Let’s be clear, certain natural products can improve modern therapeutic approaches, especially in the context of an aging population. I strongly believe and I am not the only one. My words may offend some people, but someone has to talk about it; better if it’s a researcher.
It’s not all products, of course! It is necessary to ensure the quality, the dosages of the ingredients used, and the clinical evidence that confirms the intended beneficial effects. The body of evidence is very high, but not for all products and for all applications.
For example, a recent systematic review of the scientific literature (Shinjyo et al., 2020), containing two positive meta-analyzes, concluded that valerian was effective for both daytime anxiety and sleep problems, based on 60 clinical studies. 60 clinical studies; is that enough to talk about it? Your doctor doesn’t know? This is perfectly normal; no one is going to tell them. Doctors are doing very well with what they are asked to do. The whole system needs to be reviewed.
So, I will give you 4 examples where it is obvious that the use of quality natural health products can improve conventional treatment approaches, especially for aging people. Prior to these examples, I will present 5 angles to consider when discussing the place of quality natural products versus what therapeutic approaches can offer. Therefore, in 6 points:
- The risk of dependence or addiction
- Less side effects – the fly swatter
- Unresolved issues
- Complementarity of approaches – integrative health
- The desire to favor a natural approach
- Four specific examples
1. Risk of dependence or addiction
This is something you may have heard of before, for example sleeping pills for sleep or opioids for pain. Drug dependence is the inability to reduce or stop taking a drug due to more or less repeated use. Certain drugs thus cause very strong dependencies which often require 6 months or more of withdrawal with important consequences on the quality of life during this period of withdrawal.
Addiction is defined as the decreased response to a drug due to repeated use, which then necessitates either a higher dose or the taking of a second drug. This is often accompanied by addiction since it is no longer possible to stop taking these drugs. Warnings should be explained to you by your doctor and pharmacist for these drugs.
Quality natural products that are used for the same types of applications are usually not addictive and habit-forming because their clinical benefits depend on several molecules and the cumulative effect of several mechanisms of action. Not from a single, highly stressed mechanism as is the case with drugs. Valerian, mentioned previously, is a good example for its anxiolytic effect. This is also the reason why natural health products usually have fewer side effects.
2. Less side effects – the fly swatter
As mentioned, plant extracts often derive their effectiveness from the synergy between different compounds, which makes them unusable for drug development, but also less prone to side effects. Side effects of drugs often result from very targeted, very powerful action on a single mechanism of action. Using drugs for some mild ailments is like using a hammer to kill flies: it will work, but you might knock holes in the walls. So natural health products are the fly swatter one should try first. For example, for depression, Amsterdam and colleagues (2016) had identified 2 randomized clinical studies with placebo and 7 observational clinical studies (N = 860 in total) which suggested an antidepressant effect of rhodiola. This effect was compared to an antidepressant drug, sertraline, with the conclusion that rhodiola is somewhat less effective, but with less than 50% of the side effects of the drug (Mao et al., 2015).
3. Unresolved issues
There are several types of problems that are not solved by conventional therapeutic approaches, either because the person does not respond to treatment, or because they are allergic to the molecules used, or because there is simply no treatment or clear diagnosis. For example, for chronic pain, a person allergic to anti-inflammatory drugs may find potential solutions in quality natural health products. This is then an alternative that can be tried. The same goes for fibromyalgia or chronic fatigue syndrome. Also, there might be solutions for the long Covid (residual symptoms that last for several months following contamination with Covid-19).
4. Complementarity of approaches – integrative health
In some cases, it is simply possible to get better results by combining the two approaches. To take the example of rhodiola, another group of researchers has confirmed an additive effect to sertraline depending on the dose (Gao et al., 2020). So, in addition to being an alternative to taking antidepressants, rhodiola could be used concomitantly and thus either reduce the dose of the drug (to reduce side effects) or improve the quality of treatment. Since it has fewer side effects, it should logically be tried first to see if it is suitable for the depressed person. Your doctor doesn’t know? This is perfectly normal; no one will tell them and no training is offered in the field in Quebec.
Another example, a recent study (Xi et al., 2021) demonstrated better results for the treatment of chronic obstructive pulmonary disease (COPD) by combining the approaches of modern medicine with Traditional Chinese Medicine. This is a confirmation of the importance of integrative health. Perhaps it is time to teach it in our universities?
5. Desire to promote a natural approach
This last aspect refers to the desire and respect of patients. For example, for the treatment of depression or insomnia, maybe many people would like to try to avoid antidepressants or sleeping pills by trying a natural approach with a quality product first. It is obvious that if this option is not offered to them, they will have no choice but to take the drugs that are often presented to them as the only option.
6. Four specific examples
Did you know that according to a clinical practice guide published in the journal “Canadian Family Physician | Le médecin de famille canadien (2018)“, there is no justifiable use of benzodiazepines for people over 65 and for more than 4 weeks for those under 65? The team for this scientific publication consisted of 8 clinicians: 1 family physician, 2 psychiatrists, 1 clinical psychologist, 1 clinical pharmacologist, 2 clinical pharmacists and 1 geriatrician. These are therefore both drugs causing dependencies and addictions, significant side effects (risk of falls, increased risk of Alzheimer’s), but also unresolved problems since usually nothing else is proposed to either accompany withdrawal or replace this inappropriate medication. There is clearly a place here for integrative health and the use of quality natural products.
Anxiolytic drugs very often cause addictions or habituations just like sleeping pills. Often, these are the same drugs or the same type of drugs. Therefore, the previous comments about sleeping pills apply here as well. In addition, there is the use of antidepressants. Personally, I believe this is a class of drugs that is overused, without sufficiently advising users of the potential risks. It should be noted that Canada, and even more particularly Quebec, is one of the places in the world that uses the most antidepressants. It must be depressing to come from Quebec…
However, the main problem is not there. These drugs, which should be avoided as much as possible, are presented as the only valid option, without any other alternative. Don’t get me wrong, in many situations the use of antidepressants is necessary and desirable, but for many people, physical activity, a better lifestyle, cognitive behavioral therapy and/or quality natural health products might have avoided the use of medication.
Seasonal or other forms of depression
Unfortunately, the use of antidepressants follows an annual variation which reflects external factors predisposing to depression. Among these, seasonal affective disorder naturally finds part of its reasons in the decrease in luminosity (and the production of vitamin D), but probably also in the change of activities, the decrease in the level of physical activities, change in diet and other factors. Here too, before treating the symptom with drugs that can cause harm, we should consider the sources of the problem and act upstream. Lifestyle habits, improved sleep, diet and quality natural products can certainly help.
Pain management is one of the facets for which the response to complementary treatments or approaches varies greatly. Several approaches can be considered and they should be offered along with the medication, before, concomitantly or as a last resort if people are allergic or have too many side effects or do not respond to the proposed treatments. Consult your naturopath! They will be able to direct you to the various possibilities available to you, including supplements applicable to your situation.
There is a place for effective natural health products, not only for the nutritional aspects, but also to complement the needs of conventional approaches. The disease is not a symptom of drug deficiency and we must stop opposing everything as if one approach holds the truth. Integrative health, which consists of taking into account all of the scientifically documented approaches, should allow greater benefits for all, while respecting the choices of the individual.
- Amsterdam JD, Panossian AG. Rhodiola rosea L. as a putative botanical antidepressant. Phytomedicine. 2016 Jun 15;23(7):770-83.
- Eric Simard, Dr en biologie et Jacques Lambert, MD : Vivre jeune DEUX fois plus longtemps, chapitre 12 : Sommeil. Marcel Broquet la nouvelle édition, 270 pages.
- Gao et al, 2020. Antidepressants effects of Rhodiola capsule combined with sertraline for major depressive disorder: A randomized double-blind placebo-controlled clinical trial. J Affect Disord. 2020 Mar 15;265:99-103.
- Georgiev et al, 2013. Harpagoside: from Kalahari Desert to pharmacy shelf. Phytochemistry. 2013 Aug;92:8-15. doi: 10.1016/j.phytochem.2013.04.009. Epub 2013 May 1. PMID: 23642455.
- Mao et al, 2015. Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial. Phytomedicine. 2015 Mar 15;22(3):394-9.
- Pottie et al, 2018. Déprescription des agonistes des récepteurs des benzodiazépines. Guide de pratique clinique. Vol 64: MAY | MAI 2018|Canadian Family Physician | Le Médecin de famille canadien. 16 pages.
- Site Internet Choisir avec soin : choisiravecsoin.org. Choisir avec soin est la version francophone de la campagne nationale Choosing Wisely Canada. Choisir avec soin agit comme porte-parole national pour la réduction des examens et des traitements inutiles en santé.
- Shinjyo et al, 2020. Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis. J Evid Based Integr Med. 2020 Jan-Dec;25:2515690X20967323.
- Xi et al, 2021. Application of traditional Chinese and Western medicine combined with chronic disease management in pulmonary rehabilitation and evaluation of efficacy. Am J Transl Res. 2021;13(6):6372-6381. Published 2021 Jun 15.