Notes on Complementary and Alternative Therapies

Chapter 5: Complementary and Alternative Therapies

Overview of CAM

  • Complementary and Alternative Medicine (CAM)
    • Definition: Encompasses a variety of practices and products that are not considered part of conventional medicine.
    • Types of CAM:
    • Botanicals
    • Nutritional products
    • Herbal supplements
    • Effects: CAM therapies can have both positive and negative effects.
    • Interaction potential: CAM therapies can interact with prescription and over-the-counter medications.
    • National Center for Complementary and Integrative Health (NCCIH):
    • Purpose: Lists current clinical trials concerning herbal products.

Dietary Supplement Health and Education Act of 1994 (DSHEA)

  • Definition of Dietary Supplements:

    • Intended to supplement the diet.
    • Contains one or more dietary ingredients.
    • Must be taken orally.
    • Must be labeled as a dietary supplement.

  • Label Requirements:

    • Name of the supplement.
    • Amount of the supplement.
    • Nutrition labeling: Information on the nutritional content.
    • Ingredient list: All ingredients must be specified.
    • Name and place of manufacturer, packer, or distributor: Identification of the producer.

Current Good Manufacturing Practices (CGMPs)

  • Purpose and Standards:
    • Standards mandate that package labels declare the quality and strength of contents.
    • Products must be free from contaminants and impurities.
    • A seal of approval is awarded to products that meet specific criteria for safety and quality.

Commonly Used Herbal Remedies

  • Asian Ginseng:

    • Uses: Increases resistance to environmental stress, improving overall well-being.

  • Chamomile:

    • Uses: Relief of anxiety, sleeplessness, digestive complaints, skin conditions, and oral ulcers.
    • Side Effects: Range from mild allergic reactions to severe anaphylaxis.

  • Echinacea:

    • Uses: Treatment for colds, flu, and infections by stimulating the immune system.
    • Side Effects: May include gastrointestinal effects and allergic reactions.

  • Garlic:

    • Uses: Used for lowering cholesterol and blood pressure; reducing heart disease risks; potentially preventing stomach and colon cancer.
    • Side Effects: May include heartburn, upset stomach, body odor, and decreased blood clotting.

  • Ginger:

    • Uses: Used to alleviate nausea, motion sickness, diarrhea, and to relieve pain and swelling associated with arthritis.
    • Side Effects: Might cause gas, bloating, heartburn, and nausea.

  • Ginkgo Biloba:

    • Uses: Aids in treating anxiety, allergies, dementia/memory issues, eye problems, tinnitus, and peripheral artery disease.
    • Note: Research findings on efficacy may be conflicting or unreliable.
    • Side Effects: Possible headaches, dizziness, gastrointestinal upset, increased bleeding, and allergic reactions.

  • Lavender:

    • Uses: Employed for anxiety, depression, digestive symptoms, and burns.
    • Note: Lack of high-quality studies showing effectiveness.

  • Saw Palmetto:

    • Uses: Addresses urinary symptoms from benign prostatic hypertrophy, chronic pelvic pain, and hair loss.
    • Side Effects: May include digestive problems and headaches.

  • St. John's Wort:

    • Uses: Treatment for depression, menopausal symptoms, ADHD, somatic symptom disorder, and OCD.
    • Caution: Interacts with certain medicines in potentially dangerous or life-threatening manners.
    • Side Effects: Include anxiety, dry mouth, dizziness, headaches, fatigue, sensitivity to sunlight, gastrointestinal issues, and sexual dysfunction.

  • Turmeric:

    • Uses: Commonly employed for heartburn, stomach ulcers, gallstones, inflammation, and cancer.
    • Note: High doses may lead to nausea and diarrhea.

Potential Hazards of Herbs

  • Safety Considerations:

    • Natural substances are not inherently safe— caution is advised with herbal consumption.
    • Herb-Drug Interactions: Possible interactions with medications.
    • Lab Test Interference: Herbal products may alter lab results.
    • Safety routes: Not all herbal compounds are safe for every route of administration.

  • Surgical Concerns:

    • Herbal products can interfere with the absorption, breakdown, and excretion of anesthetics, anticoagulants, and other drugs used in surgery.
    • Recommendation: Discontinue herbal therapy 2 to 3 weeks prior to surgery for safety.

Tips for Consumers and Health Care Providers

  • Precautions:
    • Consult a healthcare provider before taking herbs while on prescription medications.
    • Avoid taking herbs if pregnant or nursing without medical advice.
    • Do not give herbs to infants or young children without guidance.
    • Adhere to label instructions for use.
    • Discontinue use if side effects occur and consult a healthcare provider promptly.
    • Be aware that herbs may contain multiple compounds not listed on labels.