NIH and Alternative Medicine
Under the urging of former Congressman Berkley Bedell and Senator Tom Harkin, Congress
appropriated two million dollars last year and an additional two million this year
for the creation of an Office of Alternative Medicine, under the auspices of the
National Institutes of Health (NIH). In June and September, meetings were held near
Washington, DC in which both practitioners of Alternative Medicine and the public
made recommendations on how the Office should be set up and what it should study.
In attendance were representatives from many disciplines, including nutritional therapy,
alternative cancer therapy, energy medicine, psychoneuroimmunology, and structural
Although some individuals involved in the Alternative Medicine movement believe they
have been unfairly treated in the past by NIH and other conventional medical institutions,
it appeared to most attendees that the attitude of NIH toward the new Office was
one of support, rather than sabotage.
A $2 million budget pales in contrast to the multibillion dollar annual NIH budget.
Nevertheless, this type of seed money can set some important wheels in motion. Preliminary
recommendations from the Office are that some of the funds be used to support “site
visits” to clinics where promising treatments are being undertaken. If objective
evidence shown that better-than-usual results are being obtained, then recommendations
for further study will be made. In addition, individuals or clinics interested in
conducting research on various aspects of Alternative Medicine may apply for a $50,000
research grant. Approximately ten such grants will be available in the present fiscal
Along with Townsend Letter editor, Jonathan Collin, M.D. and columnist Tori Hudson,
N.D., I have been fortunate to be a member of the advisory panel concerned with diet,
nutrition and lifestyle. We are in the process of writing a report which describes
nutritional medicine and how it can be successfully incorporated into the medical
mainstream. Emphasis will be placed on the cost effectiveness of specific treatments,
a point which will hopefully catch the eye of a cost-conscious government.
Below are some examples included in the report:
Benign Prostatic Hypertrophy (Prostate enlargement)
Conventional Therapy: Surgery; medication; Proscar
Estimated Annual cost of conventional therapy: $2 billion for surgery (400,000 operations
at $5,000 per operation - surgical fees and hospital costs) $1,080,000 for medication
(2,000,000 men receiving treatment at $540 per person-year)
Alternative therapy: Oral capsules of an extract of Seronoa repens (saw palmetto
berries). Double-blind studies have demonstrated effectiveness. This treatment is
commonly used in Europe and costs 60% less than Proscar. Research suggests Seronoa
repens is more effective with fewer side effects that Proscar.
Annual cost of therapy: $100-200 (median $150) Estimated annual cost savings with
Total savings: $2.78 billion per year
$780 million saved by using Seronoa repens instead of Proscar. $2 billion saved by
reducing surgical procedures by 50%.
Reference: Campault G, et al. A double-blind trial of an extract of the plant Seronoa
repens in benign prostatic hyperplasia. Br J Clin Pharmocol 1984;18:461-462.
Conventional therapy: Medications: Tagamet, Zantac, Pepcid, Prilosec, Carafate.
Estimated annual cost of conventional therapy: $2 billion for medication
Alternative therapy: Extract of licorice root (deglycyrrhizinated licorice, or DGL).
Studies have shown that DGL is as effective as Tagamet or Zantac, in healing peptic
ulcers and in preventing recurrences. Side effects are less with DGL than with conventional
Cost of alternative therapy: Approximately one-third that of standard anti-ulcer
Estimated annual cost savings with alternative treatment: Approximately two-thirds
of $2 billion, or about $1.33 billion.
Recommended study: Large-scale comparative of DGL and standard therapy.
Reference: Glick L. Deglycyrrhizinated liquorice for peptic ulcer. Lancet 1982;2:817.
Atherosclerosis (hardening of the arteries)
Conventional therapy: Medication, coronary artery bypass, balloon angioplasty, carotid
artery bypass, femoral artery bypass, amputation.
Estimated annual cost of conventional therapy: $30 billion
Alternative therapies: Dietary modification: Nutritional therapy including vitamin
C vitamin E, vitamin B6, magnesium, chromium, carnitine, Coenzyme Q10. These nutrients
are often of value in the treatment of angina and congestive heart failure. Chelation
therapy - An alternative to bypass surgery and angioplasty. It involves the intravenous
infusion of EDTA, a drug which improves arterial blood flow.
Clinical observations and medical journal reports indicate that the need for surgery
is eliminated more than half of the time, and the number of prescription medications
can be frequently reduced with chelation therapy.
Cost of alternative therapy: Variable, depending on the nature and severity of the
condition. However, as an example, the average cost of chelation therapy is around
$3,000, compared to more than $30,000 for coronary artery bypass.
Estimated annual cost savings with alternative treatment: Estimates are difficult,
but a saving of 30%, or $9 billion annually would be likely if all patients were
offered alternative therapy.
Recommended study: Outcome comparison of alternative therapies and conventional therapy.
Acute Myocardial Infarction (heart attack)
Conventional Therapy: Fibrinolytic (“Clot-busting”) drugs such as tissue plasminogen
activator (TPA) or streptokinase.
Estimated annual cost of conventional therapy: TPA costs $2,300 per dose, streptokinase
$280 per dose. Approximately $500 million to $1 billion spent annually on these drugs.
Alternative therapy: Intravenous magnesium. Controlled studies show that magnesium
reduces the death rate from acute myocardial infarction as much as or more than the
fibrinolytic drugs and has fewer side effects. Magnesium costs about $5 per dose.
Estimated annual cost savings with alternative treatment: The cost of magnesium is
negligible, so approximately $500 million to $1 billion would be saved annually if
doctors used magnesium instead of fibrinolytic drugs.
Reference: Sheckter M, Hod H, Marks N, Behar S, Kaplinsky E, et al, Beneficial effect
of magnesium sulfate in acute myocardial infarction. Am J Cardiol 1990;66:271-274.
Conventional therapy: Nonsteroidal anti-inflammatory drugs.
Estimated annual cost of conventional therapy: $2-4 billion, including cost of medications
and cost of treating complications of the medications (such as peptic ulcer and kidney
Alternative therapy: Niacinamide, an inexpensive B-vitamin, ameliorates osteo- arthritis
in at least 50% of cases, and is particularly effective against osteoarthritis of
the knees. Side effects are negligible, although occasional monitoring of liver function
tests is recommended. Identification and avoidance of allergenic foods. Approximately
half of individuals with osteoarthritis will have improvement with specific dietary
modifications. Using the above two approaches, at least half of individuals can control
osteoarthritis without prescription medication.
Estimated annual cost savings with alternative treatment: Estimates are difficult,
but the savings from less prescription medication and from fewer complications of
these medications would probably be in excess of $1 billion annually.
Recommended studies: 1) Comparative study between niacinamide and standard anti-inflammatory
medications; 2) Outcome study on the effect of food allergy elimination in individuals
with osteoarthritis of the knees.
Reference: Kaufman W. Niacinamide therapy for joint mobility. Therapeutic reversal
of a common clinical manifestation of the “normal” aging process. Conn State Med
Recurrent Ear Infections
Conventional therapy: Antibiotics. Tubes in ears if condition persists
Estimated annual cost of conventional therapy: $650 million (10 million ear infections
annually at cost of $50 for office visit and medication and 100,000 children with
tubes put in ears at $1,500 per procedure).
Alternative therapy: Allergy elimination diet with individual food challenges to
identify allergenic foods. This approach eliminates recurrent ear infections and
eliminates the need for tubes in the ears at least 75% of the time.
Estimated annual cost savings with alternative treatment: $487.5 million by reducing
the incidence of recurrent ear infections by 75%
Recommended study: Outcome study on the effect of food allergy elimination in children
with recurrent otitis media.
Conventional therapy: Medications
Estimated annual cost of conventional therapy: At least $10 billion, including doctors’
Alternative therapy: Elimination diet with individual food challenges to identify
allergenic foods. This approach produces significant improvement in at least 75%
of asthmatic children and in about one-third of adults. Nutritional supplements including
vitamin C, vitamin B6, magnesium. These supplements often reduce the frequency and
severity of asthma attacks.
Estimated cost savings with alternative treatment: At least $3 billion annually in
terms of fewer hospitalizations, emergency room visits and doctors’ visits.
Recommended studies: Controlled studies on the effect of a combination of nutrients
(vitamin C, B-complex, magnesium) on childhood asthma.
• Rowe, A.H., Young, E.J., Bronchial asthma due to food allergy alone in ninety-five
patients. JAMA 1959;169:1158
• Ogle KA, Bullock JD. Children with allergic rhinitis and/or bronchial asthma treated
with elimination diet: a five-year follow-up. Ann Allergy 1980;44:273.
• Collipp PJ, Goldzier S III, Weiss N. Soleymani Y, Snyder R. Pyridoxine treatment
of childhood bronchial asthma. Ann Allergy 1975;35:93-97.
It is hoped that the Office of Alternative Medicine of NIH will be a catalyst for
more widespread dissemination of the type of information presented above and for
a shift in research priorities toward evaluation of more cost effective treatment
Alan R. Gaby, M.D.
Reprint, Townsend Letter for Doctors, February/March, 1993