“Where’s the evidence it works?” Fans of a strictly conventional approach to medicine often ask this question in an attempt to shut down any rational discussion about holistic therapies. In any conversation about holistic or integrative medicine, in fact, it’s not unusual to hear the term “evidence-based” medicine thrown around. Usually, this term is used by opponents to an alternative approach to healthcare.
One of my goals is to start an integrative medicine course at my alma mater for Texas A&M University College of Veterinary Medicine. A friend of mine, a proponent of integrative medicine, had the opportunity to discuss my proposal with the dean of the school. His response was that while some of the students and a few faculty members had shown an interest in integrative medicine, most of the latter were opposed to the idea. He stated they were a conservative school and wanted to teach only “evidence-based” medicine.
The evidence is there
There is actually a large body of evidence behind the therapies we use in integrative medicine. For example, many years of research have shown the benefits of joint supplements such as glucosamine for arthritis. Not only do the studies show positive benefits when the proper joint supplements are used correctly, but we also have cellular evidence demonstrating exactly how they work in the body.
Omega-3 fatty acids, meanwhile, have been recommended for animals for over 30 years. They were originally proposed to help with allergic skin disease, but we now know through research exactly how omega-3 fatty acids work, and that they have positive benefits on a number of conditions, including heart, joint and kidney diseases and even cancer.
I’ve had the pleasure of writing 12 books on integrative medicine for animals, and have contributed to many other books and articles on the topic. My books came about after carefully researching the evidence-based medicine that supports the therapies I described. I regularly read textbooks and medical journals in both the human and veterinary medical fields describing evidence-based natural therapies that can be used in place of, or in conjunction with, conventional therapies.
Not all conventional therapies are proven
Ironically, many conventional therapies have been used in both human and veterinary medicine before a full understanding of how they worked was known. Even today, certain medications are rushed to market in an attempt to help severely ill patients before a full body of “evidence” is obtained.
As a good example, where is the “evidencebased” medicine supporting the worn-out and dangerous practice of annual vaccination? The easy answer is that there is none. There is no research proving that dogs and cats require annual vaccination for every infectious disease. And if annual vaccinations are so important for dogs and cats, why we don’t vaccinate people every year against infectious diseases? There are really two reasons.
The first is that most vaccines produce long-lasting immunity in people (and animals!). In other words, annual vaccination is not necessary, and would actually constitute malpractice in human medical practices. Based on years of research, we know the approximate duration of immunity each vaccine will produce in a given human patient.
The second reason for not administering vaccinations to people on an annual basis is to prevent serious and possibly fatal side effects. These can include serum sickness (a severe allergic reaction to vaccine components), immune diseases of the blood and other organs, and even cancers. Knowing all this, it is tempting to ask why we vaccinate companion animals every year.
Research done over the last ten years shows that the high quality vaccines we use in practice produce long-lasting immunity in animals, similar to what is found in people. At this point, we don’t know the maximum duration of immunity for each vaccine, but studies have shown that some can produce immunity for five or ten years, and possibly even for the life of the animal.
While current recommendations from conventional veterinary experts are for vaccinations every three years, integrative doctors including myself recommend only vaccinating healthy animals based on the results of inexpensive blood titer tests. What is “evidence ”? The other question that’s tempting to ask is: what constitutes “evidence?” How do doctors gather that evidence?
Whether we’re talking about a drug or natural therapy, evidence is obtained only by using that therapy in patients. We know, for example, that ibuprofen works well in humans to control headaches, inflammation and mild pain because millions of people have used many doses of the medication. For the same reason, we know the NSAID Metacam works well in dogs and cats to minimize inflammation and pain seen with musculoskeletal problems and following surgical procedures.
Likewise, we know the nutritional supplement choline works very well to help prevent and treat cognitive disorder in animals, and that glucosamine, chondroitin and hyaluronic acid are great for relieving arthritis pain. We have evidence these therapies are effective because someone thought they might work, tried them in a small number of patients, and found them to be safe and effective. Finally, many doses were used, confirming those initial findings of safety and effectiveness.
Integrative medicine has plenty of evidence to back it up and should be accepted as freely as conventional medicine. Keep this in mind next time someone tries to convince you that only “proven” therapies can help your dog or cat!
The “art ” of medicine
Keep in mind that medicine is part “art” as well as part “science.” While it’s great to have a lot of science behind what we do, integrative medicine also appreciates the art of medicine.
There is no single cookie cutter approach to treating every patient. Experience from treating large numbers of patients, along with staying open to trying whatever therapy might help a particular patient, constitute the art of medicine. Often, the “art” is what is missing from the strictly conventional approach.
Most of what I and my holistic colleagues do is try to find the best therapy for each patient based on historical and examination data. While I have science to back up everything I do, it’s my application of that science (the “art” of medicine) that determines each case’s outcome.