Much has been made lately about my opinions regarding Natural Medicine. One issue, in particular, is that of chili peppers and their role in heart health. What is widely misunderstood due to this flood of propaganda and disinformation by a self-proclaimed “Real Doctor” with “savior complex” is the role in medicine that I serve. People ask my opinions regarding natural remedies and I promote natural remedies. I’m a licensed Medical Doctor in the Philippines (whereas the self-proclaimed “Real Doctor” is not) and I’m also licensed by the Philippines Department of Health PITAHC as a Naturopath.
I do not promote natural medicine as the only route to health. I do not tell people to stop their medications. I do not tell people to avoid hospitals. I do not denigrate other doctors or their opinions. I do not promise cures to anyone, nor have I EVER. If someone is in the midst of a life-threatening medical emergency such as a heart attack, they need to seek medical attention as quickly as possible. Every video I make encourages people to consult with their doctor and seek appropriate medical attention. Once again, I’ll debunk the self-proclaimed “Real Doctor” here using peer-reviewed science.
Chili Peppers.
Nowhere have I ever stated that the only answer for a heart attack is chili peppers. In addition, I’ve never stated that chili peppers are the best answer for a heart attack. The brief video clip that has been widely circulated was a very brief statement from a live video of mine. Taking this brief quote of mine out of context is like claiming 18-20 years of medical experience when you’ve only been a doctor for 11 years, like the self-proclaimed “Real Doctor” with “Savior complex” recently did.
The statement I made was geared to my primary audience, the average Filipino who is poor and struggling. I know what it is to be extremely poor and to live a life of struggle. When I was a child, we lived as squatters in East Rembo. I know what it was like to be hungry. I remember what it was like not having money to go to the hospital when we were injured or sick. As a child, I dislocated my arm while playing, and my mother had to take me to the “witch doctor” to set it back in place. Many of my fellow kababayans and I know the feeling of being poor or treated as a second-class citizen because we’re Filipinos. I came from simple beginnings and still live a simple life unlike the serial bully who’s been obsessively & ruthlessly attacking and slandering me me since I was nearly 9 months pregnant. I don’t drive a luxury Range Rover SUV, take luxury vacations or make up to ₱7.5 MILLION per year like the self-proclaimed “Real Doctor”. How can they claim to be fighting for the poor versus the rich when they already so financially set? For any rich foreigner to act like they are fighting for the poor of my country while they don’t even live in the Philippines, and they advertise their products on nearly every post they make is obscene, disgusting and a prime example of “savior complex”. How is a rich foreigner a savior for the poor when at the same time they are profiting from the poor by selling unregistered black and red rice? Freedom of speech is important, but it does not give someone a free pass to break the law, defame others, encourage online mobs, and when people respond after being attacked, it does not allow targeting them for online vengeance.
Enough with talking about a rich foreigner, let’s talk about my people.
Nowadays, 54% of Filipinos consider themselves poor (1), which is about 13.1 million Filipino families, and this was BEFORE the current pandemic struck.
The average Filipino doesn’t have their own reliable transportation. The average Filipino has little if any money saved. The average Filipino has a significant part of their diet comprised of processed foods. These are just some of the things that weigh on my mind when I share my opinions regarding natural therapies which are, for the most part free. My opinions are geared towards people who are just like my family when I was a child. I’m here to help them, to give them a chance.
Philippines economic officials recently stated that a family of 5 can live on ₱10,727 per month (2). The officials presented a food budget of ₱7,500 per month and that “the remaining budget will go to non-food items, such as clothing, fuel, light, water, rent, house repairs, medical care, education, transportation, and personal care.”
So, ₱2,727 ($56.63) per month for everything else, for everyone in the family?
How can a family of 5 pay for “clothing, fuel, light, water, rent, house repairs, medical care, education, transportation, and personal care”, with less than 19 pesos per pay per person in the family?
This intense rate of poverty is why many Filipinos are terribly concerned about their ability to afford medical treatment and why many seek natural remedies.
I became a doctor to help people and provide the best care possible to the sick and ailing. I NEVER charged professional fees to any patient. My facility didn’t charge fees for exams or doctor visits to anyone. I love my country and I love my fellow citizens. In this way I was serving everyone from all walks of life. Try to set an appointment at the clinic of the self-proclaimed “Real Doctor” and see if you can get one without an insurance card!
If someone is close to a hospital and feel they are suffering a heart attack, then by all means they should get to the hospital as quickly as possible. A heart attack is a dangerous and life threatening medical emergency. On the other hand, if someone is far from a hospital, poor, without a vehicle and suffering what is believed to be a heart attack, what should they do?
“Many Filipinos continue to have little or no protection from catastrophic illness, and families often end up burdened both by the loss of a loved one and financial ruin.” – Dr. Gideon Lasco, M.D., Ph.D., Senior Lecturer, University of the Philippines Diliman, Research Fellow, Ateneo de Manila University. (3)
Section 15, Article II of the 1987 Constitution guarantees healthcare as a fundamental human right: “The State shall protect and promote the right to health of the people and instill health consciousness among them.” (4)
“Every Filipino, regardless of status in life, should have equal access to health care… the law states that all cases should be treated and admitted, if necessary, by a hospital.” (5) – Philippines Department of Health Secretary, Dr. Enrique Ona.
Do the poor get treated equally in a healthcare setting if they cannot afford their healthcare?
It’s against the law in the Philippines for hospitals or medical clinics to require advance deposits or refuse to provide medical treatment to patients who need urgent care under Republic Act No. 10932, known as the “Anti-Hospital Deposit Law”. If a hospital does not have enough beds, patients may be transferred to other health care facilities able to provide treatment. (6)
However, section 1 of the Act provides that, “such transfer shall be done only after necessary emergency treatment and support have been administered to stabilize the patient and after it has been established that such transfer entails less risks than the patient’s continued confinement.” (7)
Everyone hopes that if they or a loved one is having a serious medical event such as a heart attack, that they can be seen and attended to very quickly by trained and compassionate health experts. But when you’re poor, this is often not the case.
The Philippines has even tried to legislate care and compassion into the medical profession.
Republic Act No. 8344 from 1997 is, “An act penalizing the refusal of hospitals and medical clinics to administer appropriate initial medical treatment and support in emergency or serious cases.” (8)
This act from back in 1997 prohibits denying care to poor or uninsured patients because of their inability to pay hospital fees. Despite this, more than two decades later, poor Filipinos and even foreigners residing in the Philippines are still being denied access to medical care, even in life-threatening situations.
Manila hospitals warned against turning away patients who can’t pay deposit – New Straits Times (9)
Penniless Nobel Laureate dies after private hospital refused to treat him – The Manila Times (10)
Pregnant woman who was turned away by hospital buried with baby – GMA News (11)
“Chan said the admissions staff refused to admit her child because they could not pay the P30,000 deposit for the intensive care unit (ICU)…“My daughter has an intubation and needs to be brought to the ICU. She’s been in the ambulance for hours, we traveled a long distance, please, it’s really an emergency,” she recalled pleading with the staff. But she said her pleas fell on deaf ears.” (5)
The 10 year old girl died.
DFA chief issues apology to UK for Briton’s death
“Foreign Affairs Secretary Teodoro Locsin Jr. apologized to the British government after a Briton died while being made to wait in an ambulance for eight hours in a hospital in Cebu. Locsin said the British national, who was turned away by a hospital, was referred to another hospital where he was made to wait in an ambulance.” (12)
“He never complained; got cardiac arrest; doctors didn’t help. He died. Shame. Abject apologies to UK.” -Foreign Affairs Secretary Teodoro Locsin Jr. (12)
Philippines to probe death of Briton turned away by local hospital | ANC
Inquirer- DOH to hospitals: No turning down of patients despite coronavirus crisis (13)
CNN- President Rodrigo Duterte on Thursday ordered the Department of Health to conduct an investigation on hospitals reportedly refusing to accept COVID-19 patients. (14)
Even though it’s illegal to do so, hospitals still turn away the poor. This is something that NEVER happened at my facility.
When you’re poor and do get admitted into a hospital, what should be done if they won’t let you leave?
Illegal Hospital Detention
There needed to be legislation passed to protect Filipinos from being illegally detained by hospitals and medical clinics. To eliminate medical detentions, the Philippines passed Republic Act No. 9439 back in 2007, basically known as the Anti-Hospital Detention Law. This law is supposed to prevent Hospitals and clinics from detaining patients who cannot pay. (15)
Republic Act No. 9439- “An act prohibiting the detention of patients in hospitals and medical clinics on grounds of nonpayment of hospital bills or medical expenses.” (15)
After the anti-hospital detention law was passed, The Private Hospital Association of the Philippines was planning to strike with 300 hospitals and bar entry to all patients.
“The Private Hospital Association of the Philippines (PHAP) has put off the plan of its 300 member-hospitals to deny patients on Friday in protest of a new law that bars them from holding patients with unpaid bills.” (16)
A protest to deny patients access because you can’t detain people over unpaid bills?
How have things changed?
2018- Associated Press- “In the Philippines, Annalyn Manalo was held at Mount Carmel Diocesan General Hospital in Lucena City for 1½ months starting last December following treatment for heart problems. Administrators refused initially to allow her family to pay in installments — and the cost of each extra day in detention was added to the bill.” (17)
2018- The Philippines Senate committees on health, social justice, and finance hold a hearing regarding the detention of patients and cadavers in hospitals.
Dec 2019- “The Department of Health is currently investigating 77 cases of illegal detention in violation of Republic Act 10932 or the Anti-Hospital Deposit Law…“The accused, most of them are private hospitals who refused their patients to leave because they cannot settle their bill.”- Department of Health Secretary, Dr. Francisco Duque (18)
“This practice ultimately prevents the sick from getting the medical treatment because they fear of being detained in the hospital with their hospital bills getting higher and higher each day. This should not be tolerated”. -Senator Christopher Bong Go (19)
“The bill amounted to more than P600,000. Unfortunately, due to the unpaid amount of P475,000, the hospital wouldn’t release his death certificate and thus the family couldn’t bring his body down from Baguio for a proper wake and burial.” (3)
“In his opening statement, Go lamented that despite a law in place, the practice of detaining patients remains pervasive.” (19)
The poor are often denied care and can even be illegally detained if they can’t pay the hospital bills. The poor are my people because that is where I came from. I am here for them. They are who I strive to help. I’m not some rich, foreign, self proclaimed “Real Doctor” with “savior complex” peddling products to poor Filipinos for “Likes”, “Shares”, and fame. Some people don’t have the goods to make it as a doctor of note based on their abilities so they have to keep reminding you that they are a “Real Doctor”.
So, let’s take a look at Chili Peppers.
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in developed countries.
I cannot personally prove cause-and-effect, I can only show associations or correlations since cause-and-effect is an extremely high bar to reach in medicine, and one that cannot be met in a single article. It is not usually possible to make causal deductions based upon the evidence of any single study or even multiple studies. We often need to make determinations based upon the totality of evidence. For example, it took decades to reach a consensus on cause and effect for lung cancer and cigarette smoking despite considerable evidence to demonstrate it.
A 2018 review of studies from the IOSR Journal of Applied Chemistry (20) stated that;
“The benefits of cayenne are almost too unbelievable; but its reputation keeps growing and growing, and deservedly so. It can do everything from killing cancer cells in the prostate, lungs, and pancreas to immediately stopping a heart attack within 30 seconds.“
The review further stated that;
“There are evidences that prove that giving cayenne extract orally, to a patient, helps to stop heart attack.” (20)
This review was also referenced on Healthline.com (21) in an article “What Helps Increase Circulation in Your Legs?”, which was Medically reviewed by Angela M. Bell, MD, FACP. Dr. Bell is double board certified in internal medicine and sports medicine and practices in the Chicago, Illinois.
In the book, “Curing with Cayenne”, Dr. Richard Schulze, PHD, NMD, MH (Master Herbalist) makes numerous statements regarding the utility of Cayenne pepper for heart attacks.
“You may not realize it, but when a person has a heart attack, calling “911” is not enough. Doctors can save less than 50% of the heart attack victims — in
spite of the high-speed ambulance pickups, and all the attempts at resuscitation.” (22) page 43
“Cayenne pepper can save your life before a heart attack makes you brain dead. If that is allowed to happen, no ambulance in the world can save you.” (22) page 43
“If you have had a heart attack, and your heart has stopped and it takes three minutes to get 911, and two minutes for the car to get there, well, that’s five
minutes. But in five minutes, your brain is dead.“ (22) page 44
“Cayenne should be in every home, in every ambulance, and in every emergency room in the country. But doctors won’t use it. They are idiots. They not only won’t use cayenne in emergency medicine, they won’t use anything simple.“ (22) page 44
“Dr. Christopher believed that cayenne was one of the finest foods for the heart. He wrote, “I have used cayenne so many times over the years with such success. We have been called out time after time on heart attack cases. Cayenne always saves them.” (22) page 49
“In 35 years of practice, and working with people and teaching, I have never, on house calls, lost one heart attack patient. The reason is, whenever I go in, if they are still breathing, I pour down them a cup of cayenne tea (a teaspoon of cayenne in a cup of hot water.) Usually, within minutes, they are up and around.” (22) page 49
“Here is Dr. Christopher’s advice for treating someone who has suffered a heart attack. “Prepare one teaspoon of cayenne in one cup of hot water. Steep until it is cool enough to drink without scalding. Prop up the patient and pour the cayenne tea down the patient’s throat. The heart attack will stop immediately. In case you don’t have cayenne around, use black pepper, but triple the dose.“ (22) page 50
“Cayenne stopped me from having a heart attack as sure as God made little green apples.” (22) page 53
“Cayenne is the surest first aid remedy for a heart attack“ (22) page 64
From Blackdoctor.org we can see the article, “3 Ingredients That Stop A Heart Attack“, written by Dr. P. Gould.
It states; “If you have cayenne pepper at home, give the person having a heart attack a teaspoon of cayenne pepper in a glass of water. The patient has to be conscious for this to work.” (23)
The Epoch Times- “A heaping tablespoon of cayenne tincture (or extract) in a glass of warm water, or 10 dropperfuls (half oz.) is the treatment/dosage needed for someone having a heart attack or a stroke.” (24)
The former Republic of the Philippines Director of the Department of Health (PITAHC) Philippine Institute for Traditional and Alternative Heath Care is Dr. Jimmy Dy-Liacco. His book, “The Power of Natural Healing” was published in 2017. He’s a Bicolano practitioner of natural healing and the only metabolic doctor in the Philippines. He shared his knowledge regarding Siling Labuyo in the Manila Bulletin in 2018 where he said; “To stop a heart attack or a stroke in process, crush 12 big or 24 small silis in a cup of warm water and drink it right away. It will stop the attack or the stroke“. (25)
“Cayenne is a certain remedy for heart attack…” – Dr. John Christopher, renowned American Doctor and herbalist. (26)
“In 35 years of practice, and working with the people and teaching, I have never on house calls lost one heart attack patient and the reason is, whenever I go in–if they are still breathing–I pour down them a cup of cayenne tea (a teaspoon of cayenne in a cup of hot water, and within minutes they are up and around). This is one of the fastest acting aids we could ever give for the heart, because it feeds that heart immediately.” – Dr. John Christopher, renowned American Doctor and herbalist. (27)
The Beatrice Nutrition and Health Sciences division of Beatrice Foods Corporation produced a document called, “Nutrition Recipes: Cayenne Pepper”. The document covers medicinal uses of Cayenne Pepper and states; “Heart Attack: Prop up the patient and pour hot cayenne tea down, and the attack will stop immediately. A teaspoon of cayenne should bring the person out of the heart attack. In case cayenne is not around and you have a heart attack, the dosage of black pepper can be tripled and used.” (28)
The Hindu Krishnas of Utah state that, “Cayenne has been known to stop heart attacks within 30 seconds…If a heart attack should occur, it is suggested that a teaspoon of extract be given every 15 minutes or a teaspoon of Cayenne in a glass of hot water be taken until the crisis has passed.” (29)
They further noted, “It is a good idea to always have some Cayenne extract on hand for emergencies. Dr. Anderson carries capsules of cayenne with him in the car and whenever he goes hiking, backpacking or mountain climbing. He says, “You never know when you may find someone having a heart attack or some other emergency.” (29)
Former Republic of the Philippines Department of Health Secretary, Dr. “Jimmy” Galvez-Tan, MD, addressed Siling Labuyo (Chili Peppers) in the Philippine Daily Inquirer. “He said silinglabuyo (chili pepper) is “one of the most powerful medicinal plants in the world” because it is anti-inflammatory, relieves pain and heart troubles, and helps speed up metabolism to aid weight loss.” (30)
A study published in Journal of the American College of Cardiology in 2019 (31) showed chili peppers to be very preventative in heart disease and stroke. Researchers followed 23,000 people in Italy for eight years and found that those who ate chili peppers at least four times a week had a 40% lower risk of death from heart attack and a more than 50% lower risk of death from stroke.
CNN reported the study (32) and even quoted one of the study authors.
“As already observed in China and in the United States, we know that the various plants of the capsicum species, although consumed in different ways throughout the world, can exert a protective action towards our health.” – Dr. Licia Iacoviello, M.D., Ph.D., Professor of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed and Department of Medicine and Surgery of the Insubria University of Varese, Italy. (32)
“Hot peppers, or even green or red peppers, are able to reduce heart disease and reduce death from heart disease,” says Dr. DeLisa Fairweather, Ph.D., Director of translational research for the Department of Cardiovascular Diseases at Mayo Clinic’s Florida campus. (33)
This study in Thrombosis Research reported that the capsaicin in cayenne pepper helps to clear away artery-narrowing lipid deposits and dilates arteries and blood vessels to clear away clots. (34)
“Dietary studies investigating the effects of chilli supplementation on haemostasis in normal individuals and patient groups, will contribute toward the evaluation of capsaicinoids as agents for the prevention and treatment of CVD.” (34)
Researchers from the Chinese Academy of Medical Sciences investigated data gathered from 2004 – 2008 as part of the China Kadoorie Biobank. They researchers explored the spicy food consumption of over 487,000 people from 30 to 70 years of age across 10 regions in China. They excluded the participants with heart disease, stroke and cancer.
Then the researchers analyzed the records of 20,224 participants who had died during the following 7 years. They found that those participants who ate spicy foods 6-7 times per week had a 14% lower risk of prematurely dying for all causes than those who ate spicy foods less than once a week. The findings were published in the BMJ. (35)
This 2012 report was part of the 243rd National Meeting and Exposition of the American Chemical Society (ACS), the world’s largest scientific society. It reported that capsaicinoids block the action of a gene that makes arteries contract, and lowers cholesterol levels by reducing accumulation of cholesterol in the body. (36)
“The team found, for instance, that capsaicin and a close chemical relative boost heart health in two ways. They lower cholesterol levels by reducing accumulation of cholesterol in the body and increasing its breakdown and excretion in the feces. They also block action of a gene that makes arteries contract, restricting the flow of blood to the heart and other organs. The blocking action allows more blood to flow through blood vessels.” (36)
Research published in the journal Circulation concluded that a common, over-the-counter pain salve containing capsaicin rubbed on the skin during a heart attack could serve as a cardiac-protectant – reducing or even preventing damage to the heart. “Capsaicin is FDA-approved, inexpensive, widely available, and used topically to treat pain. Most importantly, topical capsaicin has no known serious adverse effects and could be easily applied in an ambulance or emergency room setting, well in advance of coronary reperfusion. If proven efficacious in humans, this simple therapy has the potential to reduce myocardial injury in the setting of I/R (Cardiac ischemia/reperfusion [inadequate blood supply to the heart]), thereby reducing the extent and consequences of acute MI (Myocardial Infarction [heart attack]).” (37)
The excerpt below is from Naturopathic Doctor News & Review, “Cayenne as a treatment: Effects on circulatory disorders and acute coronary adverse events” (38), by Dr. Dan Carter, N.D.
“Capsaicin inhibits platelet aggregation while avoiding interference with normal blood coagulation (39). Platelet aggregation contributes to arterial thrombosis after the disruption of vulnerable plaque, so platelet aggregation inhibitors such as aspirin or clopidogrel are often prescribed for patients with increased risk of myocardial infarct. Both aspirin and clopidogrel carry increased risk of serious bleeding (40, 41). Unlike aspirin and clopidogrel, capsaicin decreases the danger of excessive bleeding. Studies in Japan showed that capsaicin stimulates sensory-afferent neurons and inhibits both bacterial growth and platelet aggregation. The later finding supports cayenne’s use in preventing thrombosis (42). Researchers in Pennsylvania studied the signaling mechanisms for the chest pain caused by myocardial ischemia and found that the VR1 capsaicin receptor is expressed on sensory nerve endings of the heart (43). Between the platelet aggregation inhibition and binding to cardiac capsaicin receptors, thrombi are inhibited and the pain subsides. Two studies showed that capsaicin evoked concentration-dependent relaxant responses in precontracted arteries (44), and dilated and relaxed blood vessel walls (45). Capsaicin can stimulate the vanilloid receptors in the brain, which release two neuropeptides, namely calcitonin gene-related peptide (CGRP) and substance P. CGRP mediates the vasodilatation caused by capsaicin. The other active constituents of cayenne include vitamins A and C, carotenoids and volatile oils” (46).
“For centuries, folk medicine practitioners used capsaicin to aid digestion, fight infection and stimulate the kidneys, lungs and heart.” (47)
Here is a search for Capsaicin and Heart from the PUBMED database of the U.S. National Center for Biotechnology Information, U.S. National Library of Medicine with over 950 entries.
https://pubmed.ncbi.nlm.nih.gov/?term=capsaicin+heart
Here is the search for Capsaicin and heart attack with 60 current study entries.
https://pubmed.ncbi.nlm.nih.gov/?term=capsaicin+heart+attack
Evidence Based Medicine
When there is evidence to an experienced medical doctor that a medicinal plant is reasonably likely to offer benefits to a patient suffering from a specific illness, should we recommend it? Should we rely on our experience and the totality of evidence we have thus far? Should we rely on the opinions and expertise of others who have recommended that particular course of action and seen great results? Should we wait until someone has done clinical trials specifically for it? How is this any different from “Off-label prescribing”?
Physicians routinely write “off-label” prescriptions, that call for drugs to treat conditions that those drugs have not been officially approved or tested to treat. (48)
The Journal of Ethics for the American Medical Association talks about this in the article Prescribing “Off-Label”: What Should a Physician Disclose? (48)
It states; “Once a drug is FDA-approved for a specific indication, legally it can be used for any indication. Off-label prescribing is common; it accounts for 10 to 20 percent of all prescriptions written…” (48)
These off-label prescriptions aren’t written because they don’t work, but because there’s no good randomized-trial data to support them. In much the same way, we may not have what can be deemed by some as indisputable evidence about a particular nutrition or herbal therapy, but that’s far different from saying it does not or will not work. That’s why an abundance of relevant clinical experience is so important. This is a good reason why many doctors should be more circumspect when it comes to offering opinions in areas where they have little or no clinical experience.
“There is debate over whether physicians should tell patients when a drug or device is prescribed for an off-label use. “ (49)
Why should there be any debate when it comes to full disclosure with patients? Patients deserve to know if the drug or device being prescribed to them has been approved for that issue. If it has not and is being prescribed “off-label”, the patient deserves to have the prescribing physician explain why he thinks it will be of benefit to them. They deserve to see what evidence the prescribing physician is basing his prescription upon. The next you get a prescription, don’t be afraid to ask if it’s “off -label”.
Researchers examining off-label use in U.S. children’s hospitals concluded, “[W]e still have incomplete knowledge about the safety and efficacy of many medications commonly used to treat children across a range of drug classes and clinical diagnoses.” (50)
What about the lack of evidence when it comes to “Off-label prescribing”?
This study examined prescribing practices for 169 commonly prescribed drugs and found high rates of off-label use with little or no scientific support. (51)
“Off-label medication use is common in outpatient care, and most occurs without scientific support. Efforts should be made to scrutinize underevaluated off-label prescribing that compromises patient safety or represents wasteful medication use.” (51)
Why is it when a doctor prescribes a medication off-label with no scientific evidence to support benefit, no one cares? Yet, when a doctor relays the potential benefits of a medicinal plant for a particular condition, with evidence to support it, people lose their minds and want to crucify her?
How many “Off-label” drug prescriptions are there anyway?
Statistica tells us that, “It is estimated that in 2019, 4.38 billion retail prescriptions will be filled throughout the United States.” (52)
So, if 10% to 20% of those prescriptions are “off-label”, that would mean from 400 million to 800 million prescriptions are written annually in the U.S. alone without randomized trial data to support them or FDA approval for the conditions in which they have been prescribed!
And people degrade me for recommending things that DO have studies to support them like Chili, Garlic and Cabbage?
The key with natural therapies, as with conventional ones, is patient selection and knowledge of where the limits lie with each. That is where an abundance of clinical experience coupled with the latest evidence plays a significant role. If my fellow doctors want Randomized Control Trials for foods before we recommend them, can we see Randomized Control Trials on every prescription they write?
The U.S. National Institute on Aging tells us that, “The “gold standard” for testing interventions in people is the “randomized, placebo-controlled” clinical trial. That means volunteers are randomly assigned—that is, selected by chance—to either a test group receiving the experimental intervention or a control group receiving a placebo or standard care. A placebo is an inactive substance that looks like the drug or treatment being tested. In many trials, no one—not even the research team—knows who gets the treatment, the placebo, or another intervention. When participants, family members, and staff all are “blind” to the treatment while the study is underway, the study is called a “double-blind, placebo-controlled” clinical trial.” (53)
The vast majority of people don’t realize that when they’re getting involved in a clinical trial that the goal is not to cure them of an illness. Their experience and results or lack of results are just being used as points of data. The U.S. National Institutes of Health tell us that, “Research volunteers often receive some health services and benefits in the course of participating, yet the purpose of clinical research is not to provide health services.” (54)
As a patient-centered doctor, this is an area of research that I cannot ethically participate in. The reason is due to the ethical considerations of a doctor choosing to give what is believed to be potentially beneficial treatment to some and withholding that treatment to others.
The self-proclaimed “Real Doctor”/ “Savior” might be the type of person who when people come looking for a chance to beat their illness that he can give them a sugar pill so they can be part of a clinical trial. I’m not like that. When someone is concerned about running a clinical trial, we must always ask what the goal is. Is it to try and prove out a patent-based drug? Or is it to help others.
I see the primary duty of a physician as ensuring the patient’s best interests. More important than a patient’s will to fight their illness or malady is for them to actually have a fighting chance with their protocol of choice. I believe that many doctors have forgotten that upon entering our profession, a physician assumes the obligation of maintaining the honorable tradition that confers the title of a “friend of mankind”.
How does a “friend of mankind” reconcile themself with meeting hopeful and desperate people, knowing that many will not be helped simply so they can complete data points in a trial? This is the difference between clinical care and clinical trials. It is also the difference between a Doctor who cares about patients and one who cares about patents.
Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, USA
“During the last decade, approaches to evidence-based medicine, with its heavy reliance on the randomized clinical trial (RCT), have been adapted to nutrition science and policy. However, there are distinct differences between the evidence that can be obtained for the testing of drugs using RCTs and those needed for the development of nutrient requirements or dietary guidelines. Although RCTs present one approach toward understanding the efficacy of nutrient interventions, the innate complexities of nutrient actions and interactions cannot always be adequately addressed through any single research design. Because of the limitations inherent in RCTs, particularly of nutrients, it is suggested that nutrient policy decisions will have to be made using the totality of the available evidence. This may mean action at a level of certainty that is different from what would be needed in the evaluation of drug efficacy.” (55)
Who has the financial incentives to sponsor research into the use of chili peppers for cardiac events? Pharmaceutical companies that patent drugs will not test or promote an unpatentable plant. It just won’t happen.
I’m not saying that I’m right and anyone else is wrong. I’m just sharing my evidence-based opinions and insight while debunking really bad advice and misleading opinions.
References:
1. CNN, Highest in 5 years: 13.1 million families considered themselves poor in Q4. Jan 23, 2020, https://www.cnnphilippines.com/news/2020/12/14/sws-self-rated-poverty-survey-filipino-families.htmlhttps://bit.ly/3kxzg7d
2. CNN, ‘No frills:’ Family of 5 can live on ₱10,727, economic officials say. Dec 11, 2019. https://bit.ly/36CDvth
3. Lasco, Gideon. Holding the dead hostage. Inquirer, Jan. 7, 2016. https://opinion.inquirer.net/91812/holding-the-dead-hostage
4. The Constitution of the Republic of the Philippines, 1987. https://www.officialgazette.gov.ph/constitutions/1987-constitution/#article-ii
5. Santos, Tina G. DoH: Hospitals must admit all emergency patients. Inquirer.net, August 14, 2014. https://newsinfo.inquirer.net/629385/doh-hospitals-must-admit-all-emergency-patients#ixzz6dn505Vxz
6. Guerra, Gustavo. Philippines: Hospitals Investigated for Denying Treatment During Pandemic. April 24, 2020. The Library of Congress Law Library. https://www.loc.gov/law/foreign-news/article/philippines-hospitals-investigated-for-denying-treatment-during-pandemic/
7. Republic Act No. 10932, known as the “Anti-Hospital Deposit Law”. https://www.officialgazette.gov.ph/2017/08/03/republic-act-no-10932/
8. Republic Act No. 8344. https://doh.gov.ph/sites/default/files/policies_and_laws/RA08344.pdf
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