One can almost hear the rousing "yahoos!" in school yards around the world as summer vacation begins. Many alternative practitioners are probably yearning for those innocent days when they can toss aside the books and paperwork and just head off to the beach or lake. And a summer break, for many doctors, can not arrive soon enough. The assault on alternative and naturopathic medicine is coming from all sides, even from within our own ranks! Of course, internecine squabbles have always been part and parcel of science and conventional medicine – why should alternative medicine be any different?

Recently a patient informed me that she had had food allergy testing done outside my office. Having counseled and treated this patient for many years, I was taken aback. I always find myself getting a little piqued when patients wander elsewhere to get testing done that I readily could have provided. So I asked what sort of testing she had done and who had performed the testing. She informed me that she had had food allergy testing done by blood testing, presumably ELISA IgE or IgG antibody allergy testing. I wondered which doctor she had consulted. I was aghast when she informed me that this testing was done at a local Costco store without an appointment. Phlebotomists had been hired by Costco and, for a nominal fee and completion of a lab history form, an unnamed laboratory conducted the food allergy testing, sending the test results directly to the patient.

Food allergy testing has always been fraught with controversy. Reports published in the Townsend Letter and elsewhere have found that food allergy testing has had a certain degree of testing uncertainty. For a warehouse merchandiser like Costco to get involved with a test bearing a greater likelihood of uncertainty than cholesterol testing, for example, seems risky and not very understandable. What is a patient to do with food allergy test results without competent nutritional counseling? How can the patient sort out potential pitfalls in analyzing these test results? I still cannot fathom why Costco would want to get involved in a type of lab testing that the medical profession, by and large, does not accept at face value. Furthermore, and perhaps most importantly, the alternative medical community now has been put on notice that Costco is willing to go after its livelihood.

As noted in the Townsend Letter and elsewhere, recent research published during the last six months has assailed the value of naturopathic and herbal medicine. As summarized by Dr. Alan Miller of Thorne Research (www.thorne.com), in "Bad Medicine or Bad Reporting," numerous studies have deprecated the value of vitamin and herbal supplementation and amino acid and mineral therapy, as well as nutritional dietary counseling. Dr. Miller notes in his initial commentary that a Journal of the American Medical Association (JAMA) study found that L-arginine supplementation was not helpful in patients who had recently had heart attacks, even though previous reporting found arginine to be helpful in treating heart patients. Another JAMA study found that low-fat diets were not helpful in preventing heart, breast, or colon diseases. An article in the New England Journal of Medicine (NEJM) reported that saw palmetto was useless for the treatment of prostate enlargement. Then, another study in the NEJM questioned the value of Vitamin D and calcium in preventing fractures in osteoporosis patients, as well as the protective effect of these nutrients in preventing colon cancer. Later, yet another NEJM-published report found that lowering homocysteine levels with B-vitamins did not help prevent heart disease. Dr. Miller's report examines these studies in depth and argues that the researchers neglected the importance of data that would minimize the negativity of these report outcomes. Be sure to look up this report on www.thorne.com and keep it for future reference for patients, doctors, and the media.

It is obvious that the conventional medical world is now quite worried about patient use of nutraceuticals and herbs. There is clearly an effort being made in academic institutions to attempt to belittle the value of alternative medicine. We should be prepared for more of this sort of reporting in the future.

I was recently informed by our columnist, Dr. Gina Nick, that the AMA is once again organizing against alternative medicine. The AMA is seeking to establish councils and groups with the intended purpose of politically challenging other disciplines practicing non-AMA medicine. Dr. Nick recently assumed the presidency of the California Naturopathic Medical Association and is the spokesperson for naturopaths in California. In mid-May, she initiated a public relations campaign to counter the AMA's attempt to suppress naturopathic and alternative medicine practices. It is important for the readership to look out for the AMA's efforts to encroach on natural medicine nationally, statewide, and locally.

In Washington State, for example, Dr. Jonathan Wright informed me that the medical disciplinary board is beginning to look over his shoulder again. The putative reason for the investigation: Dr. Wright has exceeded his medical responsibility with his Tahoma Clinic web site (www.tahoma-clinic.com). Other individuals in Washington State, who coincidentally practice chelation medicine, also are being scrutinized for very dubious reasons, such as using compounded pharmacy prescriptions.

In perhaps the most bizarre instance of medical usurpation I have witnessed in three decades of practice, a non-licensed, "traditional" naturopathic practitioner has registered a trademark with the US Patent Office – for naturopathic medicine!! Beverly Betancur, ND, a doctoral graduate of Trinity College, has established an organization in Connecticut called the Naturopathic National Council Inc. For a fee of $500, a so-called "traditional" naturopathic doctor can be licensed to practice as "Doctor of Naturopathy, N.D.™ " Dr. Betancur told me that she has the authority to license doctors under trademark registration No. 3,047,099. Her organization specifies that "individuals who are engaged in the direct sale of herbs or nutritional supplements...without first being duly licensed by the Naturopathic National Council, Inc. to practice naturopathy will be subject to civil prosecution for trademark infringement." Betancur disdains naturopathic physicians who are graduates of four-year naturopathic programs. To review the policies of this organization, see www.naturopathic.us.

In this issue of the Townsend Letter, we review natural treatment approaches to controlling parasites, particularly the treatment of "Traveler's Diarrhea." We also examine the use of the herb artemisia annua in the treatment of malaria. Unlike saw palmetto, echinacea, ginkgo biloba, and other herbs that have been attacked in the conventional medical journals, artemisia is one of a few herbs the medical profession has openly embraced as an acceptable form of treatment for malaria. While researchers worry that the malaria parasite may develop resistance to artemisia as it did to quinine years ago, the parasite remains very sensitive to the herb and its derivatives at this time. The recommendation is to use artemisia in conjunction with other medical therapies. I find this approach strikes a chord with me, as I definitely think that herbals can be used judiciously with other prescription medications and vitamin/mineral therapies. In the past few years, we have been very focused on worrying about interactions between herbs and medications; it is nice to read reports of a complementary relationship between herbs and prescriptions.

Jonathan Collin, MD