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by Steven Bratman, M.D. with David J. Kroll, Ph.D.
Prima Publishing, 2000
Review by Christian Perring, Ph.D. on Jan 20th 2002

The Natural Pharmacist : Natural Health Bible from the Most Trusted Alternative Health Site in the World The publisher of Natural Health Bible, PrimaHEALTH is affiliated with The Natural Pharmacist, which has a major web site devoted to describing and assessing medicinal herbs and supplements. The book is written by Steven Bratman, M.D., medical director of TNP.com, with David Kroll, Ph.D. who is a professor of pharmacology and toxicology at the University of Colorado. In large print on the back of the book is the assertion, "This book has been scientifically and legally reviewed to be in full compliance with U.S. federal law (Section 5 of DSHEA) as it pertains to the accuracy and balance of third-party literature on dietary supplements." These all seem like good credentials. Of course, even if one of the editors is a highly qualified professor, that does not mean that all of his judgments are correct, and there's no disclosure in the book of the financial arrangement between the editors and TNP.com; and finally, the fact that the information in this book is in compliance with U.S. law is also no guarantee that it is correct. All of this is merely to say that the book has to be judged on its own merits.

The Natural Health Bible has 508 large-format pages, with two main parts. First, it health problems and the main treatments for those problems, and second, it has a larger part on "Herbs and Supplements." The conditions listed are both physical and mental; for each condition, or set of related conditions, there is one or more principal proposed treatments, then a list of other proposed treatments, and sometimes one or more "not recommended" treatments. For example, for "Depression," the principal proposed treatment is St. John's Wort, the other proposed treatments include 5-HTP, Ginkgo, SAMe, and Fish Oil, and a not-recommended treatment is Yohimbe. Following these lists are normally a few pages of extended discussion of the condition and its treatments. In the depression entry, the book explains that natural treatments are "useful only for mild to moderate depressive symptoms consisting mainly of depressed mood, fatigue, insomnia, irritability, and difficulty concentrating." Then a couple of paragraphs explain severe depression; they include the following curiously worded claim:

"The emotional structure of the brain has frozen into a pattern of misery that cannot be altered by willpower, a change of scenery, or the most earnest efforts of friends. In a sense, the brain has locked up like a crashed computer." It goes onto say that electroshock treatment is "almost the exact equivalent" of rebooting a computer, a claim that is laughable in its inaccuracy. It proceeds to discuss antidepressant medication, and claims that SSRIs like Prozac, Zoloft and Paxil do not cause fatigue, which again is a false claim, since these medications can have sedating effects. These sorts of problems in the text are a little troubling, since they suggest the author does not have a firm understanding of the basics of depression. But his expertise is on alternative treatments, so it is there that the information should be most accurate and complete.

The discussion of St. John's Wort in this section is two pages long, and explains the scientific evidence for its effectiveness, the dosage, safety issues, and drug interactions, and there is more discussion of St. John's Wort in the "Treatments" section; both include references to the scientific literature, but these are not actually in the book; you have to go to the TNP.com website to find them, and then you have to download a .zip file, unzip it, and finally you get a folder with two large .txt files - so it is hardly user-friendly. There's no recommendation of particular brands of preparations of the herb, and one of the main worries with herbal remedies is that there is great variability in quality of product from one manufacturer to another, so customers may still feel rather at a loss when looking at all the different products on the shelves of a health store or through the web pages of the many different online vendors.

The entry for Depression goes on to discuss other treatments; for example, it has a about ¾ of a page on 5-HTP. It explains that this substance is unproven as treatment for depression, although one study of 63 people did show it had equally good results as Prozac with fewer side effects. It has half a page on SAMe, explaining that it also has some evidence for its effectiveness, but it is expensive.

So if I were looking for information about herbal remedies for depression, the Natural Health Bible would be very useful, despite the problems with its description of the illness and the mainstream treatments. But it is important to point out that the book gives little or no discussion of the importance of lifestyle changes, exercise, or the wide range of other alternative approaches to improving health; it only discusses herbs, vitamins and supplements as treatments.

Most people I know are willing to try alternative treatments, and this includes both older and younger people. My father, for instance, who is now in his seventies, currently has high blood pressure, and is taking medication to keep it down, and the medication works by slowing down the metabolism, which means that he now lacks energy and is gaining weight. These are very unwelcome side-effects. Of course, he should get more exercise, which would very likely help with his blood pressure, but now with this medication he feels even less ready to go out for walks than he used to. I find on looking up "hypertension" in the Natural Health Bible that garlic can reduce blood pressure levels by about 5 to 10%. The entry on garlic in this part is short, but on looking up garlic in the "Treatments" section, I find three informative pages. When I told him about this, he was pleased to have the information, and he says he will be taking odorless garlic capsules in the hope that it will help with his blood pressure.

I am no expert on alternative treatments, so I cannot judge the validity of the claims for their effectiveness in this book, but the web site emphasizes that is uses only double blind studies, which is of course the best way to test medications, and it does certainly seem to provide a careful assessment of the relative benefits and dangers of each treatment. The Natural Health Bible does provide one of the most complete discussions of herbs, supplements and vitamins that I've seen, and I will return to it the next time I am looking for such information.

Note that TNP.com has an online Natural Health Encyclopedia, which is based on the information in the Natural Health Bible, and so may be serve as a useful alternative to buying the book. It also includes sections on alternative therapies, and so in some ways it is better than the book.

Note this review was corrected on January 22, 2002. TNP.com does not sell herbs, supplements, or medications. It only provides information, and thus has no financial incentive in promoting any particular products.

© 2002 Christian Perring. First Serial Rights.

Christian Perring, Ph.D., is Chair of the Philosophy Department at Dowling College, Long Island. He is editor of Metapsychology Online Review. His main research is on philosophical issues in psychiatry. He is especially interested in exploring how philosophers can play a greater role in public life, and he is keen to help foster communication between philosophers, mental health professionals, and the general public.