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Mike: Does this philosophy of naturopathy stand at odds with much of what's going on in the pharmaceutical industry today, which is "sell more drugs no matter what"?

Dr. Pizzorno: Very much so. You mentioned the gold standard in the pharmaceutical industry, and this is from their own literature; to find drugs people will be on for the rest of their lives. A lot of the research going on right now is to find these designer drugs. Sometimes that's appropriate, but most of the time, that's not what's best for the patient. If I have someone with migraines, is it better to give them an expensive drug, like Sumtriptan, which has significant side effects, or is it better to say, "Your diet is deficient in magnesium -- consume foods richer in magnesium." Now, only 1 out of 6 patients with migraines need magnesium. But for that 1 out of 6, increased magnesium in the diet is almost miraculous in what it does for them, because not only does it relieve the migraines, but everything else impacted by inadequate magnesium will improve as well.

Mike: What about a case like high LDL cholesterol? Of course, the statin drugs are the conventional approach -- what would your approach entail?

Dr. Pizzorno: Well, there are a lot of possibilities. One is, if you have a patient, for example, who just wants to use drugs, doesn't want to change their diet -- well, fine, use the statin drugs, because they are pretty effective. But also realize that the statin drugs have some significant side effects, and a lot of those side effects are due to the fact that statin drugs poison the enzymes of the mitochondria that produce coenzyme Q10. So if a person takes statin drugs, I would give that person an additional amount of coenzyme Q10 to help relieve the side effects of the prescription drugs. So that's an idea of, you might say, integrated or co-managed care, where we say, okay, you're going to be on the drug, but let's use some natural medicine to relieve the side effects of the drug.

Now, alternatively, most people who have elevated cholesterol and triglycerides, it is due to dietary inappropriateness. And so we go to the person's diet and look at, now what are they doing inappropriately? What food are they eating that they shouldn't be eating, what foods should they be eating that they're not eating, what nutritional supplements can we give the person to help their system start producing more appropriate levels and appropriate types of cholesterol? In addition, if we have to, there are some natural herbal therapies that can be used to help decrease their cholesterol levels. I always try first to do it with diet and nutrition, and then use the herbs.

Mike: That's interesting. Do you find that patients are able to integrate the diet and nutritional advice?

Dr. Pizzorno: Well, not everybody's willing to do that, but I admit, I see a skewed population. And that is, if people come to see me, and come to see naturopathic doctors, in general they know what to expect -- they know they're not just going to get a pill. They know they're going to have to change their lives, so people who come to see us seem to be more willing to make the changes. And they're often pretty frustrated with what their experience has been with conventional medicine, so they're willing to make changes.

Mike: Moving on to some of the contrasts between conventional medicine and naturopathic medicine, in conventional medicine a set of symptoms is frequently labeled a disease -- high cholesterol is a disease or pain is a disease, or a brain chemistry imbalance is called a disease. It seems to me, from your explanations here, that naturopaths will always go at least one step further and say, what is the cause of this symptom? Does that mean that they have different names for diseases, or a different philosophy in naming them?

Dr. Pizzorno: Well, that actually is asking a fantastic question, and it gets into an issue that I address in an editorial I wrote for Integrated Medicine, a clinician's journal. This is a journal that I'm the editor of, and about a year ago I wrote an editorial which was a bit controversial, and I said on the editorial, is disease real? And I was trying to be provocative for a reason -- if you look at conventional medicine, conventional medicine has now come up with about 7,000 disease labels, and while this has worked well for medicine -- I think one of the reasons conventional medicine has advanced as well as it has is because they came up with these standardized diagnoses, came up with standardized diseases, and then standardized therapies for those diseases.

The problem is, it assumes that everybody's the same, and they're not. We're all biochemically unique. So, I look at disease, and let's take juvenile diabetes as an example, or NIDD1. Now, juvenile onset diabetes actually describes what's going on in the patient physiologically. Basically NIDD1 means that their pancreatic cells are gone; they don't produce insulin. So there you have a good correlation between what's going on with the patient physiologically and the disease name they have. But if you look at NIDD2, or adult onset diabetes, there you have a situation where you have elevated blood sugar, and we call it diabetes. However, people get the elevated blood sugar due to a wide range of problems -- it could be that they're not producing enough insulin, or it could be that the insulin they're producing is malformed, or it could be that the insulin receptor sites on the cell walls that attach to insulin aren't working properly, or it could be the cells signaling within the cell when the cell's supposed to absorb sugar isn't absorbing sugar properly. And there are some other reasons too, but each one of those reasons is physiologically different.

Now, if you take a conventional approach, you say, oh, elevated blood sugar -- let's give that person insulin. Well, yes, the blood sugar will go down, but the underlying pathology, the underlying physiological dysfunction which results in elevated blood sugar has not been addressed. So from my perspective, the term "diabetes" actually obfuscates what's going on with the patient physiologically.

So, while I won't put a disease label on someone with insulin insensitivity on a cellular level, what I do is I try to reverse that insulin insensitivity so that the cells respond to insulin the way they're supposed to. Now it turns out that this is a very common cause of adult onset diabetes, and one of the primary reasons is because the standard American diet is very low in a trace mineral called chromium. Without chromium, the insulin receptor sites won't work properly. So what I do with these people is, not only do I put them on a diet that has lower amounts of refined sugar but I also get more chromium in the diet, either supplementary or through food, and by re-establishing normal function, the blood sugar goes down, and it goes down not because I gave them a drug; it goes down because I got the body working better.

Mike: Kudos to you, also for avoiding a quick label for individual patients, because isn't it true that many patients, once they are given a label, they adopt that as part of who they are? They say "I am diabetic,” and then even that can change their response down the road, can't it?

Dr. Pizzorno: Oh, absolutely, and I think it's very tragic when somebody adopts the disease label as kind of a point of identification. I think that's very unfortunate, because not only does it have identification, but it also starts saying, “Well, I'm limited because of this.” And you see this in patients -- they start restricting their life based on this diagnosis. Why be limited to something like that? It doesn't make sense, but that does happen to people.

Mike: There's also a widespread belief that once you've been given a label of a disease, it seems like there's less you can do to reverse it at that point.

Dr. Pizzorno: Yes. And I think it's true that once a pathology is well-advanced, there's been so much damage, there's a limit to how far you can reverse things. But for the vast majority of people in our society, and particularly those early in the degenerative disease process, that's reversible, and one of my greatest critiques of conventional medicine is basically saying to people, “Well, either you're ’normal‘ or you've got disease that is bad enough that it now warrants a drug.” Well, between normal and a disease bad enough it warrants a drug, there's a lot of physiological dysfunction going on that's easily reversible at that point. But the longer you use the drug, the longer the disease progresses, the more difficult it is for the body to re-establish normal health.

You've been reading part two of a five-part interview with Dr. Joseph Pizzorno, the founding president of Bastyr University. Dr. Pizzorno was appointed by President Clinton in December 2000 to the White House Commission on Complementary and Alternative Medicine Policy. President Bush’s administration appointed him to the Medicare Coverage Advisory Committee in February 2003. He is also the co-author of the “Textbook of Natural Medicine” and the “Handbook of Natural Medicine.”

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