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

Bodybuilding.com Alert
Thu, 05 Nov 2009 14:28:29 -0500
Bodybuilding.com and FDA notified healthcare professionals and patients of a nationwide and international recall of all lots and expiration dates of 65 dietary supplement products that were sold through the Company's website, www.bodybuilding.com.FDA believes that the recalled products contain the following ingredients that are currently classified, or the FDA believes should be classified, as steroids: "Superdrol," "Madol," "Tren," "Androstenedione," and/or "Turinabol." Acute liver injury is known to be a possible harmful effect of using steroid-containing products. In addition, steroids may cause other serious long-term adverse health consequences in men, women, and children. These include shrinkage of the testes and male infertility, masculinization of women, breast enlargement in males, short stature in children, a higher predilection to misuse other drugs and alcohol, adverse effects on blood lipid levels, and increased risk of heart attack, stroke, and death.
Study Suggests That Both Traditional and Simulated Acupuncture Relieve Pain but by Different Mechanisms
Tue, 03 Nov 2009 16:58:06 -0500
Although acupuncture has long been used to treat pain, the underlying cellular and molecular mechanisms are not fully understood. The process appears to involve the brain's ability to produce opioids (pain-reducing chemicals) that bind to neurons in distinct regions of the brain, and the ability of neurons to produce receptors for these endogenous opioids—specifically, mu-opioid receptors (MORs). Recent clinical trials have indicated that both traditional (actual) and simulated (sham/placebo) acupuncture decrease pain, but other studies have suggested that the neural mechanisms involved may be different.
November Is National Alzheimer's Awareness Month
Tue, 03 Nov 2009 11:40:18 -0500
Alzheimer's disease (AD) is an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living. Among older people, AD is the most common cause of dementia (a decline in cognitive function that interferes with daily life and activities). However, AD is not a normal part of aging. Although treatment can slow the progression of AD and help manage its symptoms in some people, currently there is no cure for this devastating disease. Scientists are learning more every day, but right now, they still do not know what causes Alzheimer's disease.NCCAM supports studies on Alzheimer's and diseases and conditions related to aging. In one recent NCCAM-funded study, it was found that 240 milligrams per day of the dietary supplement Ginkgo biloba was ineffective in reducing the development of dementia and Alzheimer's disease in older people. Those considering using CAM therapies, should talk to their health care providers to ensure safe and coordinated care.

Evidence-based Complementary and Alternative Medicine - current issue

eCAM: A Closer Look at Clinical Analyses
Cooper, E. L.
Novel Diagnosis of Lyme Disease: Potential for CAM Intervention
Vojdani, A., Hebroni, F., Raphael, Y., Erde, J., Raxlen, B. Lyme disease (LD) is the most common tick-borne disease in the northern hemisphere, producing a wide range of disabling effects on multiple human targets, including the skin, the nervous system, the joints and the heart. Insufficient clinical diagnostic methods, the necessity for prompt antibiotic treatment along with the pervasive nature of infection impel the development and establishment of new clinical diagnostic tools with increased accuracy, sensitivity and specificity. The goal of this article is 4-fold: (i) to detail LD infection and pathology, (ii) to review prevalent diagnostic methods, emphasizing inherent problems, (iii) to introduce the usage of in vivo induced antigen technology (IVIAT) in clinical diagnostics and (iv) to underscore the relevance of a novel comprehensive LD diagnostic approach to practitioners of Complementary and Alternative Medicine (CAM). Utilization of this analytical method will increase the accuracy of the diagnostic process and abridge the time to treatment, with antibiotics, herbal medicines and nutritional supplements, resulting in improved quality of care and disease prognosis.
Cost Effectiveness of Natural Health Products: A Systematic Review of Randomized Clinical Trials
Kennedy, D. A., Hart, J., Seely, D. Health care spending in North America is consuming an ever-increasing share of Gross Domestic Product (GDP). A large proportion of alternative health care is consumed in the form of natural health products (NHPs). The question of whether or not NHPs may provide a cost-effective choice in the treatment of disease is important for patients, physicians and policy makers. The objective of this study was to conduct a systematic review of the literature in order to find, appraise and summarize high-quality studies that explore the cost effectiveness of NHPs as compared to conventional medicine. The following databases were searched independently in duplicate from inception to January 1, 2006: EMBASE, MEDLINE, CINAHL, BioethicsLine, Wilson General Science abstracts, EconLit, Cochrane Library, ABI/Inform and SciSearch. To be included in the review, trials had to be randomized, assessed for some measure of cost effectiveness and include the use of NHPs as defined by the Natural Health Products Directorate. Studies dealing with diseases due to malnutrition were excluded from appraisal. The pooled searches unveiled nine articles that fit the inclusion/exclusion criteria. The conditions assessed by the studies included three on postoperative complications, two on cardiovascular disease, two on gastrointestinal disorders, one on critically ill patients and one on urinary tract infections. Heterogeneity between the studies was too great to allow for meta-analysis of the results. The use of NHPs shows evidence of cost effectiveness in relation to postoperative surgery but not with respect to the other conditions assessed. In conclusion, NHPs may be of use in preventing complications associated with surgery. The cost effectiveness of some NHPs is encouraging in certain areas but needs confirmation from further research.

BMC Complementary and Alternative Medicine - Latest Articles

Use of complementary and alternative medicine: a survey in Turkish gastroenterology patients.
Taylan Kav Mon, 26 Oct 2009 00:00:00 -0000
Background: The study examined complementary and alternative medicine (CAM) usage by patients attending a Turkish gastroenterology outpatient clinic. Methods: The survey was conducted on 216 patients presenting with gastrointestinal problems during their first visit to the clinic using a 31 item, self-report questionnaire between May and October 2005. Data included information on patient demographics and their gastrointestinal symptoms, as well as items to identify CAM use and patient satisfaction with these therapies. Results: Seventy-nine patients (36.6%) reported using one or more forms of CAM. The most commonly used therapy was herbal therapy, usually taken as a tea or infusion. These were used by 27 people (29%) in this subgroup. Common indicators for their use were epigastric pain, constipation, bloating and dyspepsia or indigestion. CAM use among upper GI patients was marginally higher than lower GI patients (41.8% versus 41.2%), but the highest usage was amongst patients with liver disease where 53.8% reported using one or more CAM therapy. About half of the patients learned about CAM from their relatives or friends, with more women than men using the therapies (p < 0.05). Clinical characteristics such as diagnosis, duration of symptoms and prior surgical intervention did not differ between users and non-users of CAM therapies. Multivariate analysis showed that being female and higher educational status were positively associated with CAM usage (p < 0.05). Conclusion: CAM usage in our sample of gastrointestinal patients was lower than that described in other countries and other chronic disease groups. This could be due to their low perceived efficacy, or the relatively transient duration of symptoms experienced by the sample. Healthcare professionals need however, to be aware of CAM usage in order to educate patients appropriately about possible adverse effects or drug-interactions.
Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in South-eastern Nigeria: socio-demographic and clinical correlates
Boniface EzeChimdi Chuka-OkosaJudith Uche Sat, 24 Oct 2009 00:00:00 -0000
Background: This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM) use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria. Methods: In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between August 2004 - July 2006, all newly presenting ophthalmic outpatients were recruited. Participants' socio-demographic and clinical data and profile of TEM use were obtained from history and examination of each participant and entered into a pretested questionnaire and proforma. Participants were subsequently categorized into TEM- users and non-users; intra-group analysis yielded proportions, frequencies, and percentages while chi-square test was used for inter-group comparisons at P = 0.01, df = 1. Results: Of the 2,542 (males, 48.1%; females, 51.9%) participants, 149 (5.9%) (males, 45%; females, 55%) used TEM for their current eye disease. The TEMs used were chemical substances (57.7%), plant products (37.7%), and animal products (4.7%). They were more often prescribed by non-traditional (66.4%) than traditional (36.9%) medicine practitioners. TEMs were used on account of vision loss (58.5%), ocular itching (25.4%) and eye discharge (3.8%). Reported efficacy from previous users (67.1%) and belief in potency (28.2%) were the main reasons for using TEM. Civil servants (20.1%), farmers (17.7%), and traders (14.1%) were the leading users of TEM. TEM use was significantly associated with younger age (p < 0.01), being married (p < 0.01), rural residence (p < 0.01), ocular anterior segment disease (p < 0.01), delayed presentation (p < 0.01), low presenting visual acuity (p < 0.01), and co-morbid chronic medical disease (p < 0.01), but not with gender (p = 0.157), and educational status (p = 0.115). Conclusion: The incidence of TEM use among new ophthalmic outpatients at UNTH is low. The reasons for TEM use are amenable to positive change through enhanced delivery of promotive, preventive, and curative public eye care services. This has implications for eye care planners and implementers. To reverse the trend, we suggest strengthening of eye care programmes, even distribution of eye care resources, active collaboration with orthodox eye care providers and traditional medical practitioners, and intensification of research efforts into the pharmacology of TEMs.
Dietary supplementation by older adults in southern China: a hospital outpatient clinic study
Wenbin LiangAndy LeeColin Binns Tue, 20 Oct 2009 00:00:00 -0000
Background: There has been little knowledge about dietary supplementation by the Chinese elderly. The aim of this cross-sectional study was to investigate the usage of dietary supplements by older adults in southern China. Methods: A total of 600 community-dwelling older adults were recruited from the outpatient clinics of three major hospitals in Foshan city between July 2007 and July 2008. Face-to-face interviews of participants were conducted to obtain information on demographics, lifestyle and dietary supplements use. Frequency and duration of usage were recorded for six categories of dietary supplements. Results: Among the 446 consented participants (241 men and 205 women) who were over 55 years of age, 19.1% consumed one or more types of dietary supplements. The prevalence of usage was significantly higher (p = 0.008) for females (24.4%) than for males (14.5%). Dietary supplements were more likely to be consumed by non-smokers (p = 0.021) and those with hyperlipidemia (p = 0.003). The most popular supplement among users was calcium (53%). The majority (71%) of the users consumed supplements on a regular basis at one or more times per day, with an average duration of 2.95 (SD 4.80) years. Conclusion: The overall prevalence of dietary supplementation in this older Chinese population was considerably lower than those in other Asia-Pacific countries.

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