October 22, 2014
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Complementary and alternative medicine

In a recent Journal of the American Medical Association, St. John's wort was reported as ineffective in the treatment of severe major depression, according to a randomized controlled clinical trial. On April 21, Deepak Chopra, former endocrinologist and author of books that have sold more than 10 million copies, packed B.C. Place Stadium in Vancouver, Canada, with people wanting to hear more. He preaches a philosophy of health, integrating ideas as diverse as Ayurvedic medicine and quantum physics. His recommendations include herbal or aromatic therapies and even crystals as part of a wide-ranging selection of cures to affect a person's harmony with the cosmos, and hence, their health.

What is CAM, complementary, and alternative medicine? Most definitions cover a broad range of healing philosophies, approaches, and therapies outside of the domain of conventional or allopathic medicine. These therapies may be separated into 5 major groups:

  1. Alternative medical systems, such as naturopathic or Ayurvedic medicine.
  2. Mind-body interventions such as music therapy and meditation.
  3. Biologically-based treatments that include most herbal, special diet, and megadose vitamin therapies.
  4. Manipulative and body-based treatments such as chiropractic and massage therapies.
  5. Energy therapies, examples of which are Qi gong, Reiki, and Therapeutic Touch.

Many mainstream therapies of today were once herbal, alternative, or complementary treatments that were proven effective and safe. The name "complementary" hints at the helpful role treatments such as chiropractic manipulation, massage therapy, or acupuncture may play when carefully selected, administered by trained professionals, and combined with more conventional medical therapies in treating complex disorders.

As Canada's physicians are under greater pressure to practice scientific or evidence-based medicine, more and more people are flocking to the fringe, to unproven alternatives for their health concerns. Why? Could it be because our world is more complex and frightening and we seem to have less control over our own lives? Or is it because powerful mass marketing of health enhancing substances, devices and cure-all therapeutic approaches is having unprecedented influence on our behaviour as consumers, convincing us we need more youth, vigour, or sex drive to be whole? Since earliest recorded history humans have shown a need to worship and to believe, yet now we see traditional religious systems being challenged and discarded. Some health techniques come complete with a religion or philosophy of hope. Doctors, our traditional western healers, under worsening time pressure as they earn their wages (fee-for-service), find themselves with too little time to provide the answers, offer support, or maintain healthy relationships with their patients.

What are the dangers of alternative therapies? Some diseases are dangerous and require timely investigation and treatment with proven therapies. Some herbal preparations can interfere with traditional medications, making conditions such as diabetes or HIV less responsive to proven medications. Certain substances can mask important symptoms of serious medical conditions. Here's my advice on complementary and alternative therapies: first check out the credentials of the person offering them. If they don't have training, experience, and haven't established a track record of successfully treating people with your condition, run - don't walk - to the nearest exit. Second, remember, the questions you need answered are:

  • effectiveness: show me evidence that it works
  • safety: prove that it will not harm me
  • cost: is the potential benefit worth the cost or are there cheaper alternatives with equal effectiveness?

Go to the Internet and read about alternative therapies for your condition. Some examples include: Consumer Reports Online, The National Center for Complementary and Alternative Medicine, The National Institute of Health Office of Dietary Supplements, The National Cancer Institute CancerNet Treatment Options, The National Council for Reliable Health Information, and Quackwatch.

And finally, discuss alternative and complementary medicines with your doctor, but be patient with us: it's nearly impossible to keep up with the latest medical developments as well as the mushrooming volume of complementary and alternative therapies. Your physician might be able to give you helpful advice to guide you on your journey. And when you do decide to use complementary and alternative therapy, for safety's sake, keep your doctor informed.

  
Dr. Ray Baker, MD 
in association with the MediResource Clinical Team 

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