Summary: Few practitioners of integrative medicine who use nutritional agents have not benefited from the teachings of Yale-educated integrative clinician Alan Gaby, MD. The publication of Gaby’s long-awaited 1374 page Nutritional Medicine, the product of 30 years of research and analysis, ranks as a historic moment for the field. Here is a look at the book, informed by Gaby’s clinical practice with over 6,000 patients. I share comments from Integrator adviser Bill Manahan, MD, Jonathan Wright, MD, and Joseph Pizzorno, ND, on the power of this textbook. Gaby believes that the book has significant public health applications. Manahan thinks comprehending Gaby’s value means recalling William Osler, MD. Wright urges a forward-thinking conventional medical school to scoop Gaby up and honor him with a professorship. I contacted Gaby to catch up with him on this turning point in his life and conclusion of a record-long gestation period. What did Gaby’s medical doctor father think of him embracing this medical direction more than 3 decades ago? Pizzorno’s advice to clinicians is simple: “Buy Nutritional Medicine now. You’ll use it every day.”
“I wouldn’t be surprised if, after reading Nutritional Medicine,
a fair and open-minded University medical school dean might
consider offering Dr. Gaby the eminently well-deserved
position of Professor of Nutritional Medicine …”
– Jonathan Wright, MD, from the Foreword
Gaby’s 1374 page tome
got this into my head in 1973,” recalls pioneering integrative medicine
expert Alan Gaby, MD. I had asked him about the length of the gestation
period for his long-awaited textbook Nutritional Medicine.
The idea that much of his professional life would be spent searching the
literature, writing and speaking on nutritional medicine hit Gaby, as
he shares, “when I was sitting on the ramp of Exit 22 waiting for a
college friend to visit.” He adds: “I just got this message saying this
is what you are going to do with your life.” Gaby, a Yale undergrad and
the son of general surgeon Sam Gaby, MD, has spent roughly two-thirds of
his professional life sifting through the escalating volume of
nutritional medicine research dating back to 1920. The other third is in
the clinical practice. The result is Gaby’s widely heralded,
recently-published 1374 page tome.
Gaby: 30+ years pursuing a calling in nutritional medicine
Gaby first became known to many in the 1980s through his regular column in the Townsend Letter for Doctors, at the time the premier periodical for physician-level clinical communication on nutrition and integrative topics. His nutritional medicine seminars
became don’t-miss events and his handouts key reference guides for any
clinician who valued nutrition in a patient’s treatment and health. Gaby
later was selected by his colleagues to serve a term as president of
the American Holistic Medical Association.
“Alan Gaby is a composite of four
of my heroes in medicine – Patch Adams,
Christiane Northrup, Linus Pauling
and William Osler.
– Bill Manahan, MD
Attendees of Gaby’s multiple-day seminars
knew they would benefit from the grounding of his teaching in his 3
decades of a continuous integrative nutritional medicine practice in
which he has treated over 6,000 patients. Seminar attendees also came to
anticipate that Gaby would likely entertain them on his guitar with a
clever, self-composed topical song.
In a forward to the book,
holistic and integrative medicine leader Bill Manahan, MD, calls Gaby a
“composite of four of my heroes in medicine” – Patch Adams, Christiane
Northrup, Linus Pauling and William Osler. Manahan, an Integrator
adviser, likens Gaby to Osler’s traits as “a brilliant clinician who
clearly understood that the majority of healing occurs from within.”
“I believe that Nutritional Medicine will stand
as one of the foundational cornerstones upon which nutrition becomes a
primary treatment modality in the 21st century.”
Gaby’s Nutritional Medicine Textbook
At a Glance
|Years in the Making
in Gaby’s data base*
|Health conditions covered
|Chapters on individual
|Patients treated by Gaby
with nutritional medicine
|Institutional price for health
* He jointly builds and manages the database with Jonathan Wright, MD.
I recently caught up with Gaby, who I first met some 22 years ago, to talk about the book, its reception, and his post-partum plans now that his long labor is over. Here are edited segments of that conversation.
Integrator: I am of course not a clinician. What’s the basic argument for nutritional medicine in lay terms?
Gaby: The book and my practice build on the work of pioneers like
Linus Pauling, Roger Williams, Abram Hoffer, and Adelle Davis who argue
that many diseases can be prevented or treated by adjusting the
concentration of molecules normally present in the body, such as
vitamins, minerals, amino acids and hormones. This is my experience.
Integrator: What is
it that makes this book unique – other than its sheer weight. Aren’t
there a number of reviews of nutritional literature out there?
Gaby: This is a textbook. It
consists of scientifically based, clinically relevant information on how to use
diet, nutritional supplements, and other natural substances to prevent and
treat more than 400 health conditions. It also discusses how to use various
individual nutrients, including biochemical effects, clinical indications,
adverse effects, interactions, preparations, and dosages. The uniqueness of the
book is in its critical analysis of a vast body of research, its direct
applicability to the clinical setting, its comprehensive nature, and its
attention to detail. I think this book
has a lot of public health implications.
Integrator: What sort of public health implications?
use of the treatments discussed in this book would improve overall health,
reduce the need for potentially dangerous medications, and lower healthcare
Integrator: How is the reception?
Gaby: When I sent it
to Bill Manahan for his review I sent a note and told him that I hoped
he found it worthwhile, otherwise I’ve wasted my entire adult life. I
was glad to find he liked it.
Integrator: You note in your
introduction that “for reasons that are not entirely clear, there
appears to be an inherent bias in academic medicine against
micronutrient supplements.” I am curious about your speculations as to
Gaby: I could have gone into great detail on this. The bias
against this is stuff is clear. At the same time, the claims that some
proponents of nutritional products put out is part of what turns more
conservative doctors off. I take on both the anti-nutrition bias and pro-supplement hype text but leave
the political issues pretty much to my editorials in the Townsend Letter and elsewhere. You’ve probably read
them. This textbook is not the place for that.
Integrator: You dedicated the book in part to your Dad, himself a medical doctor. How did he take to this life-choice of his son?
Gaby: He was a general surgeon. Early on he said “I think eating
well is important – I don’t know about this megavitamin stuff.” He
ended up doing some nutrition in his practice in later years. He started
putting 6 grams/day of IV Vitamin C in the fluids he gave his patients in their recovery.
He found that when he did he saw fewer urinary tract infections and
that they healed more quickly.
Integrator: Isn’t one of
the challenges in gaining stature for nutritional medicine that often
multiple products are used in combination. This not only breaks the mold
of single agent thinking and research but also leaves a practitioner
open to the charge of pushing supplements.
Gaby: The first nutrition book I read, in 1972, was written by Roger Williams, Nutrition Against Disease.
He said that nutrients work as a team, that the chain is only as strong
as the weakest link so sometimes one nutrient will not work if another
is not also present in adequate amounts. We know this is true with CoQ10. The complexity of
nutritional interventions is more challenging since the nutritional
therapies are typically prescribed in combination with stress reduction,
diet changes and other treatments. There is not a whole lot of research
on all of these in combination. This is a place where philosophy and
clinical experience come in.
mentioned that you have clinical experience from some 6000 patients
informing this book. What percent do you believe showed real improvement
due to the nutritional interventions?
Gaby: I estimate that 80% improved. Many of these
patients had previously failed to respond to conventional medicine. I
would never have continued
with this work all these years and written this book had I not seen
people getting better.
there a possibility here of doctors just throwing micronutrients at a
patient and sending them out the door with a bag of supplements?
believe the better trained you are, the fewer tests you need to order and the
fewer treatments you need to recommend. In some cases, the best is less. One of
the goals of my writing is to help clinicians learn how to prioritize their
treatments; how to use a medical history and physical exam to determine which
interventions are most likely to help a particular patient.
Integrator: So then, what’s next for you?
Gaby: For now I am enjoying the book’s sales, seeing who is
buying it, appearing at a series of conferences this year. After that, I
believe that my work may have something to do with the public health. I
am not sure yet. For now I am enjoying this process.
Comment: Gaby’s mention of the value of Nutritional Medicine for the public health immediately brought to mind the importance, presently on the table, of educating members of the National Prevention and Health Promotion Council, birthed by the Obama reform plan, to influence our national strategy in these areas. As Gaby writes in his introduction:
“Many of the ‘side-effects’ reported by patients
who follow a nutritional program are positive, such as more energy,
better mood, fewer cravings, better mental concentration and less aches
are wellness and health promotion changes, in individuals, fully aligned
with the Council’s agenda. In contra-distinction, the reactive,
suppressive nature of the anti-agents that dominate most conventional
practices have created a rift between clinical practice and the public
health. This book can be a healing agent. Getting Nutritional Medicine into the curriculum of our medical schools and nursing schools would be a great step toward mending this split.