From The September 2000 Issue of Nutrition Science News

On the Air with Derrick DeSilva, M.D.

by Stephanie Gailing, C.N.

If Derrick DeSilva, M.D., has his way, heart disease will soon lose its place as the No. 1 killer in America. In fact, DeSilva believes that by addressing nutritional needs as well as nutrient depletions—often due to pharmaceutical drugs—many cases of heart failure can be prevented. He has taken this message to the people via publications, a teaching position at JFK Medical Center in Edison, N.J., a syndicated radio show called Ask the Doctor and a private internal medicine practice.

DeSilva's work has garnered him 1997, 1998 and 1999 listings in America's Top Doctors, a sourcebook of the best health care practitioners, published annually by Castle Connelly Medical Ltd. He is president of the Birmingham, Ala.-based American Nutraceutical Association, serves on the advisory board of The Physician's Desk Reference (PDR) and is on the editorial board of Facts and Comparisons: The Review of Natural Products (Facts and Comparisons, 1998).

Anyone who has had the opportunity to hear DeSilva speak knows that he engages his audience with a wealth of knowledge. Recently, Nutrition Science News had the pleasure of speaking with DeSilva about his perspectives on complementary medicine, his role as a health care educator, the latest research on heart health and a variety of other topics.

NSN: How did you become involved with complementary medicine?

DD: My roots in complementary medicine go back to childhood, so it has been with me all of my life. Through my grandfather and my father I gained insight into both natural and allopathic approaches to healing and saw they could work very well together. When I lived in Sri Lanka, where I was born, my grandfather introduced me to the traditional native healers, whose approaches I found fascinating. When I was 10 years old we moved to the United States, where I gained more exposure to allopathic medicine through my father's work in the pharmaceutical industry. I never perceived that the two systems were in conflict. I just felt that their integration was the way that medicine and healing should be.

NSN: Back when you were in medical school and when first starting your career as a physician, the times were different and complementary medicine was not accepted as it is now. Did you find that challenging?

DD: The perspectives back then were different from mine, but in a way, the accepted medical perspective still is. Yet I have always thought that I should hold true to what I believe. And I constantly receive acknowledgement that this path of healing is correct and that I am doing the right thing when I see so many of my patients responding well to the integrative treatment courses I give them.

NSN: Complementary medicine is sometimes described as a marriage of allopathic, traditional and natural approaches. How does this ideal play out in a real-life medical setting?

DD: Someone asked me the other day whether I considered myself more allopathically or naturally oriented. The answer I gave them was that it all really depends on the individual situation of the patient. I believe that a focus on the individual is the most thoughtful approach and the one that holds the most integrity.

For example, if a patient comes in and his blood pressure is 200 over 110, I am not going to treat him with garlic. I am going to send him to the emergency room and use allopathic medicines to treat the acute condition. Once his blood pressure is under control, I feel it would be appropriate to talk to him about some of the more natural approaches to managing his hypertension.

On the other hand, if someone comes into my office and his blood pressure is 135 over 85, I am not going to start talking to him about prescription medications. In this case I would educate him on supplements like Co-Q10, hawthorn and garlic. In addition, I would discuss lifestyle changes that can help to improve his health status. This may include things like meditation, as it has been shown to play an important role in the relaxation response and can help people to restore balance. I use this example because it shows that with all the tools available to the physician and healer, it is really the patient's unique situation that is going to define the most necessary and effective course of treatment.

NSN: What are your perceptions of the public's education level with regard to complementary medicine, and what effects do you feel it has on health care?

DD: Studies have shown that about 70 percent of the population has tried some form of natural or complementary medicine. When it comes to health care today, people are very savvy. Patients ask a lot of questions, oftentimes appearing to test the physician or health care practitioner. My patients certainly do, and I feel comfortable with this because I think that it is an important part of the process. It seems they just want to ensure that their health care practitioner knows what he or she is talking about and has the knowledge to treat them in the most effective manner.

I believe continuing education of the public and those involved in health care will be a critical element in the progression of complementary medicine. As people become more educated, they develop a greater comfort level with their options and decisions and become more open to complementary remedies. Therefore, an extremely valuable role that health care professionals and those in the natural products industry can play is the role of the educator—which is how I see myself.

NSN: How does your work with the American Nutraceutical Association reflect your commitment to improving natural health care education.

DD: I am the president of this association, whose sole purpose is education. We have made it our mission to educate people about nutraceuticals, as we feel education is critical to public health care. We do this through the development of educational materials and programs for various groups including health care professionals and consumers.

NSN: You are going to be discussing your recent research on complementary medicine and heart health at the Natural Products Expo East in Baltimore. Can you share some of your insights with our readers?

DD: Heart health is a very important health care issue because heart disease is the No. 1 killer in this country. Every 32 seconds somebody dies of a heart attack, while about 600,000 people die of heart disease every year.

At the Natural Products Expo East, I am going to present scientific findings that represent a whole new concept in the treatment of heart disease, specifically congestive heart failure. While current medical approaches to congestive heart failure include such therapies as inotropic agents to help the heart pump better and diuretics to help reduce water retention, the research I am exploring comes from a completely different angle.

This research has shown there is a direct correlation between heart failure and low levels of nutrients in heart cells. It also has focused on the idea of replacing and replenishing these depleted nutrients, some of whose levels may have been diminished as a result of the pharmaceutical drugs patients have been given in their course of treatment. Once these depleted nutrients are replenished in people with congestive heart failure, they tend to do much better.

Not only am I very excited about this research, but many in the medical establishment are as well. I recently gave a lecture on this subject to a group of cardiologists and they were on the edge of their seats.

NSN: The topic of drug-nutrient depletions is a strong area of interest for you. Tell me about the new book you've written on this subject.

DD: The book is called Drugs That Kill and will be released by Integrative Medicine Communications this fall. It is about how certain pharmaceutical drugs deplete the body of various important nutrients. In the book, I review a whole spectrum of drugs, the effects they have on nutrient status, and which supplements may be beneficial to take adjunctively with these drugs.

To cite an example that more clearly illustrates the premise of the book, let's explore hormone replacement therapy (HRT). Many women use HRT in the hope of preventing heart disease and osteoporosis. Yet, because HRT depletes the body of vitamin B6 and magnesium, the very conditions that they are trying to prevent may be exacerbated. Vitamin B6 is critical for homocysteine metabolism and therefore plays a role in heart health maintenance, while magnesium is a critical nutrient for osteoporosis prevention. Although I am not suggesting that women stop taking HRT, I think it is important that those who do so also take vitamin B6 and magnesium supplements.

NSN: Does your radio program help you to fulfill your role as an educator?

DD: Yes. I host a nationally syndicated radio program called Ask the Doctor, which has been in national syndication for almost five years. It is an hour-long program that airs on the Talk America Radio Network every weekday at 9 a.m. Eastern time. The show is live on the air and on the Internet at TalkAmerica.com and has an audience of approximately half a million people per day.

I love doing this radio show, because it is an open-format program and I get to speak with people on a one-on-one basis and answer their medical questions. I really take my time with the callers and focus on them. Plus, I have gotten to interview key people in the medical field such as Andrew Weil, M.D., and Deepak Chopra, M.D. It is fun and very fulfilling—I really love it.

Stephanie Gailing, C.N. holds her Masters Degree in Nutrition from Bastyr University, where she currently serves as adjunct faculty. She has has been involved in the natural products industry for more than 10 years, with experiences ranging from operating her own natural products retail store to serving as a marketing consultant for dietary supplement companies.