Thousands of years ago Moses told his people, “Five of you shall chase a hundred, and a hundred of you shall put ten thousand to flight.” He was describing the principle of synergy, that the sum is often greater than its parts. One plus one is not always two; one plus two is not always three. Sometimes one plus one is four and at times one plus two is fifteen!

Nowhere is the wonder of synergy more evident than in the effect of nutrients and lifestyle changes upon the human body. A weight loss program, for example, is much more effective if dietary changes, increased physical activity, and appropriate supplements are combined than if only one factor is addressed. If a particular exercise regimen will result in a loss of two pounds over a month’s time and dietary changes will result in a loss of three pounds the combined effect may be a total reduction of not five pounds but eight.

Accepting the role of synergy was one of the most difficult challenges I faced when transitioning from the pharmaceutical approach to illness that characterized my undergraduate training and continuing medical education. It is a concept that continues to elude most pharmacists and physicians. Even some nutritionists are unable to grasp the significance of synergy.

I first became aware of the significance of synergy when studying traditional Chinese botanical medicine. Asian practitioners, particularly those in China and India, are masters in the synergistic use of botanicals.

Traditional Chinese herbalists divide herbs into three classes: Superior herbs, inferior herbs, and messenger herbs. Superior herbs are food grade plants that can be consumed on a daily basis for an extended period of time without causing any ill effects. Inferior herbs, on the other hand, are plants that may produce certain desired effects but that can also cause side effects if taken in amounts greater than needed or consumed over a period of time. Messenger herbs are plants that tell the body how to utilize a combination of herbs.

Simply simply substituting a different messenger herb can alter the action of an herbal formulation in the body. Herbal blends or combinations produce a synergistic effect and are often far more effective than a single herb in addressing medical conditions. Because smaller amounts of each component may be used, blends often have fewer side effects than a single herb taken at a higher dosage.

Combination pharmaceutical products were in common use thirty years ago. Government regulators, however, decided that products should only contain a single component unless overwhelming evidence of increased effectiveness of a combination of ingredients could be presented. Faced with the massive challenge of performing controlled studies to demonstrate the superiority of each formulation manufacturers withdrew nearly all combination products from the marketplace.

While a few combination preparations are marketed today, most pharmaceuticals are composed of a single constituent. As a result medical professionals have come to look for the “active ingredient” in any product and have largely forgotten the principle of synergy.

As I became re-educated I realized that vitamins, minerals, amino acids, fatty acids and other nutrients act synergistically. Just as herbal combinations produce effects beyond what each herb would be expected to produce separately, nutrient combinations often provide benefits that cannot be achieved by taking individual nutrients.

I rarely use or recommend single ingredient products such as vitamin E, vitamin C, ginkgo biloba or calcium today. I accept the fact that advances in the management of medical conditions come as much from identifying synergistic combinations of nutrients as they arise from the discovery of a magical new substance.

I would like my pharmacist and physician friends to be as accepting of this principle as I, but their usual response to a combination product is to look at the label and pronounce with an air of confidence and superior knowledge, “Oh, this is co-enzyme Q-10,” or, “This works because it contains ginkgo.”

At that point I have learned to smile submissively and return to my office, reassured in the knowledge that those who are facing a challenge, those most in need of an effective solution will be less critical. They will be willing to accept the benefits available to them through the wonder of synergy.