Complementary and Alternative Medicines (CAM)

Complementary and alternative medicines (CAM) are health care therapies that are not used by all health care providers. These remedies are often excluded from standard practice due to lack of evidence.

What does CAM include?

There are several broad categories that CAM fall into. Some can be in more than one of these categories.

Healing System

Healing systems are both practice and theories to heal the body.These focus on a way of life. Some are based on traditional practices of individual cultures. Examples include:

• Ayurveda: Traditionally from India, this system highlights mind, body and spiritual wellness. This system includes a healthy diet, exercise, meditation, herbs, massage, exposure to sunlight, and breathing techniques.
• Homeopathy: In this western system, practitioners use small doses of prepared plant extracts to stimulate the body's healing.
• Naturopathy: This western system focuses on correcting the body's processes. Therapy can include diet, homeopathy, acupuncture, herbal medicine, hydrotherapy, spinal and soft tissue manipulation, energy therapy, light therapy, and counseling.

Mind Body Connections

The core belief is that when your mind and body are in harmony, you will have better health. Some of these are accepted as standard treatments. Examples of mind and body treatments include:

• Meditation,
• Yoga,
• Prayer,
• Hypnosis,
• Relaxation techniques, and
• Art therapy.

Biological treatment

This includes natural and biological products to promote health. These typically include herbal treatments, special diets, and individual biological treatment.

Important points to consider about biological CAM treatments:

• Natural is not the same thing as safe. Some herbs can be toxic if taken too much or too often. Other chemicals and fillers are sometimes added to supplements and herbs (in different forms).
• Individuals will respond differently. The effects on pregnancy and child development are unknown.
• Herbal and dietary supplements can interact with other drugs and cause other side effects. Always tell your health care provider what supplements you are using.
• The safety of over the counter CAM, such as dietary supplements, depends on the:
  • Ingredients and where they come from can change the quality and safety of the product.
  • Quality of manufacturing: Over the counter dietary supplements are approved by the FDA, but are not be tested by the FDA prior to marketing. Products cannot be labeled with claims to diagnose, cure, treat, or prevent unless the product passes through the same approval processes as any new drug. Products that make such claims are illegally sold.

Touch

Practitioners promote healing through manipulation and movement of the body.

Examples include:

• Chiropractic: Focus on the relationship between the structure of the body, its function and its effect on the health of the individual.
• Massage: Focus on returning soft tissues, such as muscles, to normal.
• Osteopathy: Focus on the interaction between body systems and works to restore balance of these systems.

Energy

Practitioners of energy healing believe there are energies that flow in the body or external energy fields. Illness may occur when the body's energy is blocked or out of balance. Each variety of energy therapy has a unique set of beliefs about how to correct this energy.

Examples include:

• Therapeutic touch: From the tradition of "laying-on of hands," the practitioner's healing force balances the energies and improves the healing abilities of the body.
• Reiki: A Japanese tradition focused on channeling spiritual energy to improve circulation and immunity.
• Qigong: A traditional oriental medicine, involving meditation, movement and controlled breathing to enhance the flow of energy.
• Acupuncture: A traditional Chinese medicine that restores and maintains health by stimulating specific energy points on the body.

How do I decide if it is real or bogus?

Before beginning any new therapy, it is important to be well-informed. This is especially important with complementary and alternative medicines. Little is known about many of these treatments, and some can cause adverse side effects if used.

• Learn about scientific studies that have been done on the therapy. While stories can be intriguing, they do not guarantee that a CAM is safe. As interest in CAM continues to grow, more scientific studies are being done to look at effectiveness and risks.
• Talk to your health care provider. Tell them what therapy you are considering and what you know of the risks and the benefits. Be prepared to ask your health care provider any additional questions you have about the therapy.
• Let your health care provider know if you are using a CAM. There may be interactions with medications or medical conditions.
• Use the internet to search medical libraries and databases for information.
  • Avoid using search engines that promote commercial websites and blogs. These sites may be profit-oriented and may not be supported by scientific research.
    • Read NCCAM's "10 Things To Know About Evaluating Medical Resources on the Web."
  • Public medical databases
    • CAM on Pubmed database
    • MedLine Plus

Considering Costs

Insurance does not normally cover this type of health care. You may be asked to pay for these treatments out-of-pocket. Depending on the treatment there may be a minimum number of sessions required to fully benefit from the therapy.

Complementary and Alternative Medicine Practitioners

Like any health care practitioner, complementary and alternative medical practitioners should have certification and licenses. Make sure the practitioner you are considering has the proper training. Selecting a CAM provider.

Additional Information

Office of Dietary Supplements (National Institute of Health)

CAM on Pubmed research database (National institute of Health)

National Center for Complementary and Alternative Medicines (National Institute of Health)

Complementary and Alternative Medicine (Medline Plus National institute for Health)

Complementary and Alternative Medicine Video List (National Institute of Health, Senior Health)

HerbMed (Alternation Medicine Foundation)

Alternative Medicine Foundation

Complementary and Alternative Medicine updates (Journal of the American Medical Association)

Resources

About Complementary / Integrated Medicine. The university of Texas MD Anderson Cancer Center. Available at: http://www.mdanderson.org/departments/CIMER/dIndex.cfm?pn=7B632E4A-56B2-11D5-812100508B603A14. Accessed on: April 1, 2009.

Are you Considering Using CAM? National Center for Complementary and Alternative Medicine. National Institute of Health. Available at: http://nccam.nih.gov/health/decisions/consideringcam.htm. Accessed on: April 1, 2009.

Be an Informed Consumer. National Center for Complementary and Alternative Medicine. National Institute of Health. Available at: http://nccam.nih.gov/health/decisions/. Accessed on: April 1, 2009.

Complementary and Alternative Medicine: What is it? Mayo Clinic. Available at: http://www.mayoclinic.com/health/alternative-medicine/PN00001. Accessed on: April 1, 2009.

What is Complementary and Alternative Medicine? National Center for Complementary and Alternative Medicine. National Institute of Health. Available at: http://nccam.nih.gov/health/whatiscam/. Accessed on: April 1, 2009.

Guidance for Industry: Complementary and Alternative Medicine Products and Their Regulation by the Food and Drug Administration. Food and Drug Administration. http://www.fda.gov/RegulatoryInformation/Guidances/ucm144657.htm. Accessed on: April 6, 2009.

Authored by: Nikole Allen
Reviewed by:  Mariann Carle, MD