Alternative medicine describes practices used in place of conventional medical treatments. Complementary medicine describes alternative medicine used in conjunction with conventional medicine. The term complementary and alternative medicine (CAM) is an umbrella term for both branches. Alternative medicine includes practices that incorporate spiritual, metaphysical, or religious underpinnings; non-European medical traditions or newly developed approaches to healing.

The National Center for Complementary and Alternative Medicine defines complementary and alternative medicine as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine". It also defines integrative medicine as "mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness" . Ralph Snyderman and Andrew Weil state "integrative medicine is not synonymous with complementary and alternative medicine (CAM). It has a far larger meaning and mission in that it calls for restoration of the focus of medicine on health and healing and emphasizes the centrality of the patient-physician relationship" [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11863470 PMID 11863470.

Proponents of evidence-based medicine regard the distinction between conventional and alternative medicines as false, preferring "good medicine" with provable efficacy and "bad medicine" without. "Bad medicine" is any treatment where the efficacy and safety of which has not been verified through peer-reviewed, double blind placebo controlled studies, regarded as the "gold standard" for determining the efficacy of a compound. It is thus possible for a method to change categories in either direction, based on increased knowledge of its effectiveness or lack thereof. Richard Dawkins, Professor of the Public Understanding of Science at Oxford, argues that alternative medicine should be defined as that set of practices that cannot be tested, refuse to be tested or consistently fail tests. He also states that "There is no alternative medicine. There is only medicine that works and medicine that doesn't work."

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NCCAM Featured Content

Colds and Flu and CAM: At a Glance
Tue, 09 Feb 2010 12:24:26 -0500
No one looks forward to the cold and flu season. Americans catch an estimated 1 billion colds each year. In fact, the common cold is among the leading reasons for visiting a doctor and for missing school or work. The flu, with its potential complications, can be an even greater concern. Each year, an estimated 5 to 20 percent of Americans come down with the flu. Although most recover without incident, flu-related complications result in more than 200,000 hospitalizations and 36,000 deaths annually.In an effort to prevent or treat these all-too-common illnesses, some people turn to complementary and alternative medicine (CAM) approaches. This fact sheet provides basic information on colds and flu, as well as "what the science says" about some of these CAM approaches. If you are considering using a CAM therapy for colds or flu, this information can help you talk to your health care provider about it.
NCCAM's Advisory Council Welcomes Five New Members
Fri, 05 Feb 2010 16:49:25 -0500
The National Center for Complementary and Alternative Medicine (NCCAM) welcomes five new members to the National Advisory Council for Complementary and Alternative Medicine (NACCAM). The council serves as the principal advisory body to NCCAM, the lead Federal agency for complementary and alternative medicine (CAM) research, and a component of the National Institutes of Health.The council is composed of physicians, scientists, licensed CAM practitioners, and members of the public who contribute their time and expertise over a four-year term. Members meet three times per year, offering advice and recommendations on prioritization, conduct, and support of CAM research, including research training and communication of evidence-based health information.
Updated Advisory Council Meeting Agenda for February 5th 2010
Thu, 04 Feb 2010 15:09:17 -0500
Update: Due to the impending major snowstorm predicted for the mid-Atlantic region on Friday, the agenda for the February 5, 2010, meeting of the National Advisory Council for Complementary and Alternative Medicine will be shortened. Those who wish to provide public comments must be present at the meeting. For updates, please visit http://nccam.nih.gov/ or call 301.594.9632.

Evidence-based Complementary and Alternative Medicine - current issue

eCAM: Proteomics, BioArt and Integrative Medicine?
Cooper, E. L.
Traditional Chinese Medicine for Chronic Fatigue Syndrome
Chen, R., Moriya, J., Yamakawa, J.-i., Takahashi, T., Kanda, T. More and more patients have been diagnosed as having chronic fatigue syndrome (CFS) in recent years. Western drug use for this syndrome is often associated with many side-effects and little clinical benefit. As an alternative medicine, traditional Chinese medicine (TCM) has provided some evidences based upon ancient texts and recent studies, not only to offer clinical benefit but also offer insights into their mechanisms of action. It has perceived advantages such as being natural, effective and safe to ameliorate symptoms of CFS such as fatigue, disordered sleep, cognitive handicaps and other complex complaints, although there are some limitations regarding the diagnostic standards and methodology in related clinical or experimental studies. Modern mechanisms of TCM on CFS mainly focus on adjusting immune dysfunction, regulating abnormal activity in the hypothalamic-pituitary-adrenal (HPA) axis and serving as an antioxidant. It is vitally important for the further development to establish standards for ‘zheng’ of CFS, i.e. the different types of CFS pathogenesis in TCM, to perform randomized and controlled trials of TCM on CFS and to make full use of the latest biological, biochemical, molecular and immunological approaches in the experimental design.
Who Uses CAM? A Narrative Review of Demographic Characteristics and Health Factors Associated with CAM Use
Bishop, F. L., Lewith, G. T. Complementary and Alternative Medicines (CAM) are used by an extensive number of patients in the UK and elsewhere. In order to understand this pattern of behavior, it is helpful to examine the characteristics of people who use CAM. This narrative review collates and evaluates the evidence concerning the demographic characteristics and health status factors associated with CAM use in community-based non-clinical populations. A systematic literature search of computerized databases was conducted, and published research papers which present evidence concerning associations between CAM use and demographic and health characteristics are discussed and evaluated. The evidence suggests that people who use CAM tend to be female, of middle age and have more education. In terms of their health, CAM users tend to have more than one medical condition, but might not be more likely than non-users to have specific conditions such as cancer or to rate their own general health as poor. The multivariate studies that have been conducted suggest that both demographic and health characteristics contribute independently to CAM use. In conclusion, demographic characteristics and factors related to an individual's health status are associated with CAM use. Future research is needed to address methodological limitations in existing studies.

BMC Complementary and Alternative Medicine - Latest Articles

Antibacterial activity of Artemisia nilagirica leaf extracts against clinical and phytopathogenic bacteria.
Abdul AhameethunisaHopper W Fri, 29 Jan 2010 00:00:00 -0000
Background: The six organic solvent extracts of Artemisia nilagirica were screened for the potential antimicrobial activity against phytopathogens and clinically important standard reference bacterial strains. Methods: The agar disk diffusion method was used to study the antibacterial activity of A. nilagirica extracts against 15 bacterial strains. The Minimum Inhibitory Concentration (MIC) of the plant extracts were tested using two fold agar dilution method at concentrations ranging from 32 to 512 mug/ml. The phytochemical screening of extracts was carried out for major phytochemical derivatives in A. nilagirica. Results: All the extracts showed inhibitory activity for gram-positive and gram-negative bacteria except for Klebsiella pneumonia, Enterococcus faccalis and Staphylococcus aureus. The hexane extract was found to be effective against all phytopathogens with low MIC of 32 mug/ml and the methanol extract exhibited a higher inhibition activity against Escherichia coli, Yersinia enterocolitica, Salmonella typhi, Entrobacter acrogens, Proteus valgaris, Pseudomonas aeruginosa (32 mug/ml), Basillus subtilis (64 mug/ml) and Shigella flaxneri (128 mug/ml). The phytochemical screening of extracts answered for the major derivative of alkaloids, amino acids, flavonoids, phenol, quinines, tannins and terpenoids. Conclusion: All the extracts showed antibacterial activity against the tested strains. However, methanol and hexane extracts showed high inhibition against clinical and phytopathogens, respectively. The results also indicate the presence of major phytochemical derivatives in the A. nilagirica extracts. Hence, the isolation and purification of therapeutic potential compounds from A. nilagirica could be used as an effective source against bacterial diseases in human and plants.
What rheumatologists in the United States think of complementary and alternative medicine: results of a national survey
Nisha ManekCynthia CrowsonAbigale OttenbergFarr CurlinTed KaptchukJon Tilburt Thu, 28 Jan 2010 00:00:00 -0000
Background: We aimed to describe prevailing attitudes and practices of rheumatologists in the United States toward complementary and alternative medicine (CAM) treatments. We wanted to determine whether rheumatologists' perceptions of the efficacy of CAM therapies and their willingness to recommend them relate to their demographic characteristics, geographic location, or clinical practices. Methods: A National Institutes of Health-sponsored cross sectional survey of internists and rheumatologists was conducted regarding CAM for treatment of chronic back pain or joint pain. In this study we analyzed responses only from rheumatologists. Response items included participant characteristics and experience with 6 common CAM categories, as defined by the National Institutes of Health. Descriptive statistics were used to describe attitudes to CAM overall and to each CAM category. Composite responses were devised for respondents designating 4 or more of the 6 CAM therapies as "very" or "moderately" beneficial or "very likely" or "somewhat likely" to recommend. Results: Of 600 rheumatologists who were sent the questionnaire, 345 responded (58%); 80 (23%) were women. Body work had the highest perceived benefit, with 70% of respondents indicating benefit. Acupuncture was perceived as beneficial by 54%. Most were willing to recommend most forms of CAM. Women had significantly higher composite benefit and recommend responses than men. Rheumatologists not born in North America were more likely to perceive benefit of select CAM therapies. Conclusions: In this national survey of rheumatologists practicing in the United States, we found widespread favorable opinion toward many, but not all, types of CAM. Further research is required to determine to what extent CAM can or should be integrated into the practice of rheumatology in the United States.
The antioxidant and antiproliferative activities of methanolic extracts from Njavara rice bran
Akiri RaoSareddy ReddyPhanithi BabuAttipalli Reddy Thu, 28 Jan 2010 00:00:00 -0000
Background: Free radical-induced oxidative stress is the root cause for many human diseases. Naturally occurring antioxidant supplements from plants are vital to counter the oxidative damage in cells. The main objective of the present study was to characterize the antioxidant and antiproliferative potential of rice bran extracted from an important Indian rice variety, Njavara and to compare the same with two commercially available basmati rice varieties: Vasumathi, Yamini and a non medicinal variety, Jyothi. Methods: Methanolic extracts of rice bran from four varieties; Vasumathi, Yamini, Jyothi and Njavara were used to study their total phenolic and flavonoid contents, in vitro antioxidant activities including total antioxidant activity, scavenging of nitric oxide and 1,1-Diphenyl-2-picrylhydrazyl (DPPH) radical, reducing power and cytotoxic activity in C6 glioma cells. Correlation coefficient and regression analysis were done by using Sigmastat version 3.1 and Stata statistical package respectively. Results: Rice bran methanolic extract from Njavara showed the highest antioxidant and cell cytotoxic properties compared to the other three rice varieties. IC50 values for scavenging DPPH and nitric oxide were in the range of 30.85-87.72 ug/ml and 52.25-107.18 ug/ml respectively. Total antioxidant activity and reducing power were increased with increasing amounts of the extract. Total phenolic and flavonoid contents were in the range of 3.2-12.4 mg gallic acid-equivalent (GAE)/g bran and 1.68-8.5 mg quercetin-equivalent (QEE)/g bran respectively. IC50 values of cytotoxic assay (MTT assay) were 17.53-57.78 ug/ml. Correlation coefficient and regression analysis of phenolic content with DPPH and NO scavenging, MTT (-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay, total antioxidant assay and reducing power showed a highly significant correlation coefficient values (96-99%) and regression values (91-98%). Conclusion: The results of the present study show that the crude methanolic extract from Njavara rice bran contains significantly high polyphenolic compounds with superior antioxidant activity as evidenced by scavenging of free radicals including DPPH and NO. Njavara extracts also showed highest reducing power activity, anti-proliferative property in C6 glioma cells. In conclusion, it is conceivable that the Njavara rice variety could be exploited as one of the potential sources for plant - based pharmaceutical products.

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