Andrew Weil, MD Discusses the Relationship between Science and Complementary and Alternative Medicine
Many people, doctors and patients alike, are reluctant to try treatments that have not been proven by conventional scientific measures. In this interview, Andrew Weil, MD discusses effective complementary and alternative medicine (CAM) treatments and shares his thoughts on the relationship between science and CAM.
Loolwa Khazzoom: What are some common ailments that you have seen treated effectively through complementary and alternative medicine (CAM)?
Andrew Weil, M.D.: First of all, in treating autoimmune and inflammatory disorders, I have seen great success using an anti-inflammatory diet that I have developed. I also recommend the use of herbal medication (especially things like ginger and turmeric), mind-body methods (everything from guided imagery to stress reduction), lifestyle counseling, different forms of exercise, and sometimes the use of Chinese medicine.
For depression, I think there are a huge range of approaches that are very effective, from aerobic exercise to high-dose fish oil, and various dietary supplements. I find the anxiety-reducing breathing exercise that I teach to be more effective than the standard pharmaceutical drugs.
LK: How is it that these methods work? Why is it that they work? People generally expect to have to do something high-tech to respond to something that’s gone awry in our bodies.
AW: I think this is the key question of what’s wrong with American health care. It has us all dependent on high-tech solutions that are expensive. I think these low-tech methods work because the body has an innate healing capacity, and there are many ways of accessing it. I think that people, in this culture especially, have little confidence in their body’s ability to restore health.
Many of these methods have very sensible mechanisms behind them. High-dose fish oil affects brain chemistry; there’s a lot of research on that. With breathing exercises for anxiety, there is a logical mechanism: Breath affects the involuntary nervous system.
But there is very little research on the impact of breath work, because it is something that is just not taken seriously by the research community, probably because it is so simple. I have worked for years to try and get studies going on it. There is a little bit starting now, but the lack of interest in this kind of stuff is remarkable.
LK: What do you tell people who insist on having hard scientific data?
AW: There is a lot of science out there. It is just often published in places that most doctors don’t look. I think the first thing is to see what evidence there is. Second, we should get into the habit of using a sliding scale of evidence, which works like this:
The greater the potential of a treatment to cause harm, the stricter the standards of evidence it should be held to for efficacy. In the case of something like a breathing technique, the potential for harm is so low that I feel quite comfortable recommending it, in the absence of hard scientific evidence of its efficacy. I know it works, because I use it myself, and I use it widely on patients. It’s not going to hurt people.
One of my colleagues is a Norwegian doctor, heading the Norwegian government committee on CAM. He’s a research methodologist, and he has come to believe that evidence-based medicine is a conspiracy of the pharmaceutical companies, because all of the evidence-based recommendations come down to drug treatment. They don’t look at other things.
LK: It also seems to me that the system that has been established for testing effectiveness – the guidelines, if you will – are not applicable to a number of things in CAM.
AW: Absolutely. It’s a big problem. It’s easy to blame the pharmaceutical companies for all this, but really they’re just capitalizing on a mindset that has taken hold of both doctors and patients in our culture — that the only legitimate way to treat illness is drugs.
LK: I find that I keep encountering, not just in regards to complementary and alternative medicine, but in other things as well, a disbelief that simple things can actually work.
AW: This is the infatuation with technology, which developed in the past 100 years. This is exactly what I run into with the breath work: It is one of the most powerful interventions that I have ever discovered, for a wide range of conditions — high blood pressure, heart arrhythmias, chronic digestive problems, anxiety, insomnia. The fact that you can’t get people to do studies on it is remarkable, and it really is because it’s “too simple.”
There is a prejudice. People wonder how it possibly could work, being that it doesn’t involve a drug, and it doesn’t involve a device. That, to me, is the big problem in this area. I think that the answer is education about the body’s remarkable capacity for self-maintenance and healing and about the value of knowing and using these low-tech solutions before going to complex, expensive ones.
If low-tech methods don’t work, then sure, you go to stronger methods. Or if you’re dealing with an emergency, then you use more drastic methods. But for the vast majority of conditions out there, there are inexpensive, low-tech, simple methods that people ought to know about.
LK: With an absence of hardcore scientific evidence proving that some treatments work, how can a person who is not that educated in complementary and alternative medicine distinguish between treatments that really work and stuff that is a gimmick?
AW: This is the whole point of the integrated medicine that I teach. We have now graduated over 500 physicians from intensive training. The training enables them to make those distinctions and teach their patients to do the same.
Ideally, you find a trained health-care professional, preferably a physician or a nurse practitioner who has this kind of training, who can advise you. Our website gives a directory of all our graduates.
If pharmacists were trained in the use of vitamins and minerals, herbs and other dietary supplements, they would be the best people to advise both patients and doctors about the uses of CAM and its interactions with pharmaceutical drugs. It’s really a matter of getting trained people out there.
LK: What are three basic steps people should take in trying out natural, preventative medicine?
AW: Learn the basics of good nutrition and how diet affects health. The simplest rule is to try and get rid of refined products and manufactured foods. They may be what is causing all the trouble.
It’s also a good idea to have a home medicine chest with simple remedies. There are about half a dozen herbal treatments that are very useful — like Valerian for sleep and peppermint for stomach upsets.
Lastly, have some kind of relaxation technique to practice. My favorite is simple breathing methods, because they are so time efficient.
Andrew Weil, M.D., is an internationally recognized expert on integrative medicine, medicinal herbs and mind-body interactions. He is the founder of Weil Lifestyle, LLC, a resource for integrative medicine education, information, products, and services. He also established the Weil Foundation, an organization dedicated improving the training of health care professionals; educating the public about health, healing, and nutrition; reforming public policies governing health care; and researching the application of integrative medicine.