On February 1, 2013, Susannah Meadows published an article in the New York Times Magazine entitled “A Boy With a Thorn in His Joints.”  The article details her journey of treatment of her son’s illness, Juvenile Rheumatoid Arthritis, with both usual medical care, and with alternative treatments, including dietary changes and Chinese herbal medicine.  In the end, her son improved, and she posited that “diet and supplements” worked.  However, her son was also on methotrexate initially, and she admitted “there’s no way to know for sure what worked.”

The alternative treatment, called the Walker regimen in the article, consisted of dietary changes-no gluten, no refined sugar, no dairy, no nightshades (e.g. potatoes, tomatoes); probiotics; two tablespoons of Montmorency cherry juice; and at least 2000 mg of omega 3’s from fish oil; and a centuries old anti-inflammatory Chinese herbal medicine called four-marvels powder.

The article elicited an immediate, generally positive, response from readers, with over 500 comments posted soon after the article was published.  Why is the article so popular?  Because it is a story of the way we face health problems:  see medical doctor; call a friend for advice; search the internet; see or talk to an alternative practitioner; get referral from medical doctors to other medical doctors and/or alternative practitioners.  And what we end up doing is an amalgam: sometimes taking the medical prescription, while worrying about its toxicity, efficacy, and cost; and often taking herbs or supplements without the same worry.  Unfortunately, many patients waste time on ineffectual treatments while their disease continues its relentless course.  Rheumatoid arthritis (RA) is a severe disease, with a mortality comparable to end stage cardiovascular disease or end stage Hodgkins lymphoma.  There is a “window of opportunity” for treating RA early-generally within three months after diagnosis.  Treating appropriately Early RA can prevent morbidity associated with Established or End-Stage RA.  With regard to Chinese herb toxicity:  in the past, there were concerns  about contamination and adulteration of Chinese herbal medicines.  A recent article reinvestigates this “Heavy Metal and Pesticide Content in Commonly Prescribed Individual Raw Chinese Herbal Medicine.”  (Harris et al  Sci Total Environ 2011 Sept 15 409(30) 4297-4305.

What happened to the boy?  What caused his cure?  It may be the natural history of the disease, with remission/relapse; It may be the effect of the methotrexate; It may be the effect of methotrexate combined with diet and supplements; It may be effect of diet and supplements alone; or it may be the placebo, or some other unknown reason.

Certainly, now there is much more integration and acceptance of alternative medicine at all levels of healthcare.  For example, in the article, the Walker regimen was researched by Charlotte Walker LMT, MSW, NCTNB, who works at North Shore University Health System in the integrative medical clinic.

Still, as shown by the comments to the article on the New York Times, there is tension on both sides: with medical doctors stressing the importance of scientific data, while sometimes belittling “quack” treatments; and with others saying doctors are in the “pockets of Big Pharma.”  But there is more dialogue, and more studies being done, and less name calling; because in the end, we all desire the same result: health and well being.

The future is perhaps here already, exemplified by a physician who commented on the article: Dr Carla Guggenheim.  She is a Naturopathic Rheumatologist, who commented, ” Physicians already realize patients health problems are due to dietary choices.  (However) For the most part patients want us to “throw boulders” in the downstream events of autoimmune disease(rather than change their behavior)”   Classic Naturopathy consists of five elements: phytotherapy or herbal medicine; hydrotherapy; exercise therapy; dietary therapy; and life style regulation therapy.  Perhaps if all physician added these elements to their practice of excellent medicine,  the results would be similar to that of the boy with a thorn in his joints, Shepherd.