The Complete Patient

My son and daughter-in-law gave me a t-shirt last night that reads, "Raw Milk Outlaw". Very cute, especially coming at the end of such an eventful year affecting nutritional freedom.

For me, personally, this past year has been a time of important education, prompted in significant measure by the raw-milk crackdowns, as to the vast power that has accrued to the food and drug establishment. Every industry hates change--if it was up to horse-and-buggy makers, we wouldn't be driving cars--so it shouldn't be surprising that the dairy industry is fighting tooth and nail against even a hint of inroads by raw milk. If raw milk catches on further, it could force huge changes in that industry and, perhaps more signficant, expose shortcomings throughout the food-factory system.

I expect the coming year will be equally interesting in this arena. Raw milk will continue as a symbol of the regulatory and health problems created by the factory system. The pressure on this sytem will likely intensify, as more people become educated as to the problems of the existing system, and the opportunities for better health by going in new directions. And our legal system will be stretched by the challenges that will mount. The legal decision a few days ago in Ohio (described in my previous posting) provides encouragement that our system retains enough flexibility to change and adjust. (By the way, I finally figured out how to upload a copy of the decision and link to it.)

Ohio’s Department of Agriculture has prided itself on being the toughest agriculture agency in the country on raw milk farmers. Over the last year-and-a-half, it has mercilessly harassed at least a half dozen farmers, most of them involved in cow-share arrangements to distribute milk. (For details, see my BusinessWeek.com column about Ohio’s enforcement practices.)

Well, today the ODA got a bit of its own medicine. In a biting opinion, Judge Jonathan Hein of the Common Pleas Court of Darke County took the ODA to task over “the failure of the Department to articulate specific problems with the cow share agreement” involving dairy owner Carol Schmitmeyer and her herd’s 150 shareholders. His decision restores her Grade A dairy license, which ODA suspended last September, and allows her cow share arrangement, unless the ODA appeals within 30 days. Carol had worried she might lose her farm if the court upheld the ODA's license suspension.

Should the ODA appeal, it will face judges who will have Judge Hein’s harsh opinion of the agency’s operations in front of them. "This is a very well written and reasoned decision that should withstand any appeal," says Gary Cox, a lawyer with the Columbus firm Lane, Alton & Horst, who represented Carol.

Judge Hein's opinion states: “In spite of the Department’s claims that it possesses no statutory authority to permit the sale of raw milk under any circumstances to the ultimate consumer...the Court opines that the Department possesses administrative authority to adopt rules and definitions, within the scope of the law." In other words, the ODA could have established guidelines for cow share arrangements, if it so chose.

In his analysis of the ODA’s unwillingness to tolerate cow share agreements, and only allow raw milk to be consumed on farms, the judge raises a number of pointed questions designed to portray the agency as arbitrary in cracking down on cow shares: “Does the Department allow herd owners and their children/family members to consume raw milk? Or must the children/family members reside in the farm household? Or must the children/family members also be active participants in the milking operation in order to ‘legally’ consume raw milk?” Further, “if the cows are owned by a partnership, can all partners consume raw milk? Or must the partners be family members? Or must the partners consuming the raw milk reside on the farm? And if the cows are owned by a corporation, the same troubling questions apply with even more shareholders being involved in the equation.”

The judge provides an answer of sorts to his questions when he states, “The Department…argues that the ‘herd share agreement’ is a transparent attempt to circumvent the law. If the herd share agreement is a circumvention of the law, so is the Department’s inexact practice of allowing owners and their families, etc. to consume raw milk.” Pow!

Actually, the judge really gets into the absurdity of the situation. At another point, he says, “Under another hypothetical, the Court could define a ‘sale’ in a way which would allow delivery of raw milk to all persons who have a small or remote interest in a dairy cow, provided the owner consumes the raw milk on the farm. This definition might allow delivery to herd share owners, but only if the raw milk is consumed on the farm. Numerous other examples could be propounded depending on the practices allowed by the Department.”

Finally, the judge encourages the Ohio legislature to adopt pending legislation that would clearly define cow shares and permit them as a means of distributing raw milk.

It’s a busy time on the farm these days. A few items:

--There’s this little movement gaining a foothold among Michigan cattle farmers opposed to the National Animal Identification System (NAIS) that I guess you could call the beginnings of civil obedience. The state’s farm grapevine has it that at least some farmers plan to respond to the Michigan Department of Agriculture’s (MDA's) order to affix tags to all cattle by this March 1…by returning the MDA’s order letters to the agency…including a note to this effect: “I choose not to have my premises identified by the government.” (For background on the Michigan order letters, see my BusinessWeek.com column of earlier this month.)

No one farmer wants to be associated with leading the movement, and for good reason: the government has this nasty little habit of picking out individual farmers, and using them as examples to scare everyone else. Witness Richard Hebron, of the Family Farms Cooperative, who drove into a raw-milk sting last October.

--Also today, the federal Food and Drug Administration (FDA) announced that it is approving cloning of farm animals. It says it can’t find any difference between meat and milk from conventional animals and cloned animals. But we know it can’t be that simple. For now, major food processors are taking a wait-and-see attitude, apparently because much of the rest of the world isn’t nearly as sold on cloning as the FDA. Consumers are also said to be uncomfortable about the idea, but since when does agribusiness care about them?

--And the movement by farmers to sell directly to consumers continues to gain in popularity. I’ve tried to capture the dynamics of this change, from a farmer and business perspective, in my latest BusinessWeek.com column, just posted. The marketplace is making farming ever more attractive as a business, for those farmers willing to wade into the marketplace.

I sometimes marvel at hugely beneficial, and often inexpensive, health ideas I’ve picked up over the years, and even wonder how my life might have changed had I known about them sooner. Chinese herb detox treatments. The green vegetable juice drink that increases my energy level. Colostrum to build up immunity.

I was reminded about such techniques as I read Linda Diane Feldt’s wonderful primer on relieving menopause symptoms (commenting on my most recent post). Now, maybe because I’m a man, I haven’t heard of Motherwort and Black Cohosh, but I suspect many women haven’t, either.

She argues that bioidentical hormones should be seen as a last resort among herbal-food remedies. The reason they are pushed right up ahead of the less powerful herbs is that the less powerful herbs have less powerful proponents. It’s the problem she identifies as “the promotion of drugs and herbs and supplements by the people who directly profit from them.”

I don’t know how you get around that problem in a capitalist society such as ours. It would be nice if the government at least helped in the education effort, but it can’t/won’t because its key officials have been bought off or are graduates of the corporate establishment themselves. In other words, the small pharmacies that push bioidentical hormones because that’s what they have to sell are working from the same incentives as Big Pharma.

This phenomenon helps explain why many of the powerful inexpensive remedies never get tested to the satisfaction of the science establishment’s control-group criteria. There’s not enough money to be made from such remedies, so there’s no financial backing of studies that would document their efficacy. The old chicken-egg routine.

I’ve been following the news reports about a sharp decline in breast cancer rates that seem to coincide with reduced usage of the Wyeth estrogen drug, Prempro.

That is certainly encouraging news, though the likelihood that a major prescription drug substantially increases cancer risk shouldn’t be a surprise.

I’ve been wondering about a related matter: What, if any, is the role of the so-called bioidentical hormones made from soy and other plant materials?

Last April, I wrote a BusinessWeek.com column about Wyeth’s attack against pharmacists and others making bioidentical hormones. Wyeth claimed the natural hormones were potentially dangerous to women because they weren’t overseen as closely as Wyeth’s Prempro by the federal Food and Drug Administration. But, of course, Wyeth was obviously concerned that the bioidentical hormones’ popularity was cutting into sales of Prempro.

What turned my head while doing research for the column was reading hundreds of letters women wrote to the FDA about how their lives had been improved by bioidentical hormones. Many of the women said they had previously taken Prempro, with disastrous results.

So my question when news of the decline in breast cancer rates came out was this: Do bioidentical hormones present the same risks for women that Prempro does? Today a New York Times article raises just that question—in a provocative way, for the Times—as part of an interview with a prominent researcher specializing in estrogen and breast cancer. The interviewer: “Some people suggest that the real problem was that the hormones women were taking were artificial or were given in artificial ways. Prempro, for example, gets its estrogen from pregnant mares. Some say other hormone preparations, for example, so-called bioidentical hormones, would be safe. Do you agree?”

The researcher answers the question only by inference. “We’ve been talking about women’s ovaries producing estrogen and progesterone. When a woman enters menopause, hormone levels drop dramatically. The longer you bathe a woman’s breast in these hormones, the more likely she will have cancer…And that is with natural hormones, the ones in your body.”

My guess is the researcher hasn’t spent any time or energy examining bioidentical hormones, but didn’t want to say so. Instead, he applied his theory to an area he hadn’t researched.

I actually had a discussion a week ago about this subject with a friend who is a physician, and his response was similar to the scientist interviewed by the Times. Except he added another caveat: The reason we have the FDA is to make sure professionals monitor the drugs people take. When people have the freedom to take things like bioidentical hormones on their own, they are putting themelves in danger.

Needless to say, we had a lengthy discussion. My feeling is people should have the freedom to take whatever supplements or plant-based materials they want, and that it’s up to them to evaluate the risks. Based on the letters I read from women taking bioidentical hormones, many are even willing to increase their risk of getting breast cancer sometime in the future so as to live a much more comfortable life today.