Arsenic is natural too…

…mercury, for that matter, but I wouldn’t take it as a supplement. Pro/am skeptic extraordinaire, Steven Novella, and some doctor buddies have started “Science Based Medicine” a blog that defends the explanatory powers of the scientific medicine versus quackery.

Here, Dr. N. takes on the big dog, the New York Times, for not questioning the basic (false) assumption that there is a fundamental difference between natural products (herbs, plant-derived materials, etc.) and man-made pharmaceuticals. Some folks insist (and profit of the notion) that anything natural is automatically superior to man-made drugs.

The difference is especially puzzling when you look at the efforts of government agencies and the drug companies to discover, screen and refine natural products into working drugs. NIH, for example, maintains a huge Natural Products Repository where they story samples of biological material (mostly ground-up plants and microbes in jars, so to speak) from around the world (through a nifty agreement to license any potential drug compounds with the country it came from). The difficulty is in screening, each sample can be a mix of many, many biomolecules), but automation and cleverness work wonders.

So why are natural products so interesting? Because nature has had a few billion-years head start on humans in developing biologically active molecules. They weren’t “created” to fight cancer or HIV, but there might be some happy coincidences in all that biodiversity. (Although, it isn’t a stretch to see why microbes would create antibiotics to kill other microbes, ask Dr. Fleming…)

Taxol and Irinotecan are two such examples of cancer drugs derived from plants, but there are plenty of others in development being tested. And “tested” is the answer, as Novella points out the supplement industry doesn’t have to face the same standards of evidence as the pharmaceutical industry.

It is critical for effective health care and consumer protection that practitioners, educators, the industry, and regulations focus on that which is important – evidence for safety and effectiveness. Here there is a clear distinction between substances marketed under the regulations for drugs and those under the far looser regulations for herbs and supplements. Drugs typically have far greater evidence for both safety and effectiveness. Herbs, on the other hands, are typically marketed based upon tradition and anecdote with insufficient scientific evidence for safety or efficacy.

So what Kilham [the subject of the Times article] should be advocating is for higher and more uniform standards of scientific evidence for all pharmaceuticals, whether they are plant based or not.