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THE PATH AHEAD
Fooling Mother Nature Is Usually a Bad Idea
Joseph Pizzorno, ND, Editor in Chief
I still remember vividly a debate I had with a medical
doctor back in the early 1970s. While attending naturopathic
medical school, I was also working as a research assistant at
the University of Washington School of Medicine. One of the
research medical doctors and I had many, mostly friendly,
debates about philosophy and treatment. However, our dis-
cussions stopped when we suddenly came to the realization
that our core perspectives were so fundamentally incompati-
ble that all we had left was arguing. With the clarity that
comes from many in-depth conversations with someone who
disagrees with you, I finally was able to effectively articulate
my strong beliefs in the healing power of nature and that a
doctor’s responsibility was to understand what was in nature’s
way. His position was that nature is flawed and makes mis-
takes, so the doctor’s role is to fix them.
As a student at the time, there were no grays for me, and
he was obviously misguided. However, it did not take long in
practice to realize that in some situations he was clearly cor-
rect—as well demonstrated by some of the almost miraculous
success of conventional medicine. Congenital malformation
repair, limiting the effects of shock so the body has the oppor-
tunity to heal, emerging science for the repair of genetic
defects—there are many examples where the “interventionist”
approach works very well indeed. The problem, of course, is
that the interventionist approach does not work in the long
run for most of our patients and is a key cause of the “health
care crisis.” In fact, there are a lot of examples where the inter-
ventionist approach demonstrably makes the situation worse.
Hence, the title of this editorial. Following are a few of the
more notable:
Bacteria. The first time I saw research to support the
idea that bacteria actually could be beneficial to the body was
a 1970s article (sorry, I could not track it down) where clini-
cians in an emergency room measured the rate of healing
when comparing wound washing with either saline or penicil-
lin (back in the days before bacterial resistance) in nonseptic
injuries. They were surprised to find the exact opposite of
what they had expected: sterilizing the wound with penicillin
slowed the rate of healing by (if I remember correctly) 35%.
Clearly part of the trigger that nature uses to initiate the tis-
sue repair process is the presence of bacteria.
Inflammation. Another example is the use of aspirin
and other nonsteroidal antiinflammatory drugs (NSAIDs) for
osteoarthritis. While clearly effective at decreasing pain and
inflammation, these drugs actually inhibit collagen matrix
synthesis, thus impairing cartilage regeneration.1
Retrospective clinical studies have shown that NSAID use is
associated with acceleration of osteoarthritis and increased
joint destruction2-4 It would seem that some of Mother
8 Integrative Medicine • Vol. 9, No. 2 • Apr/May 2010
nature’s triggers to stimulate car-
tilage repair are the chemicals
released by damaged cartilage.
Fever. A key part of the
body’s resistance to infection is
fever. Elevating the body’s temperature both activates immune
cells and makes the tissues less hospitable to bacteria and
viruses. In order to be infectious, organisms have to adapt to
the temperature of the tissue of the body they colonize. For
example, rhinoviruses that infect the cooler upper airway and
sinuses grow best at 33 to 35° C.5 This is why inhaling hot,
wet steam helps treat the common cold.6 This is also why
using agents that lower fever actually impair the body’s
efforts to fight infection.7 Animal research has shown that
when fever is suppressed, viral infection lasts longer.8 In fact,
some drugs, such as aspirin, actually increase the production
of some viruses.9 Early clinicians recognized the value of
fever. For example, a 19th-century treatment for gonorrhea
was increasing the body temperature to between 40.5° C and
42.5° C for several hours at a time.10 (Please note that I am not
recommending indiscriminant whole-body hyperthermia
here, as fevers above 40.5° C are dangerous.) A new study has
just shown that incubating Neisseria meningitidis B in proteose
peptone or whole blood at 40° C instead of 37° C results in a
dramatic 90% reduction in growth rate after 8 hours with the
inhibition becoming evident after 1.5 hours.11
Fear of the Sun. The problem with misguided interven-
tions is not limited to drugs. The widely promulgated, stupid
medical advice to avoid the sun to prevent skin cancer may be
one of the leading, if not the leading, causes of unnecessary
death and disease. Yes, I rarely use polemics, but I have
argued against this misadvice for decades. Michael Holick,
MD, the most prolific vitamin D researcher I’ve found (a
PubMed search yields 127 articles he has authored or co-
authored), has written extensively on the increased level of
disease and death caused by this advice, as have others. A
recent BMJ (British Medicine Journal) article summarized
research comparing those with the lowest level of vitamin D
to those with the highest and found an odds or hazard ratio of
all-cause mortality of 1.8 to 2.1.12 This is comparable to the
risks of cigarette smoking, which is 2.0-2.2!13 (The same BMJ
article also notes that those taking vitamin D have an odds/
hazard ratio of 0.71 to 0.93). We evolved in the sun. Multiple
metabolic activities are activated in our skin upon exposure to
ultraviolet. Common sense needs to be applied.
These are but a few of the many examples I could pro-
vide. As we evolved as a species, we developed complex
physiological systems that allowed us to live in diverse, chal-
lenging environments; protect our bodies from infectious
Pizzorno—The Path Ahead
agents; and repair tissues when they became damaged. Blithely
interfering with these systems may, in the short term, seem a
good idea but often leads to unexpected, undesirable conse-
quences. Whenever I learn of a new therapy or theory of
health care—whether from a conventional or natural medi-
cine source—my first rule of thumb is, “What would Mother
Nature say?”
However, let’s not go overboard here. We know the fol-
lowing: bacteria can overwhelm the immune system, suturing
a wound speeds the healing process; excessive release of
inflammatory chemicals can become a self-perpetuating pro-
cess hastening damage to cartilage and other tissues; when a
fever gets above about 105o F, our ability to regulate body
temperature starts to fail; and severe sunburn does increase
risk of skin cancer. As we have discussed many times, we need
both supportive and interventionist health care. That is 1
reason the time is so ripe, and the world is becoming ever
more receptive, to integrative medicine.
However, when I look at the list of the top 10 drugs most
commonly used in the United States today, almost all of them
are primarily symptom relief, ie, simply fooling Mother
Nature. So the high incidence of adverse drug reactions (prop-
erly prescribed drugs are the fourth leading cause of death)
and the increasing burden of disease we suffer should be no
surprise. We need a health care system that prioritizes work-
ing with nature rather than against it, while understanding
that, indeed, sometimes (but only SOMETIMES) Mother
Nature’s past solutions are not the best available or she may
be overwhelmed and we have to intervene.
The effective integrative medicine clinician understands
the balance and makes the right call.
In This Issue
As I have said in the past, I enjoy the periodic submis-
sions we receive from clinicians and educators who think
deeply about health and try to see patterns that help us under-
stand our new medicine. Here we have the second and final
installment of allostatic medicine by W. John Diamond, MD
(Part I was published in IMCJ. 2009;8.6:40-44.) In part II of
this article, Dr Diamond focuses on the role of the central
nervous system in its adaptation to chronic disease, and he
explains how it accomplishes this regulation by a newly
coined anticipatory regulatory concept called allostasis—a
process that increases bodily efficiency by matching resources
to perceived anticipated need.
Sadly, Dr Diamond passed away in December 2009 while
we were doing the final edits on Part II, so this is a particu-
larly poignant and much appreciated article (and also the
reason why there was a 1-issue break in the publishing of this
second part). Dr Diamond’s son, Dave, told us, “You should
know that the last thing my father ever read was the article in
IMCJ. While he physically could not read the entire article, he
gained great comfort that his allostatic theory found circula-
tion.” We, too, are glad and are honored to be able to present
his work as a testament to a life well lived.
Last century (it stills seems strange to say this), biochem-
Pizzorno—The Path Ahead
ist and molecular biologist Mirko Beljanski discovered 2 plant
extracts that appeared to inhibit the growth of cancer cells
without causing any harmful side-effects: Pao pereira and
Rauwolfia vomitoria. In more recent times, clinical studies
using a combination of the pao and rauwolfia extracts have
yielded encouraging preliminary results by reducing prostate-
specific antigen levels in men and improving symptoms of
benign prosthetic hyperplasia. Our article this issue entitled
“Two Herbal Extracts Protect Prostate Cell DNA” by Melissa
Burchill, RD, CDN, summarizes this research.
Following our mission to advance integrative medicine,
we are reviewing and publishing more articles on acupuncture
and Chinese medicine. Our review article on cancer pain by
Harrie Anne Kessler, MS, MAc, LAc, will be of value to clinicians
advising their patients with this challenging disease. Pain is a
pervasive, major symptom of most cancer disorders and can
have a major impact on a patient’s quality of life.
Conventionally, pain is treated with analgesic medications,
many of which can have profound side effects. Acupuncture
has been used to treat pain, including cancer pain, for millen-
nia. There is a growing body of research supporting its efficacy
in alleviating pain with minimal or no negative side effects.
Thus, acupuncture can be a useful adjunct to conventional
therapies in the treatment of cancer pain.
In the second part of his review on the Standardized
Information on Dietary Ingredients (SIDI) Program, Rick
Liva, ND, RPh, discusses its strengths and weaknesses, includ-
ing running through an example form on raw materials to be
used by botanical manufacturers. I especially like Rick’s use of
specific examples to make his important points.
Christy Lee-Engel, ND, LAc, and Chris Adams, MD, are
among the founders of One Sky Wellness Associates, a decade-
old integrative medicine practice in Seattle, Washington.
They have a lot to teach on what they found works and what
doesn’t. Last summer I spent a fascinating evening with these
dedicated physician-healers. I hope you enjoy your time with
them as much as I did.
As usual, John Weeks’ Industry Insights provides useful
news about the politics and business of integrative medi-
cine. I think of particular importance is the issue of effective-
ness research.
My last task each issue before sending off my editorial is
to read and comment on Bill Benda, MD’s, BackTalk. I save Bill
until last as a treat to reward myself for getting another issue
off to the printer—he always makes me think, and I always get
at least a couple usually rueful chuckles. I won’t spoil his evi-
dence-based medicine article, but go to PubMed and do the
search “BMJ parachute use 2003” to see the article I happened
to have read while writing this editorial.
The BMJ conclusion14: “As with many interventions
intended to prevent ill health, the effectiveness of para-
chutes has not been subjected to rigorous evaluation by
using randomised controlled trials. Advocates of evidence
based medicine have criticised the adoption of interventions
evaluated by using only observational data. We think that
everyone might benefit if the most radical protagonists of
Integrative Medicine • Vol. 9, No. 2 • Apr/May 2010 9
 evidence based medicine organised and participated in a
double blind, randomised, placebo controlled, crossover
trial of the parachute.” A N INDISPENSIBLE REFERENCE
WITH THE LATEST
ALTERNATIVE APPROACHES

Joseph Pizzorno, ND, Editor in Chief

drpizzorno@innovisionhm.com
http://twitter.com/drpizzorno

References
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function. Eur J Rheumatol Inflam. 1993;13(1):7-16.
2. Brooks PM, Potter SR, Buchanan WW. NSAID and osteoarthritis—help or hin-
drance? J Rheumatol. 1982;9(1):3-5.
3. Newman NM, Ling RS. Acetabular bone destruction related to nonsteroidal anti-
inflammatory drugs. Lancet. 1985;2(8445):11-14.
ONLY
4. Solomon L. Drug induced arthropathy and necrosis of the femoral head. J Bone Joint
Surg Br. 1973;55(2):246-261. $18.95
5. Fowler AW. A/H1N1 flu pandemic. Fever as nature’s engine? BMJ. 2009 Dec plus shipping
31;339:b3874. and handling
6. Tyrrell D, Barrow I, Arthur J. Local hyperthermia benefits natural and experimental
common colds. BMJ. 1989;298(6683):1280-1283.
7. McCracken J. A/H1N1 flu. HPA advice on antipyretics does not contradict NICE.
BMJ. 2009 Sep 1;339:b3501.
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sion of fever in ferrets infected with influenza viruses of differing virulence. J Infect Dis.
1982;145(4):520-524.
9. Stanley ED, Jackson GG, Panusarn C, Rubenis M, Dirda V. Increased virus shedding
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10. Fajardo LF. Pathological effects of hyperthermia in normal tissues. Cancer Res.
1984t;44(10 Suppl):4826s-4835s.
11. Dixon G, Booth C, Price E. Fever as nature’s engine. Part of beneficial host response?

REGAIN AN ACTIVE LIFESTYLE!

BMJ 2010;340:c450
12. Pearce SH, Cheetham TD. Diagnosis and management of vitamin D deficiency. BMJ.
2010 Jan 11;340:b5664.
13. Boyle P. Cancer, cigarette smoking and premature death in Europe: a review includ-
ing the Recommendations of European Cancer Experts Consensus Meeting, Helsinki,
October 1996. Lung Cancer. 1997;17(1):1-60.
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tational challenge: systematic review of randomised controlled trials. BMJ.
2003;327(7429):1459-1461.
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