Everyone loves natural. Natural is awesome. Natural is the life of the party. The cool one. The one you want to buy a beer (gluten-free, of course). Natural approaches to health and natural medicine are all the rage. Most patients will say they seek natural approaches first. Excellent! I like natural approaches too. In fact, I have generally referred to my clinical practice as natural medicine. I have spoken at natural medicine and natural health conferences, educated professionals from the natural products industry and even consulted companies with natural in their name. However, I was recently consulting with a company who asked me to NOT use the term natural. Natural, in the context of nutritional supplements and food products, is poorly defined and at times a meaningless adjective was the argument. I’m pretty sure I went through the entire grieving process about this. I denied it. If I use natural in the right context, they’ll change their mind. I became angry. How could they be so stupid to not use the most powerful word in our industry? I bargained. If we would have been more careful in using the term in the past, then we could still use it to describe supplements, herbs, and functional foods. I became depressed. I worried that I couldn’t complete the project or the intended message without natural. That’s when I needed a hug. I cycled between all of these experiences until I arrived at acceptance and I understood.
My epiphany: Natural is a relative term, rather than an absolute term, especially as it relates to products and procedures.
Let me illustrate. My son and I play 20 Questions quite frequently. Sometimes he will ask me if the object is “big.” I always correct him. “Big is a relative term. Restate your question with a comparison.” He does, he gets his clue, and moves on. However, I’m not as smart as my eight year old.
When we say natural medicine we really mean more natural than…
Most things that we ascribe absolute value are not absolute. I have numerous examples but let’s stick to natural for a minute. I have, in my possession, a capsule of pure, unadulterated powdered organic, non-GMO herb. No fillers, additives, excipients, flow agents, colors, flavors, nothing. You can make the case it is all-natural. But you can also make the case that isn’t natural at all. Powdered herbs do not exist in nature. Neither do capsules. However, the herb is a reasonable substitute for a popular medication. I’d argue the herbal supplement is neither all-natural or unnatural, but rather MORE natural than the medication.
Another example is red yeast rice versus statin medications. We are working with essentially the same mechanism of action so given the potential variability of red yeast rice formulations, I’d probably end up going with statins. That is, if I bought into the benefits that either offer.
Dose is another example. I ran into an integrative medicine practitioner a few years ago who explained to me that he tends not to use coenzyme Q10 because the therapeutic doses that are required are far more than what is found in food. He made the same argument for niacin and several other common supplements. At the time I found it strange, but now I see the consistency in logic. I don’t happen to have the same philosophy. I am not as tied to natural levels, natural forms, or even natural medicine. I do, however, prefer more natural, less invasive, and products and procedures with a wider therapeutic window when possible. When using natural with my patients, I’m now always using it in context to compare two approaches. This is more natural than that.
I wrestled with this concept in chiropractic school as well. Are spinal manipulations natural? I went back and forth on that question. I’m more comfortable now saying that spinal manipulation is more natural than pain medications and more natural than spinal surgery. If efficacy is equal, give me the more natural approach.
But isn’t this just semantics? Isn’t it a silly argument of words? Mental gymnastics? Academic at best, but not practical? I’d take the position that no, words mean things. Word choice is important. Our messages to our patients, current and future, and the public at-large will affect not only our therapeutic interactions today, but also the future of the practice of healing. Natural as an absolute term cannot be defined. It if cannot be defined, then using it to describe one’s practice, approach, product, or procedure causes this too to be undefined. I can’t speak for you and I do not intend to, but I will concede that I prefer that services I provide be well-defined and delineated from other healing professions and modalities.
Image credit: Nina Matthews