Does Natural Mean Safe?

Carefully weigh all aspects of a remedy before deciding what’s best for you

Pill bottles with licorice plants and homeopathic medicine
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There is a sentiment in the modern world that “natural” is synonymous with safe. It fuels reticence to use statins for lowering cholesterol and reducing mortality, in conjunction with unfounded faith in the healing power of goji berries or coconut oil. It fosters vaccine opposition and a never-ending quest for the most super of superfoods.

But the entire premise is misguided. Natural does not mean safe, and scientific does not mean dangerous.

Rattlesnake venom and botulinum toxin are natural. So, too, the rabies virus, the smallpox virus, and the polio virus. The vaccines that have eradicated smallpox and nearly eradicated polio are, of course, science, as is the germ theory that enabled us to understand the underlying cause and effect in the first place.

Hurricanes and earthquakes are natural and unsafe; meteorology and seismology are science that makes us a bit safer. Statin drugs, for the right patients, reliably lower LDL, prevent heart attacks, and lower all-cause mortality. There is no such evidence for coconut oil, despite the abundant claims implying otherwise.

The Constant Search for Something Better

How did we come to acquire and propagate the meme that “natural” is safe? I can only make an informed guess: It’s all about that greener grass.

Famously, the grass is always greener on the other side of some dividing line. What the adage means is that we tend to long for whatever we happen not to have.

In the much more natural world of the past, what little science could do was often (but not always) very welcome because it was the greener, elusive grass. When a cholera epidemic ravaged London in 1854 and John Snow applied the science of epidemiology, then barely nascent, to end it and save lives, he was a hero.

When it first became clear that means had been identified to prevent polio, parents accustomed to its annual toll could scarcely wait to get their kids in the line. Throughout history, science has recurrently been the greener grass.

A Yearning for the Basics

We live now in a world of constant science. We hold in our hands and pockets computers that could not have fit in a room two generations ago. We mundanely rearrange electrons to beam our thoughts to specified targets though the mysterious expanse of cyberspace, including thoughts impugning the reliability of the very science we are using. Awash in technology and what we might call the “lint” of constant science, nature takes on a particular and understandable glow. The natural is now the rare and the elusive, and, thus, the inviting.  Nature is, figuratively as well as literally, where the greener grass now resides.

Sadly, and yet predictably, we apply even this longing inconsistently. Even as masses of us embrace pop-culture nonsense about miscellaneous natural remedies, too few of us rally to protect the natural world from our ravages. I can understand a longing for and faith in the natural conjoined to real concern about biodiversity, sustainability, and climate change.

I don't understand the former at all in the absence of the latter.

What's Best Is Best

For 15 years, I directed an integrative medicine center where naturopathic physicians and I worked side by side, caring for and about the same patients. We would see new patients jointly, and confer both about and with them. A cornerstone of this model, along with commitments to holistic, patient-centric care, was that we didn’t care whether a given treatment was a product of nature or science. We didn't care if it came from a tree leaf or a test tube.

What we cared about was whether it was the best choice. The best choice for any given patient was the safest, most effective option.

When a natural approach satisfied, we were always glad to choose it. But when a drug was the obvious winner, my naturopathic colleagues would join me in recommending it. We found our model to be powerful and persuasive much of the time. Patients dubious about an alternative to a drug were often reassured when I (an internist) could tell them why it was a reasonable choice. Patients reluctant to take any drug were often assuaged when a naturopath made the case.

I draw on my time in that clinical model now to make the same recommendation to you. There are innumerable false claims about natural products. On the other hand, the pharmaceutical industry aggressively peddles its products, too, and will even go so far as to invent diseases to justify the sales of a drug. I’m sorry to say that “caveat emptor” is wise counsel when considering either.

What would be unwise is to restrict your consideration to just one category. The best treatment for anything is the safest and most effective. For us to know which that is, there must be interpretable evidence, not just marketing hype. Press your doctor about your options, be assertive about your preferences, but also be open-minded. We rarely get to the best answers when we close our minds before asking questions.

Natural approaches to health can be, and often are, the best. I consider lifestyle as medicine the best of all options whenever applicable. But lifestyle does not prevent the measles, and a vaccine does.

The grass is greenest wherever the grass is greenest. Sometimes we simply fail to look straight down and acknowledge we are standing there already.

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