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Doctor Nice

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In science, the gold standard for testing theories is the double-blind, randomized, placebo-controlled study, which adjusts for bias on the behalf of both the scientist and the subject. But Hotze eschews that methodology and relies on vague "in-house" studies, such as the one where his testosterone supplement increased his male patients' "mental sharpness, memory, abstract thinking, mathematical ability, goal-setting, initiative, assertiveness, decisiveness, sense of well-being, self-confidence, depressed moods, anxiety, irritability, muscle strength and romantic inclinations." Curiously, there was no mention of sharpened map-reading skills.

In addition to his natural hormones, he developed an interest in other conditions that exist only on the fringes of medicine, such as "yeast hypersensitivity syndrome." In his prospective patient booklet, Hotze states that an overgrowth of yeast in the colon "produces toxins which depress the immune system and make it more reactive to allergy." A person with yeast overgrowth "often becomes allergic to yeast, and therefore allergic to food products which contain yeast, such as beer, wine, breads, etc." Symptoms include lethargy, depression, gas, difficulty concentrating, athlete's foot, jock itch, joint and muscle pain, and hives. Hotze claims the condition can be remedied by purchasing megadophilus supplements from his in-house dietary supplement store.

In 1986 the American Academy of Allergy, Asthma and Immunology called this syndrome "speculative and unproven," adding that "the basic elements of the syndrome could apply to almost all sick patients at some time."

And his treatment of thyroid disorder is in keeping with similar "wellness centers" across the country: Instead of treating all problems associated with the thyroid, Hotze treats the one condition -- underactive thyroid -- where patients need to buy thyroid replacements. The only drug he prescribes for hypothyroidism is Armour Thyroid, made from desiccated pig or cow hormones. Endocrinologists at the nation's leading hospitals contacted for this story all described Armour Thyroid as an inferior, antiquated product. Hotze, however, prefers its "natural" qualities to those of synthetic thyroid replacements. (For some reason, Hotze argues that pig hormone originally provided by the Armour hot dog people is perfectly natural for humans, while Premarin, an estrogen replacement derived from mare's urine, is not.)

"That's like selling snake oil," says Dr. Carlos Hamilton Jr., a professor of medicine at the University of Texas Health Science Center-Houston. He is also a past president of the American Association of Clinical Endocrinologists.

"For one thing, when you give this, you're giving all the other things that sort of come up with ground-up pig thyroid, and you don't necessarily want those," says Dr. Susan Kirk of the University of Virginia Medical Center in Charlottesville.

In conventional medicine, hypothyroidism is best diagnosed by a blood test and a review of symptoms. While Hotze administers blood tests, he states in his booklet that a more important tool in determining hypothyroidism is the measure of a patient's basal body temperature. This method, discredited in conventional medicine, is a technique used to detect a dubious hypothyroid condition called Wilson's syndrome. The American Thyroid Association states that there is no scientific evidence proving the syndrome's existence, and that any diagnosis and treatment of the condition could be harmful.

From the thyroid association's Web site: "The 'Wilson's syndrome' website states that Dr. Wilson named this concept after himself 'because it had not been previously described.' In fact, for more than a century, the same set of symptoms has been given different names and attributed to a variety of causes by others, including the syndromes of neurasthenia, chronic fatigue, fibromyalgia, multiple chemical sensitivity, chronic Ebstein Barr disease, and chronic candidiasis," or yeast hypersensitivity syndrome.

According to Dr. Manuel Quinones of UCLA's David Geffen School of Medicine, "it would be malpractice, it would be unethical for somebody to diagnose somebody by a body temperature…In the medical community, we would say immediately, 'What's his or her gimmick?' "

Dr. Bill Ladenson of Johns Hopkins Hospital also is skeptical of using basal body temperatures to diagnose hypothyroidism.

"Part of this whole naturopathic gospel is [blood] tests don't detect, somehow, a group of patients with thyroid problems who can only be detected by basal body temperature," he says. "There's just no scientific evidence for this. If you want to check your basal body temperature tomorrow morning or for the next few mornings, I think that you would find you would readily fulfill this doctor's criteria for having an underactive thyroid gland…It's a good way of kind of assuring that 90 percent of your patients are going to want the treatment."

And Hotze's allergy drops, administered under the tongue, are considered experimental in the United States and are not endorsed by the American Academy of Allergy, Asthma and Immunology. In his booklet, Hotze claims that sublingual drops can "neutralize" a patient's allergic reaction to foods, but there is no scientific evidence supporting this claim.

Dr. David Weldon, vice chair of the AAAAI's immunotherapy committee, says that while European testing has shown that extremely high-dosage drops are effective for certain airborne allergies (but not food allergies), advocates in the United States of the drops often use diluted, ineffective doses to cut costs.

"Believe me, I wish that the sublingual stuff in Europe was a lot more practical and used in the United Sates," says the board-certified Weldon, who is also president of the Texas Allergy, Asthma and Immunology Society. "We have a great dilemma in the state of Texas regarding practitioners providing alternative care under the umbrella of allergy. And that alternative care, in the majority of instances…amounts to nothing more than a placebo effect. But it's a very expensive placebo effect."

He adds: "My colleagues who are board-certified or board-eligible have gone through the training in order to prove their worth and have been tested. What they do after that is up to them. But the vast majority of physicians that belong to the TAAIS practice allergy, and not the business of allergy."

In 1994 President Clinton signed the Dietary Supplement Health and Education Act, setting into non-motion one of the least effective pieces of legislation in recent memory.

The act broadened the definition of "dietary supplement" beyond essential nutrients and transferred safety monitoring from the FDA to the manufacturer. Today, most dietary supplements are not subject to premarket testing.

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