If you've ever taken herbal products, seen a chiropractor
or tried megavitamin therapy, you've ventured outside
the boundaries of conventional medicine.
There's a term for those therapies -- "complementary
and alternative medicine," or CAM -- and it describes
the wide range of health systems, practices and products
that fall outside the mainstream. The National Center
for Complementary and Alternative Medicine (NCCAM) catalogues
dozens of them -- from acupuncture to zinc supplementation.
The list of CAM therapies continually changes, as the
ones proven safe and effective become well integrated
into conventional medicine and new therapies are introduced.
There are also important distinctions between complementary
and alternative medicine. Complementary medicine is something
that is used in conjunction with conventional medicine,
while alternative medicine is used in place of conventional
treatment.
"You can have conventional cancer therapy along
with, say, some music therapy or something that's soothing
but relatively innocuous. It isn't going to affect your
conventional treatment," explained Jackie Wootton,
president of the Alternative Medicine Foundation in Potomac,
Md.
"On the other hand," she added, "alternative
medicine, such as coffee enemas, can be used as an alternative
to conventional treatment."
In the United States, 36 percent of adults are using
some form of complementary or alternative medicine, according
to a 2004 study by NCCAM and the National Center for Health
Statistics. The number rises to 62 percent when the definition
of CAM includes megavitamin therapy and prayer specifically
for health reasons.
According to the survey, prayer is the most commonly
used CAM therapy. It is considered a type of "mind-body"
therapy.
About one-fifth of people surveyed used natural products,
such as Echinacea, ginseng, ginkgo biloba, garlic supplements
and glucosamine.
Recognizing CAM's possible potential to prevent disease
and promote wellness, some health care providers practice
what is known as "integrative medicine," which
combines conventional treatment with CAM therapies for
which there is some evidence of safety and effectiveness.
But if, like many Americans, you see a conventional physician
and use complementary or alternative medicine on the side,
play it safe and tell your doctor what you are doing.
People shouldn't be afraid to broach the subject, Wootton
urged. Physicians are much more accepting of CAM these
days, and it's vital that they know what you are doing,
she said, especially if you are ingesting something, such
as herbal supplements.
Experts say one reason to share this information is the
pittance of scientific evidence demonstrating the results
of various therapeutic combinations.
"We know very little about the herb-drug interactions
or the herb-herb interactions or vitamin-drug interactions,"
said Fredi Kronenberg, director of the Richard and Hinda
Rosenthal Center for Complementary & Alternative Medicine
at Columbia University in New York City.
You want your doctor to be in the loop because a particular
supplement you are taking may interact either positively
or negatively with a drug you are taking.
"It could interact negatively if you're taking a
blood thinner and now you're taking a supplement that's
a blood thinner, and now you get too much of a good thing,"
Kronenberg explained.
On the other hand, she added, "You could have a
supplement that synergizes the effect of a drug -- that
makes a drug work better -- and therefore you might need
less of that drug."
Conventional doctors may not be CAM experts. But they
are aware of some of the benefits and problems of CAM,
Kronenberg pointed out. "And they're aware mostly
that their patients are using these things, and they need
to know about it if only because their patients are using
them," she said.