopeful," Panush said. This spring the National Institutes of Health is likely to pay for a long-term study to test the effectiveness of the glucosamine compounds, but Panush still doesn't recommend people take them. He is "disturbed and offended" that such recommendations are made to the public before a substance is thoroughly tested.
For now, weight reduction and increased exercise are probably the most important therapies, Pitsetsky said.
To those recommendations, Panush would add "common-sense" approaches to caring for your joints: "Don't abuse a joint, don't tear up your knees, don't do a job or sport where that can happen."
McKoy cautioned that if you do take supplements or follow a special diet, you should do so in cooperation with a doctor knowledgeable about arthritis. Some supplements can interfere with prescription drugs, for instance, he said.
DEFENSIVE TACTICS
Although there is no set eating plan for arthritis sufferers, the Arthritis Foundation gives the followingguidelines for a healthful diet:
- Eat a variety of foods and avoid those that may interact with your medications.
- Maintain a healthy weight.
- Eat plenty of vegetables, fruits and grain products.
- Consume sugar, fat, salt and cholesterol in moderation.
- Drink alcohol only in moderation.
- Get daily minimums of vitamins and minerals, including calcium.
- Add fresh fruit and bread to a frozen dinner to make a complete, satisfying meal.
The Arthritis Foundation also suggests the following ways to ease the strain on joints during cooking:
- Plan rest breaks.
- Use good posture to avoid strain while performing kitchen tasks.
- Arrange your kitchen for maximum convenience; keep utensils you use most within easy reach.
- Be on the lookout for healthful convenience foods, such as precut vegetables from the supermarket produce department.
- Use labor-saving gadgets and appliances such as electric can openers and microwave ovens to make cooking tasks easier.
Features
What's the
alternative?
Hazel Courteney
12/28/97
Sunday Times -
London
News International
Page Style 35
(Copyright 1997)
For many orthodox doctors, alternative remedies remain a hard pill to swallow. In this, her final column of the year, HAZEL COURTENEY explains why freedom of choice is the best medicine
Over the festive season I have attended my fair share of parties and met people involved with both alternative and orthodox medicine. At one gathering, a medical doctor congratulated me on my column and suggested I must be "making a fortune from vitamin companies". I was appalled. He then regaled us with details of a recent all-expenses- paid trip to Switzerland, courtesy of a pharmaceutical company that wanted to promote its latest painkilling drug. I had to laugh.
No vitamin company has ever bought me dinner, let alone offered me any financial inducement to write about their products on this page. Sure, I receive samples, dozens of them - that's how I find out about new products. But if I were to swallow every sample I am sent, I would never have time to do my work. In fact, most are sent on to people who need them.
I made it crystal clear to the doctor that a mention in this column is not for sale.
"Why, then, do you use similar telephone numbers every week?" he inquired. I felt like telling him where to stick his stethoscope, but patiently explained that there are about 15 manufacturers of top- quality food supplements in the UK, and that I recommend only those companies that produce well- researched, high-quality products. After all, there are good, average and bad in every business, and many supplements sold at Pounds 3.99 for a month's supply are a waste of money as they do not contain sufficient quantities of the active ingredient. Of course, people are free to buy their supplements from whomever they choose, but I'm stuck between a rock and a hard place - if I suggest a specialist supplement that has been proven to help a specific condition and don't give a number, I receive angry letters complaining that I didn't tell people where to get hold of it.
We live in a cynical world, which is why people need to understand that I am not just a journalist. For almost 35 years, I suffered chronic illness. Ear infections in my childhood left my ear drums permanently scarred and I contracted all the normal childhood conditions - measles, scarlet fever and chickenpox - plus the odd broken ankle and wrist. In my teens, I was prescribed continuous antibiotics for acne, which triggered chronic thrush and fatigue. In my twenties, while working as an air stewardess, I suffered amoebic dysentery and hepatitis; and 10 years of taking the pill caused haemorrhages that necessitated a hysterectomy at 31. While I have, on occasion, been saved by orthodox medicine, prescription drugs have also caused me great harm.
Everything changed in my early thirties when I met Kathryn Marsden, a nutritionist, who told me that our bodies are made of what we eat. That statement was to change my life. Every year our bodies make a new skeleton and liver, our gut lining is replaced every 72 hours and our skin every 28 days.
We are primarily made of what we have eaten during the past year. No wonder I had been so ill - my diet was a disgrace. I soon discovered that there is a huge body of scientific evidence regarding food and nutritional supplements that has not reached mainstream medicine, and five years ago, after much research, I began writing in the hope of helping others.
Not surprisingly, many orthodox doctors disagree with me and my colleagues. They are so busy trying to deal with the tidal wave of patients - and information sent by drug companies - that they don't have time to keep up with alternative remedies. In five years at medical school, doctors receive three hours' training in nutrition, if they are lucky, and none in the use of supplements for prevention and cure. I recently met a young GP who left medical school not even knowing whether chicken was a protein or starch. So how, for instance, can doctors be expected to know that papaya can help to lower blood pressure, contains digestive enzymes or aids wound healing when applied topically?
Food is a medicine
Medicine is currently defined as any substance or combination of substances presented for treating or preventing disease. Yet while herbs, plants and foods have been used to treat and prevent disease for centuries, woe betide anyone who makes health claims for their food, herb or supplement today. The reality is that nobody can make a claim for a product unless it has been licensed by the Medicines Control Agency (MCA).
The MCA is a quasi-autonomous organisation affiliated to the Department of Health. Its primary function is to issue licences, the cost of which can be anything from Pounds 60,000 to Pounds 120,000, depending on the number of medical claims being made for the product involved. Multimillion-pound drug companies can afford product licences; most supplement manufacturers cannot, and so aren't permitted even to hint at the benefits of taking their supplements - even those that have been exhaustively tried and tested. This is why, if you ask a vitamin company to explain the benefits of a particular supplement, they are not legally allowed to do so.
Many readers have written in, desperate for authoritative information. But any advertisements, literature, customer testimonials and medicinal claims are also illegal unless you have a product licence.
In Germany, the herb ginkgo biloba is a licensed medicine, prescribed by the majority of doctors for circulatory conditions.
In the UK, however, a licence has been refused, even though the MCA has been presented with numerous double-blind studies on ginkgo's effectiveness. Similar positive trials have been carried out on the plant St John's wort, which elevates mood, in some cases; milk thistle, which cleanses the liver and reverses liver damage; and glucosamine , an amino sugar that reduces joint pain by restoring the gelatinous fluid that cushion joints - but manufacturers risk prosecution if they tell you this. In Spain, Portugal and Italy, glucosamine is the preferred treatment for arthritis, but in the UK most doctors have never even heard of it.
The problem is that you cannot patent a substance in the form that it occurs in nature.
But once elements are isolated from plants by drug companies - such as aspirin from willow bark - they become patentable and highly profitable drugs. So it's left to people like me to tell you which supplements to try and why.
Why we need nutritional supplements
Many doctors and dieticians would have us believe that if you eat a healthy, balanced diet, you don't need supplements. In truth, about 3% of the western population eats a healthy, balanced diet and even some of them are lacking in vital nutrients. In the UK, we have the highest incidence of heart disease in the EU. Overuse of pesticides has depleted our soil of vital minerals such as selenium, which is known to protect the heart.
In Finland and Denmark, selenium is added to fertilisers with the result that the rate of heart disease is falling.
Many people don't even know what constitutes a healthy diet, let alone what vitamins and minerals are. One reader wrote to me saying: "I'm sitting here with all these chemicals you recommended..."
My goodness. Vitamins and minerals are not chemicals or drugs, but vital nutrients, essential to life. Unfortunately, as the majority of our food is now refined and processed to death, virtually no nutrients survive. If a weevil cannot live in a bag of white flour for a week, what chance do we have? Thanks to intensive farming and overuse of pesticides, many fruits and vegetables contain 50% fewer nutrients than they did 50 years ago.
Maurice Hanssen, the director of the Council for Responsible Nutrition, says:
"Until 4,000 years ago, the average human diet contained about 225 different foods. Today, 90% of our average calorie intake comes from just 18 foods. The majority of people are lacking in virtually every vitamin and mineral and yet the Minister for Food Safety wants to erode our freedom to take food supplements. At the moment he is looking at B6, which has never hurt a soul - and yet alcohol, cigarettes, salt, toxic chemicals and preservatives known to trigger cancer or other diseases are freely available. Each year, over-the counter drugs such as paracetemol kill hundreds of people in the UK alone. The fact remains that 80% of orthodox medicine remains unproven and 1m people are admitted to hospital every year suffering side effects from prescription drugs."
It's time for people to open their eyes to the bigger picture. Freedom of choice is one of the big issues facing the health industry and the public today. In 1998 I hope for all our sakes that some enlightened soul makes the right choices. Meanwhile, I wish you all a happy and healthy New Year.
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