In Celebration: Townsend Letter’s 30-Year Journey

by Jule Klotter

Thirty years ago, in 1983, Sally K. Ride became the first U.S. woman astronaut to enter space; Motorola began testing cellular phone service in Chicago; and Jonathan Collin, MD, published the premier issue of Townsend Letter for Doctors. What began as an “informal newsletter for doctors communicating to doctors” has matured into a 120-page magazine with an international reputation for presenting the clinical experiences of alternative/integrative doctors and practitioners. Collin, who has had a lifelong interest in publishing, wanted to provide an outlet for doctors who thought and worked outside the medical status quo. He envisioned the publication as “a bulletin board for doctors to share their pet therapies and mad-scientist ideas.” Unlike professional journals that specialize in one branch of medicine, Townsend Letter is a kaleidoscope, a truly holistic publication that has not shied from discussing any subject that affects alternative/integrative practitioners and the patients whom they serve.

The Early Years

The Townsend Letter office consists of the dining room and a bedroom in a small, two-story house, which also holds Dr. Collin’s Olympic Peninsula medical practice, in uptown Port Townsend, Washington. It was there that Collin and Editor Jan Kelley prepared the very first eight-page issue. That issue contained three articles and six advertisements. One article was a press release about a proposed study that would use bone densitometry to monitor changes in patients undergoing EDTA chelation therapy. “Controversies in Nutrition,” written by Collin and Kelley, discussed the digestion and absorption of fat-soluble vitamins A and E.

The third article concerned the use of chiropractic and thyroid gland support to help athletes with chronic pain. Dr. Collin and colleague Harold McCoy, DC, had observed a correlation between severe muscular stress in the neck and hypothyroid area and hypoglycemic-type complaints and thyroid symptoms. Dr. McCoy had become a staff consultant for the University of Washington intercollegiate athletic department in 1980, the first chiropractic physician, ever, to consult for a university. “A delicate balance exists between the thyroid gland and the musculature of the head and neck,” Dr. Collin wrote in this article. “A wide number of individuals demonstrating muscular stress in the neck also demonstrate symptoms typical of thyroid underactivity.” Both chiropractic adjustment and iodide-containing biologics/treatments, such as kelp, or thyroid hormone (USP) reduced symptoms and muscle stress.

Those first articles modeled the inquiry, debate, and clinical observations that Collin and Kelley hoped to receive from the newsletter’s readers. They made it very clear in that first issue that Townsend Letter for Doctors was intended to be different from other medical publications: “…By expressing a minority opinion, asking for helpful information on a patient case, disputing a previously published report, offering a suggestion for another physician’s inquiry, we can establish a network for physician communication.”

By November 1985 (#32), Townsend Letter for Doctors was a 28-page publication – too lengthy to be a newsletter but not yet a bound magazine. Chelle Roberts had been hired to handle subscriptions and circulation, and Alan Gaby, MD, signed on as Medical Editor. Gaby had written for the Northwest Academy of Preventive Medicine newsletter when Collin was editor. “I was impressed with his open-mindedness and his interest in nutritional medicine,” Dr. Gaby told me by email. “When he founded the Townsend Letter and asked me to be a writer, I was happy to be a part of his new endeavor.”

That issue contained many of the same features found in the magazine today. The front page, however, consisted of text – in this case, the text of Stephen Barrett’s August 23/30, 1985, JAMA article that condemned commercial hair analysis. In “Letters to the Editor,” E. Blaurock-Busch, PhD, and colleagues at Trace Minerals International rebutted Barrett’s article; and George Hickok, chairman/CEO at Doctor’s Data, described steps that his company had taken to defend hair analysis from assault, including PR countermeasures and hiring a lawyer to combat New York Department of Health’s intention to outlaw it. Other TLfD features in issue 32 included reviews in “Book Corners,” editorials by Jonathan Collin and Alan Gaby, “Townsend Calendar,” and Gaby’s “Literature Review. True to Collin’s original vision, multiple letters debated patients’ allergic reactions to the starting material for ascorbic acid manufacture (corn, sago palm, tapioca, potato starch).

The next year, 1986, brought major changes to TLfD’s small core staff. Both Jan Kelley and Chelle Roberts left. Reba Be (later Rebecca Brown) took charge as managing editor. She kept track of subscriptions, advertisers, did paste-up layouts for each issue, and oversaw the mailing. Ten times each year, the mail crew – a group of adults and teens – took over the living-dining room of Dr. Collin’s clinic to address, add inserts, and organize according to zipcode and post office regulations the boxes of finished issues, trucked from The Printery down the street. Irene Alleger, a writer who also managed Dr. Collin’s Port Townsend medical practice, became TLfD’s editor. Alleger was known for her ‘eagle-eye’ attention to detail and thought-provoking editorials and book reviews. Barbara Smith performed TLfD’s typesetting, layout, and film at the The Printery, tasks that she continued as a private contractor (The Typesmith) in 1987.

By June 1986, those 28 pages had grown to 36 pages and five advertiser inserts, held together with a single, heavy-duty staple centered on the right-hand side of the magazine. In headline articles on the front page, Bruce Halstead related his dealings with the California State Board of Medical Quality, resulting in a truly “draconian sentence” of four years in state prison, $10,000 fine, delicensure, and court orders to “desist from all professional activity in the health care field.” He was also ordered to “desist from … professional or scientific activity within the World Life Research Institute,” an organization that researched marine biotoxicology. Halstead was the institute’s cofounder and president. What terrible actions had led to this sentence? Halstead had recommended a homeopathic herbal preparation to patients in the hope of enhancing their immune function. He neither manufactured the product nor profited from its sale. Dr. Halstead was just one of numerous physicians being prosecuted in the US for advocating alternative therapies.

No Longer a Newsletter

With the August/September 1988 issue (#61/62), Townsend Letter for Doctors graduated to magazine; two staples on the publication’s spine secured the issue’s 64 pages. Two editorials headlined on its front page. In the first, Jonathan Collin marveled at New England Journal of Medicine’s acceptance of research linking cobalamin (vitamin B12) deficiency to neurologic and neuropsychiatric disorders and the therapeutic value of B12 injections; conventional medical journals usually ignored or disparaged vitamin therapy studies, especially ones with positive outcomes. In the second editorial, homeopath Dana Ullman, MPH, reviewed the response to Nature’s publication of Jacques Beneviste’s research in which potentized, highly dilute preparations of IgE produced basophil degranulation. Although that famous (or infamous) experiment has been reproduced at other laboratories, it is still widely denounced because it seems to validate homeopathy.

Inside that 1988 issue, a robust “Letters to the Editor” section debated the possible toxicity of Streptococcus faecium used in some probiotic products. In other letters, Warren M. Levin, MD, suggested applying nitroglycerine patch to acupuncture point Pericardium 6. Bernard Rimland, PhD, asked for scientific references that support kinesiology. Serafina Corsello, MD, responded to an earlier writer’s criticism of the “interventive naturopathic approach.” Sherry A. Rogers, MD, notified doctors of a recent paper that explained how to test for environmental chemical reactions, at a time when sick building syndrome and multiple chemical sensitivities were just beginning to be acknowledged. TLfD had become the “bulletin board,” the forum for questioning and discussion as physicians and patients sought answers to recognized illness and to new syndromes that failed to respond to conventional therapies.

While mainstream press assured readers that the new disease AIDS was “incurable and almost always fatal,” TLfD reprinted an article by Robert F. Cathcart, III, MD, describing his clinical use of large doses of ascorbic acid (vitamin C) and other nutrients along with a clean diet to lessen symptoms. While conventional medicine and the chemical lobby maintained that people with a bewildering array of symptoms were delusional, TLfD gave people with chemical sensitivity and environmental illness a place to voice their experiences and gave practitioners a venue for sharing their clinical insights. AIDS, attention deficit hyperactivity disorder, chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivities, chronic Lyme, autism – a profusion of new diseases and syndromes erupted in the 1980s, conditions that affected mind and body and could not be cured with a simple procedure or magic pill.

The surging interest in alternative therapies caused the U.S. Congress to give National Institutes of Health $2 million to establish the Office of Alternative Medicine (OAM). OAM and an advisory panel were charged with recommending a research program that would investigate promising unconventional medical practices. Jonathan Collin, Townsend Letter for Doctors’s publisher and editor, served on that panel. OAM became the National Center for Complementary and Alternative Medicine (NCCAM) in October 1998.

The First Milestone

With its 100th issue in November 1991, Townsend Letter for Doctors added color to its cover and some of its 120 pages. Staff had grown to include JoAnn Reuther, manager of the Subscription Department; Jill Tomasi, who assisted Reba Be and managed Dr. Collin’s Port Townsend clinical practice; and Jule Klotter, who developed an index for the magazine. Later, Collin asked Klotter to write book reviews that provided information for busy doctors and the “Shorts.”

“Letters to the Editor” still held the TLfD’s core, but new columns joined Gaby’s “Literature Review and Commentary” as regular features. Morton Walker, DPM, presented information about products, therapies, and clinics outside the mainstream in his “Medical Journalist Report.” In addition, naturopathic physicians Judyth Reichenberg-Ullman and Robert Ullman began their “Healing with Homeopathy” column in 1990, soon after they read TLfD for the first time. Dr. Judyth remembers thinking, “Holistic medicine is well represented, but why isn’t anyone writing about homeopathy in the Townsend Letter?” She says, “All it took was a call to Jonathan and we have been columnists ever since!”

The November 1991 issue also reflected the turmoil surrounding the FDA’s attempts to regulate dietary supplements as if they were drugs. TLfD contained testimonies, written by Jeffrey S. Bland, PhD, and Kirkpatrick W. Dilling, that were submitted to the FDA Dietary Supplement Task Force. FDA agents had shut down several clinics and supplement manufacturers and suppliers over the years, restricting access and consumer choice.

FDA’s actions gained widespread notoriety in May 1992, when armed police and FDA agents raided Dr. Jonathan V. Wright’s Tahoma Clinic in Kent, Washington. What “illegal” substance instigated the raid? B vitamins. The police thought they would find narcotics. Dr. Wright fought a hard legal battle for almost four years until the FDA finally dropped the charges in 1995. The highly publicized raid generated more urgency to pass the federal Dietary Supplement Health and Education Act (DSHEA). The legislation, which was an ongoing topic in TLfD for several years, asserted consumers’ right to have access to safe dietary supplements. It was finally signed into law in 1994.

Decade Two

With its March 1993 issue (#126), Townsend Letter for Doctors commenced 10-plus years of growth. These were the Clinton years of growth and trade. The European Union formed; the FDA approved the use of genetically engineered bovine somatotropin (rBST) in dairy cows to increase milk production; and Marc Andreeson developed Mosaic, which would become the main navigating system for the World Wide Web. Within in a few years Townsend Letter would have its first Web page.

As Townsend Letter grew, costs grew also. The January 1994 issue (#126) announced a change in printers from Port Townsend’s Printery to Seattle’s Consolidated Press. The move reduced printing and mailing costs, allowing Collin to retain low-scale subscription rates and advertising fees.

“What we do best, offer dialogue between our readers, will remain the keystone to the Townsend Letter,” Collin assured readers in that first Consolidated Press issue. “What we do worst, publish uncorroborated and unreferenced, unproven reports, will remain our second keystone … providing to professionals and public the thoughts and practices of an alternative practitioner is invaluable. It is only when such thoughts have public expression that peer review begins to take place.” The savings achieved by the change in printers meant that Townsend Letter could continue to grow – in print and online.

Each of TLfD’s issues in the early 1990s ran 132 pages or more, providing information from nearly 30 editors, columnists, and general contributors, for a yearly US subscription cost of $42 per year. That January 1994 issue contained Dr. Melvyn R. Werbach’s “Nutritional Influences on Illness” column, which became a mainstay for almost two decades. Sherry A. Rogers, MD, wrote a column on environmental medicine. Anna MacIntosh, PhD, ND, reviewed research studies related to exercise and physical activity. Wayne Martin, a chemical engineer, contributed one of his information-packed letters to the “Letters to the Editor.” The 1930s Great Depression had prevented Martin from becoming a doctor, but his passion for biochemistry, medicine, and natural ways to prevent disease and stimulate healing impelled him to spend many hours reading medical literature and communicating with researchers and doctors. He shared his knowledge in virtually every issue of Townsend Letter until shortly before his death.

The January 1994 “Letters to the Editor” vibrated with diversity. Medical doctors, naturopathic physicians, chiropractic physicians, a veterinarian, homeopaths, a licensed acupuncturist, and laypeople shared experiences, asked questions, and debated. Harold E. Buttram, MD, suggested that routine childhood vaccinations might be a contributor to chronic fatigue syndrome. Bill Sardi shared the measures that he took to relieve his sciatica. Arabinda Das, MD, discussed research showing that nut consumption protected against coronary heart disease. It had truly become a network for communication. The diversity and growing interest in alternative medicine was also reflected in “Book Corners,” where books on parasites, chronic fatigue, functional medicine, clinical nutrition for women, chemical sensitivity, and dental amalgams were reviewed.

The move to Consolidated Press succeeded. By February/March 1995 (#139/140), Townsend Letter for Doctors had expanded to over 164 pages, including color pages. For the first time, the magazine had a spine with its name and issue date on it. Barbara Smith had become managing editor and continued to lay out the magazine. Another significant staff change occurred in circulation with JoAnn Reuther’s death in 1994. Jan Lemons became circulation manager. When Lemons left a couple years later, Joy Reuther-Costa, JoAnn’s oldest daughter, took her place. Joy had been circulation assistant for several years, a position that was passed on to her youngest sister, Julie Reuther, when Joy became circulation manager. Julie had been a longtime member of the Townsend Letter mail crew. Circulation was growing and attracting an increasing number of educated laypeople. To recognize this readership, Collin revised the magazine’s name to Townsend Letter for Doctors & Patients, “The Examiner of Medical Alternatives.”

Collin began testing the idea of having a theme for each issue. The first theme issue was devoted to lupus and autoimmune disease (August/September 1999, #192/194). That issue contained lupus patient Henrietta Aladjem’s perspective and a review of her book. Practitioners such as the late Abram Hoffer, MD, PhD, provided their perspectives as well. He and Melvyn Werbach, MD, reported that food sensitivities contributed to autoimmune disease. Environmental risk factors linked to lupus were discussed by Rose Marie Williams in her “Health Risks & Environmental Issues” column. True to form, TLDP welcomed all perspectives.

A few months later, Townsend Letter for Doctors & Patients looked at the “Best & Worst of Alternative Medicine” (February/March 2000, #199/200). Contributors included many notable names in the world of complementary and alternative medicine: Jeffrey S. Bland, PhD; Joseph E. Pizzorno Jr., ND; Abram Hoffer, MD, PhD; Richard Kunin, MD; Joseph M. Mercola, DO, and more. In addition, columnists such as Robert A. Anderson, MD, presented research on the connection between mind, emotions, and physiology in “Psychoneuroimmunoendocrinology Review and Commentary.” Tim Batchelder took on medical issues from an anthropological view. John Weeks discussed the business side of alternative medicine. Paul Yanick wrote about quantum healing and functional medicine. Bob Flaws covered Chinese herbal medicine and acupuncture. Kerry Bone, Donald Brown, and Andrew Gaeddert shared research about botanicals and phytotherapy.

Since those first theme issues, Townsend Letter has sought to focus the diverse views of its contributing writers on topics such as Lyme, chronic fatigue, multiple chemical sensitivity, cardiovascular health, allergies, respiratory health, cancer, women’s health, men’s health, mental health, inflammation, and alternative laboratory tests. With the February/March 2003, Collin invited students, faculty, and clinical physicians at the US and Canadian naturopathic colleges to submit articles for an “impromptu contest.” “The Best of Naturopathic Medicine” has been revisited about every other year since then.

Changes and Honors

During the first decade of the 21st century, the magazine shifted from adolescent to adult. “Letters to the Editor” and “Book Corners” now account for fewer pages than in the past. The passionate sharing of views and sometimes contentious debate found in its columns during the magazine’s first and second decades has ebbed. Several columnists retired or moved on to other venues, but new columnists, just as knowledgeable and diverse, have taken their place. The magazine’s title has shortened to Townsend Letter, available to doctors, patients, researchers, and all the others who make up its readership. Select articles from recent issues are posted online at www.townsendletter.com by Sandy Hershelman, who has managed the website since 2002.

Editor Irene Alleger retired in 2005, and Adrianne Harun, a college instructor and fiction writer, took her place. Under Harun’s guidance, Townsend Letter moved from paper submissions to electronic/digital editing, allowing for detection of plagiarized work. After a few years, Harun decided to focus on her first loves – teaching and fiction – and handed the position of editor over to Lauren Brown, a former copyeditor for Boston Globe and MIT Press. “Having edited the Townsend Letter for several years, I enjoy a broad overview of the world of alternative medicine,” says Brown. “When there is so much pop-nutritional information circulating in today’s media, it is reassuring to be exposed to a wide variety of authoritative material, with dedicated experts sharing their conclusions and original research.”

In 2010, Barbara Smith turned many of her office duties over to Julie Reuther and Jill Tomasi but continues to do the magazine’s layout and design – although, more times than not, it’s from the road as she and her husband Larry are enjoying his retirement traveling in their RV.

In October 2008, the American College for the Advancement in Medicine (ACAM) presented Jonathan Collin with its Legacy Media Award. The award honored Townsend Letter, then in its 25th year of publication, for its contribution to the field of alternative and integrative medicine. The award is well deserved. With an extraordinary open-mindedness, Jonathan Collin has created a unique forum for the sharing and discussion of nonconventional viewpoints. Over the years, Townsend Letter has published information that has later (often years later) been verified by mainstream research. Suicide ideation caused by SSRIs, dangers of Vioxx, the benefits of IV vitamin C in cancer, and the importance of beneficial bacteria and probiotics are just a few of the topics that appeared in TL’s pages long before scientific verification and mainstream coverage.

Tori Hudson, ND, who has written for Townsend Letter since 1992, says, “TLFD was one of the very few publications at the time that I started, that offered a resource for clinicians in a wide range of topics. The articles were topical, controversial, informative and, yes, even the ‘out there’ articles were important to me. I always liked that the TLFD editor and staff included columns and articles that were left brain and right brain, mainstream evidence-based natural medicine as well as the progressive, theoretical, unproven, and even edgy.”

To the Future

Like other publications, Townsend Letter has been affected by the economic decline that began with the dot.com/technology bubble bust in 2000, and by competition from digital media. Its size returned to its 120-page days from a high of 180 in 2003. Once again, Jonathan Collin eased financial stresses with a move to a new printer, Dartmouth Printing Company (Hanover, New Hampshire), with the July 2011 issue. Dartmouth is a specialty press that prints and mails many US journals. Townsend Letter now has a worldwide readership of about 100,000 through subscriptions, store sales, conventions, and online access. The magazine is abstracted and indexed by EBSCO Publishing, GALE, and British Library.

The need for a forum that informally presents and debates medical alternatives is as great as ever. Many alternative therapies have been studied in laboratory and clinical studies, but many others have not. Despite all the talk about “natural” and “organic,” most people, unconsciously affected by direct-to-consumer pharmaceutical advertising, continue to believe in a magic pill that will cure their ills. “Big Pharma is still winning big time,” says Dr. Curt Maxwell, a long-time TL fan and contributor. “…the vast majority of the population is very much plugged into the status quo.” Doctors, confident of medical training that lacks basic, well-established facts about nutrition and nutrients, still shut down or outright disparage the use of vitamin and supplements – which are probably the least controversial of the many alternatives discussed in Townsend Letter.

With the switch to more efficient and less costly printing and mailing, Townsend Letter is prepared to continue its unique mission as “The Examiner of Medical Alternatives.”

Possible quotes for Sidebars to the Article:

“Townsend is a very important magazine.” Philip F. Murray, MD, long-time subscriber.

Barbara Greenstein, long-time subscriber, is grateful for so many years of the good information that she has found in Townsend Letter. She has never found a better source of alternative information with research provided.

“I think the T.L. is still a very viable source of excellent info.” Dr. Curt Maxwell.

“It has been very rewarding knowing that we are reaching readers all over the country and the world. Every now and then, when we wonder if anyone is reading our column, we will get a note or email thanking us and telling us a story about how we have had an impact on someone’s healing and life. We… keep writing because we feel valued and appreciated so much by Jonathan. And he gives us the freedom to write whatever inspires us.” Judyth Reichenberg-Ullman, ND, TL columnist