Complementary and Alternative Medicine Therapies

Adding a dietary supplement to your conventional medication? Seeing an acupuncturist to augment your treatment for anxiety? Taking herbs to supplement a regimen of cancer chemotherapy? You may have heard of the terms “complementary”, “alternative”, or “integrative” medicine–but do you know what they mean?

Complementary medicine is any form of non-standard therapy used together with conventional medicine. It differs from alternative medicine because alternative medicine is used in place of conventional medicine. Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not generally considered as standard medicine in the U.S.

Recently there has been a move in healthcare toward integrative medicine–this is an approach that combines the use of conventional and CAM therapies in a coordinated way for which there is high-quality evidence of safety and effectiveness. Today, over 30% of adults use some form of CAM therapies. True alternative medicine is uncommon. Most people use non-mainstream approaches along with conventional treatments. There are 2 main types of CAM therapies:

• Natural products, such as herbs (also called botanicals), vitamins and minerals, and probiotics. These are sold as dietary supplements
• Mind and body practices, such as yoga, meditation, tai chi, and massage

If you are considering a CAM therapy that has not been prescribed or recommended by your healthcare provider, it is very important to speak with your doctor and pharmacist to discuss the pros and cons of using a particular CAM therapy.  

What Can You Trust?

Be wary of any dietary supplements that promise a cure. Avoid products that claim to be a miracle treatment, or even a scientific breakthrough, and don’t take anything that claims to have secret ingredients. It’s important to know what you are taking and that it is safe. A good rule of thumb is that if it sounds too good to be true, it probably is!

Many adults use dietary supplements other than vitamins or minerals. Similar to conventional medicines, these products have safety risks. However, unlike conventional medicines, natural products are classified as dietary supplements. Under this classification, they are considered neither food nor medicine and are not required to demonstrate safety and efficacy before they are marketed. Remember that just because something is considered “natural” doesn’t mean it is necessarily safe. Find out as much as you can about the product, its manufacturer, and scientific studies that have been done on the safety and effectiveness of the product.

Evaluating CAM Therapies

When deciding whether or not to use a CAM therapy, the first thing to do is talk with your doctor or pharmacist. Keep in mind that not all alternative practitioners–for example, tai chi instructors—are medically trained so before trying something new, talk with your doctor to make sure your new regimen doesn’t conflict with your conventional therapy.

Because there are many CAM therapies out there, it is important to carefully consider the benefits and risks associated with their use. Healthcare providers may consider several important points as they evaluate whether a particular CAM therapy is appropriate for you–some of these considerations include:

• Letting your healthcare provider know about all medications, supplements and therapies you use to manage your condition
• Asking your healthcare provider about the benefits, risks, and effective of a particular CAM therapy

If you are thinking about or currently using a dietary supplement as a CAM therapy, you and your healthcare provider may consider the following:

• Is the product obtained from a reputable source?
• What are the potential benefits and risks of the product?
• Does the product label have directions for use, "Supplement Facts", and all ingredients listed (both active and inactive)?
• Can the product interact with any medications (prescription or over-the-counter) or other dietary supplements being taken?
• Does the Federal government have anything to report about it?

What You Can Do

Here are a few other things you can do to ensure you are on the right track:

• Don’t start any CAM therapies until you’ve spoken to your doctor or pharmacist about it. And if you happen to be using a CAM therapy already, be sure to discuss its use with your healthcare provider
• Always include any CAM products you take when giving your doctor or pharmacist a list of your medications
• If you are looking for a healthcare provider trained in CAM therapies, ask for recommendations. Also find out whether he or she is willing to work with your healthcare team–it’s important to coordinate your care
• Report any interactions between your conventional medications and complementary medicines to your doctor or call the FDA MedWatch Program so that they can document the event

Being proactive and starting a conversation with your doctor and pharmacist can help them get a better picture of how you want to manage your health. It also allows for a more coordinated approach to care.

John P. Rose, PharmD, PA-C is an Associate Director in Medical Information at Pfizer, specializing in oncology.

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