A PRIMER OF NATURAL THERAPEUTICS: AN INTRODUCTION TO CERTIFICATION IN DIETARY SUPPLEMENT COUNSELING
Stephen Holt, MD, DSc, LLD (Hon.) ChB., PhD, ND, FRCP (C)
MRCP (UK), FACP, FACG, FACN, FACAM, Distinguished Professor of Medicine (Emeritus), Scientific Advisor, Natural Clinician LLC
Presentation Description: An understanding of the range and properties of dietary supplements, defined as herbals, botanicals and nutrients is important for the physician engaged in anti-aging or recuperative medical practice. However, this information must be complemented by an understanding of the practical application of these remedies of natural origin, when used in a therapeutic context.
While natural therapeutics involves eclectic medical interventions, the mainstay of management is the safe and effective use of dietary supplements. Following the advent of the Dietary Supplement and Health Education Act of 1994 (DSHEA, 1994), there has been an explosion in the use of dietary supplements on a global basis. Some academics have perceived this as reintroduction of the science of pharmacognosy, whereas others have seen natural therapeutic approaches as part of the modern biotechnology revolution.
Whatever the perception, the practice of Integrative Medicine has many influences that force a need for an evidence-base in supplement usage. Arguably, an evidence base may have been, on occasion, deficient in the last decade. There is an enigma in modern medicine where dietary supplements have to be labeled for use that does not involve disease diagnosis, prevention or treatment. This discrimination against natural medicine was made in the DSHEA, 1994 to protect the status of pharmaceuticals or avoid confusion between supplements and drugs.
Misguided concepts have emerged in natural medicine, because “natural” does not necessarily equate to safety; and some supplement formulations are sold with meager evidence of benefit. Many dietary supplements are formulated by individuals with no biomedical training and most often no clinical experience of disease or wellness management. Part of the training of therapeutics and clinical pharmacology in a university or medical school teaches the clear responsibility that rests with the healthcare giver to understand the scientific basis, relative safety, cost effectiveness and risks associated with pharmaceutical use. There is every reason to believe that the same responsibility must rest with the natural clinician.
Practitioners of natural medicine have reacted adversely to drug marketing gimmicks or “off-label” drug use, together with the over-prescription or over-usage of pharmaceuticals. While the prudent medical practitioner does not respond to the hype of pharmaceutical sales, the practitioner of natural medicine should equally not respond to over-statements of the efficacy or safety of some dietary supplements. In spite of recent hyperbolic growth in natural medicine, there is no generic agreement on an acceptable curriculum that teaches the rational therapeutic use of nutritionals, herbs or botanicals, otherwise known as dietary supplements or nutraceuticals.
After four decades of experience in research and development of drugs, dietary supplements and functional foods, I have created a “Primer of Natural Therapeutics” to guide an individual towards an evidence-based approach to the use of dietary supplements. This work is relevant to many people who are involved in the application of dietary supplements for health, including the: MD, DO, DPM, RN, ND, consulting PhD, LAc, nutritional counselor and their support staff in office practice or in a dispensary or retail environment etc. The diploma course that I have created can be used with credits toward a naturopathic degree at a specific institution. The proposals are based upon my own evolution of experience in the use of complex formulations where many natural agents can be formulated in a synergistic manner to access many different cascades of biological events that control the harmony of life.
My work is not an attempt to describe another dietary supplement, but it is a sincere attempt to teach people “how to,” when it comes to dietary supplement counseling. This approach is to develop clear therapeutic guidelines that can be applied with natural medicines. While the approach is natural and sparing of drug usage, I have not turned my back on conventional medicine, where it is applied in an appropriate manner. The current practice of allopathic medicine in many societies is not portable and it cannot be subject to cost containment.
The only practical approach to make medicine portable is to place knowledge within the hands of individuals who can advise on low cost effective, safe and gentle options for the promotion of health and wellbeing, without the premature use of drugs. My concept has been focused on the idea of “edu-therapy,” where education in itself is the most potent, cost effective way of promoting health and wellbeing in society.
GOALS AND OBJECTIVES
1. To review the biopharmaceutical potential of nutrients or botanicals with an emphasis on their practical use in anti-aging medicine
2. To understand the advantages and potential limitations of the use of multiple remedies of natural origin in synergistic formulations
3. To provide an understanding of the safe use of remedies of natural origin and their relative benefit/risk ratios in day to day clinical management
4. To understand fundamental concepts of nutritional factors for anti-aging with specific emphasis on safety
5. To understand fundamental concepts of nutritional factors for anti-aging with specific emphasis on efficacy or effectiveness
6. To introduce the concept and advantage of basic certification programs for dietary supplement counseling
7. To stress the importance of holistic approaches to health by combining dietary supplements with lifestyle medicine and other natural medical disciplines