Patient education: Complementary and alternative medicine (The Basics)

What is complementary and alternative medicine? — 

People sometimes use the words "complementary" and "alternative" medicine to mean the same thing. But they have different definitions:

●In complementary medicine, non-traditional treatments are used along with "regular" medical treatments for illness. These non-traditional treatments are supposed to help with health but are not part of "mainstream" medicine.

●In alternative medicine, these same non-traditional treatments are used instead of traditional medical treatments.

You might also hear these terms:

●"Integrative medicine" – This is the practice of complementary medicine that is based on evidence.

●"Holistic care" – This refers to considering the whole person, including their spiritual and emotional state, when treating a health problem.

What are some examples of complementary and alternative medicine? — 

There are many different treatments that are offered in alternative, complementary, and integrative medicine. But not all these treatments have evidence to support their use in treating illness. And some of them can even cause harm.

Some examples include:

●Acupuncture, massage, and mind-body techniques – These things might help when used along with other treatments.

•Acupuncture involves getting thin needles inserted into the skin in different places. The needles do not hurt, or they hurt very little. With massage, a person rubs, kneads, and presses on your body.

•"Mind-body" techniques include things like meditation, guided imagery, and hypnosis. There are also "energy therapies" such as reiki. In reiki, the practitioner places their hands on or near your body. People who believe in this think it helps direct the flow of energy throughout the body.

Talk with your doctor if you are interested in trying any of these techniques. Some people find these things can help in some situations, and they are probably not likely to cause harm. They should not replace other treatments your doctor recommends.

●Herbal remedies – These are usually pills or liquids that contain substances found in plants. Even though herbal remedies are "natural," they are not always safe. Plants sometimes have chemicals that can hurt the body or cause problems when used with regular medicines.

●Dietary supplements – These can contain vitamins, minerals, and other substances. The body does need certain vitamins and minerals, but it is usually best to get these from a variety of healthy foods rather than from supplements. In some cases, doctors might prescribe supplements, for example, calcium and vitamin D to help keep bones strong. Or they might prescribe other vitamins or supplements if you cannot get enough from foods.

Some dietary supplements claim to do other things, like help you build muscle, lose weight, or balance your hormones. Doctors generally do not recommend these, and they can cause harm.

●Special diets – People with cancer and other health problems sometimes hear their condition could improve if they ate a special diet. These diets might contain no meat, or require you to take special supplements.

Is it safe to use alternative or complementary medicine? — 

Many forms of alternative and complementary medicine are safe. And some can be helpful. For example, massage or meditation might help you feel more relaxed, which can help you manage your illness or condition more easily.

Still, it's important to be cautious, especially if you are trying things like supplements or herbal treatments. In most countries, including the US, these products are not regulated by government agencies like standard medicines are. In some cases, they have been found to contain prescription medicines or other ingredients not listed on the label that can cause harm. They can sometimes affect how your other medicines work. They can also be expensive. Be careful about any product that claims to be a "miracle pill," or says it cures cancer or another serious disease.

Many herbs and supplements, especially products with a lot of different ingredients, have not been studied well enough to understand how they work or whether they are helpful for most people. If you want to try an herb or supplement, talk with your doctor or pharmacist about how to choose a reliable product. They can help you find ones that have been independently tested and are less likely to contain unsafe ingredients.

If you are thinking about using any complementary or alternative treatment, talk with your doctor or nurse. They can tell you if there are known risks involved with the treatment, and can help guide you to make safe choices. The right approach depends on your health and situation as well as your preferences.

It is important to talk with your doctor or nurse because:

●Whether an herb is safe to use depends on the product and how much you take. Some, like turmeric, are probably safe as long as you are not using them to replace other medical treatments. Others can be harmful or even toxic. For example, kava kava (which people sometimes take for anxiety) can damage the liver. Kratom (which people sometimes take for pain or opioid withdrawal) can cause breathing problems, seizures, and liver injury.

●Bodybuilding and weight loss supplements often contain ingredients that are unknown or harmful. These products have a high risk of side effects.

●Some special diets can cause people to lose weight very quickly or have vitamin deficiencies (low levels of certain vitamins). This can cause health problems. Plus, special diets can be very expensive even though they might not help people get better.

Where can I find reliable information about herbs and supplements? — 

In addition to talking with your doctor, nurse, or pharmacist, the following websites might be helpful:

●MedLine Plus Dietary Supplements: www.medlineplus.gov/dietarysupplements.html

●National Center for Complementary and Integrative Health: www.nccih.nih.gov/health/herbsataglance

●Dietary Supplement Ingredient Database (for products sold in the US): www.dsld.od.nih.gov

●USADA Athlete Supplements Guide and High Risk List: www.usada.org/athletes/substances/supplement-connect

●Memorial Sloan Kettering Cancer Center (herbs and other products): www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs

The US Food and Drug Administration ("FDA") has consumer information about dietary supplements: www.fda.gov/food/dietary-supplements/information-consumers-using-dietary-supplements. Your doctor, nurse, or pharmacist might suggest other resources, too.

More on this topic

Patient education: Acupuncture (The Basics)
Patient education: Massage (The Basics)
Patient education: Meditation (The Basics)
Patient education: Vitamin supplements (The Basics)