Ask the doctor: Alternative vs Western medicine

Tara Ali

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Q: What’s your take on traditional and complementary medicine?

A: As a medical doctor I have an ethical responsibility to practise evidence-based medicine, and if I step outside of that square with any of my patients, then I talk to them about that. Having said that, there are so many areas in complementary medicine that have some really good evidence behind them.

It was tricky 10 years ago before we started to get this mushrooming research coming out on complementary therapies that validated their use. In my world, if I were ever asked to step back into the narrow boundaries of traditional medicine, I wouldn't do that; I would become a naturopath instead. I feel so strongly about where optimal health for my patients lies, I couldn’t do it without looking at more alternative medicine now that I know what it can offer.

Q: When a new patient sits down in front of you, what is your thought process in treating her?

A: The first thing I do is take a medical history and examine her, which is very standard medicine. Then I ask 'has this woman got a medical disease?' – for example, is she a diabetic, does she have an autoimmune disease, is there something catastrophic going on with regard to breast cancer? And that basically dictates where that consultation goes.

If it’s more general wellbeing or a fatigue or stress-related visit (which is probably 80 per cent of people I see) then I can step back and take a more holistic view of her situation. At this point they've probably been to several conventionally trained doctors who have looked at them and can't find anything wrong, but on a day-to-day quality of life point of view, they're disabled.

We then start the journey of looking at their lifestyle choices, stress management, eating habits. For the most part, my job is motivating patients to persist with changes.

Q: What are some of the issues women can treat using complementary medicine that traditional medicine falls down on?

A: Hormone problems. Often if you're a young woman it's “do nothing or take the pill” if you're an older woman it's “do nothing or take HRT”.

There haven't been many other choices offered by conventional doctors that manage a patient’s day-to-day symptoms, without the risk of things like oestrogen replacement therapy, which raises the risk of breast cancer, for example.

There are other therapies that work, and I see more and more women asking for alternatives because they're read the risks associated with other pharmaceutical drugs. Having said that, I still sometimes prescribe the pill or HRT because it's the right thing to do for that particular woman.

Q: What's one of the most successful cases you've seen of a woman being treated with complementary medicine?

A: A woman who came to me on 60mg Prozac a day (a normal dose is 20mg), she was still unable to get out of bed, cook or dress her two school-age children. Her husband took over the cooking and caring duties, she was severely depressed to the point where she'd let her diet go and the diet of her family too – it was Pizza Hut, KFC, Chinese and leftovers for the rest of the week.

When I saw her we started from scratch, I left her on Prozac, but it turned out she was severely iron and zinc and vitamin D deficient, and severely protein deficient.

She wanted to come off her medication and she did this in a very controlled environment, against my wishes and those of her psychiatrist. But she wanted to and did this over a period of four weeks, in which I saw her regularly and we looked at her 5-HTP levels and other things. She ended up saying she felt the best she had in a decade.

The hospital's expectation was that she'd crash and burn at a later date. The reality was that she went back to university and got a degree, had another child and remained very well. Her psychiatrist called me afterwards to find out what we'd worked on together. It wasn't like he could use that method, but he was interested to know how it worked because he couldn't believe it.