What’s the alternative?
A recent blog post on The Health Care Blog entitled Choosing Alternative Medicine raises some really interesting issues. The author, James Salwitz, MD complains that patients are turning to complementary and alternative medicine (CAM) therapies when they could be cured by “conventional” therapy. I think the real problem is that people are being treated with therapies that have not been proven to work when there are other more effective treatments available. Patients need to be given enough information about the research evidence to make informed choices. After learning about the evidence, if they choose a therapy that has not been proven to work when there are more effective treatments available, I would consider that an informed decision.
Rather than saying some medicines are “alternative” and some are “traditional” we should look at all treatments for which there is evidence to treat a particular condition. If there is evidence that an herbal remedy or vitamin works even if it is not as good as the evidence for a drug, patients should be able to make the right choice for them based on the evidence. Doctors need to be open to thinking about CAM therapies as treatment options if there is evidence to support their use.
In many situations, there is evidence to support the use of a CAM treatment. For example, calcium and vitamin D can improve bone health in some women and two dietary supplements, glucosamine and chondroitin sulfate may be helpful in some people with arthritis. WIth many therapies we don’t know for sure if they work so we, as patients, need to understand all of the available therapies and make an informed choice.
A major reason that we need to incorporate vitamins, supplements and other “alternative” therapies into our thinking is that over half of the adults in the United States take some form of a dietary supplement. Patients are going to continue to use CAM therapies and it is important that doctors encourage their patients to tell them about everything they are taking. Although we think of supplements as being natural, the truth is that many drugs are also made from plants and many herbal supplements contain the same active ingredients that are in medicines doctors prescribe. So it could be dangerous to take a supplement without telling your doctor about it. There are a few other things to think about when taking supplements:
- Supplements are not as well regulated as drugs so before taking them you need to check that the particular brand of the supplement you are using has been tested. There are a number of respected websites that have this information such as ConsumerLab.com
- Just because something is a supplement does not mean that it is safe for you; some supplements may cause dangerous interactions with drugs that are prescribed by your doctor
- It is important to use the same dose of the supplement that was used in the studies
As patients, the most important thing is that we know about all the treatment options (alternatives) to treat our medical problem. Whether they are drugs, vitamins, supplements, surgical procedures, etc. is not important….as long as they are effective.
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