Traditional medicine has much to offer in the treatment
of most diseases and health conditions. Yet increasingly patients
are choosing to augment their traditional medicine with complementary
therapy or to choose a different approach altogether with an alternative
medicine.
A complementary or alternative medicine (CAM) is
a medical approach that does not have adequate reliable scientific
evidence to support its safety and/or effectiveness. Therefore,
it is generally not accepted by the medical establishment. Support
for CAMs is anecdotal, that is, based on stories told by individuals
attesting that the product or approach worked for them, or is based
on limited scientific experiments that have not shown consistent
results.
CAMs include a wide range of health related products
and services. The scope of CAMs can include products such as herbal
supplements to services such as acupuncture and massage therapy.
(See the following chart for specific examples.)
Some questions to consider in making the decision
to try a CAM include:
Is the product/therapy safe?
Unfortunately, in the United States, over-the-counter products and
unregulated health services do not have to prove they are safe to
be marketed. They are removed only after being proven unsafe. It
is critical to research the CAM. Remember that anyone can make a
website and provide false or misleading information. Make sure to
access reliable scholarly sources. Look for .edu or .gov sites or
the websites of agencies that you trust.
Who is recommending the CAM?
There is a lot of quackery out there! Some charlatans are intentionally
selling bogus products so do not be duped by the claims in advertising.
The testimony of a trusted friend or relative is a better recommendation.
Be aware that anecdotal evidence can be caused by the placebo effect.
Improvement can occur simply because a person is being treated,
even if the treatment is an inert substance like a sugar pill.
Can the CAM provider be trusted?
Because the US Food and Drug Administration (F.D.A.) does not regulate
supplements for purity and potency consumers are required to trust
the manufacturers. Recently, a major consumer agency tested several
bottles of the supplement ginseng (used to increase vitality) and
found that most had significantly less than the labeled amount of
ginseng. One had no ginseng in it at all!
Is it safe for me?
Know the effects and potential side effects of a CAM. Some have
particular implications for the bleeding disorder community. Many
herbal supplements may affect bleeding. For example, the herbal
supplement ginkgo, which is used to improve memory and concentration,
inhibits platelet activity so should not be used by those with bleeding
disorders. Garlic, used as an antioxidant and disease preventative,
ginger, used for motion sickness and stomach acid, and feverfew,
a herb often used as a remedy for headaches, arthritis and fever,
have been reported to alter bleeding time and affect blood clotting.
With habitual use, echinacea, a herb primarily used to reduce common
cold symptoms, may suppress the immune system so should be avoided
by those with impaired immunity. It is also not recommended for
those with bleeding disorders since it may decrease blood clotting.
In addition, those with liver damage should not use the herbal supplement
valerian, which is commonly used as a sleep aid. The F.D.A. is currently
investigating the supplement kava, which is used to improve sleep
and to decrease anxiety, as a potential cause of severe liver problems.
Is there any risk in delaying traditional
treatment or in interactions with traditional treatment?
It just does not make sense to try an alternative when there is
a proven traditional therapy that can help. Sometimes a delay in
treatment can mean the difference between life and death. It is
important to inform health care professionals of all substances
being taken. Many herbal supplements can interfere with or increase
the effects of traditional medicines. Garlic supplements, for example
can interfere with the HIV viral medication saquinavir.
What is the cost?
Though some CAMs are covered by health insurance, most are not.
Some are very affordable and pose minimal financial risk to determine
if they are effective. Others are more expensive and not worth the
risk when potentially useless.
Thousands of individuals are using CAMs and attest
to their effectiveness. If the product or service is safe, does
not interfere with or delay conventional treatment, and is affordable,
there is probably no harm in giving it a try. However, because Complementary
and Alternative Medicines are not regulated the way pharmaceuticals
are, buyer beware!
Examples of Complementary and Alternative
Medicines
Alternative Systems of Medicine:
- acupuncture
- homeopathy
- chiropractics
- naturopathy
- crystals
Mind/Body Interventions:
- biofeedback
- laughter as therapy
- aromatherapy
- guided imagery
Manual Healing:
- therapeutic touch
- reflexology
Herbals:
- valerian root
- ephedra
- echinacea
- saw palmetto
- aloe
- block cohosh
- ginseng
- gingko
- St. John’s wort
Hormones:
- melatonin
- DHEA
- androstenedione
- creatine
- human growth hormone
- phytoestrogen
Diet/Nutrition:
- food promotion (e.g. garlic)
- megadoses of any vitamin megadoses of any mineral
- vitamin C
- zinc
- chondroitin sulfate
- glucosamine
- coenzyme Q10
- hydroxycitrate
- lecithin
Hormone Related Substances:
- melatonin
- androstenedione
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