Complementary and alternative health


The term meditation refers to a variety of techniques or practices intended to focus or control attention. Most of them are rooted in Eastern religious or spiritual traditions. These techniques have been used by many different cultures throughout the world for thousands of years.

People have used prayer and other spiritual practices for their own and others’ health concerns for thousands of years. Scientific investigation of these practices has begun quite recently, however, to better understand whether they work; if so, how; and for what diseases/conditions and populations. Many Americans are using prayer and other spiritual practices. Prayer is the therapy most commonly used among all the CAM therapies.

Manipulative and body-based practices include methods that are based on manipulation and/or the movement of the body. For example, chiropractors focus on the relationship between structure (primarily the spine) and function, and how that relationship affects the preservation and restoration of health, using manipulative therapy as an integral treatment tool. Massage therapists manipulate the soft tissues of the body to normalize those tissues.

Energy therapies focus either on energy fields originating within the body (biofields) or those from other sources (electromagnetic fields). Biofield therapies are intended to affect the energy fields, whose existence is not yet experimentally proven, that surround and penetrate the human body. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields. Examples include Qi gong, Reiki, Prana and Therapeutic Touch. Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields or alternating current or direct current fields, to, for example, treat asthma or cancer, or manage pain and migraine headaches.

Hypnosis is an altered state of consciousness. Hypnotherapy has the potential to help relieve the symptoms of a wide variety of diseases and conditions. It can be used independently or along with other treatments.

Natural and biologically-based practices, interventions and products refer to the use of dietary supplements and include herbal, special dietary, orthomolecular and individual biological therapies. Examples include botanicals, animal-derived extracts, vitamins, minerals, fatty acids, amino acids, proteins and prebiotics, Thousands of studies of various dietary supplements have been performed. However, no single supplement has been proven effective in a compelling way.

In India, which is the home of several alternative systems of medicines, Ayurveda, Siddha, Unani and Homeopathy are licenced by the government, despite the lack of reputable scientific evidence. Naturopathy will also be licensed soon because several universities now offer bachelors degrees in it. Other activities such as Panchakarma and massage therapy related to Ayurveda are also licensed by the government now .

About half the general population in developed countries uses CAM . A survey released in May 2004 by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health in the United States, found that in 2002, 36% of Americans used some form of alternative therapy in the past 12 months, 50% in a lifetime—a category that included yoga, meditation, herbal treatments and the Atkins diet. The majority of individuals (54.9%) used CAM in conjunction with conventional medicine. Most people use CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain. Women were more likely than men to use CAM. The largest sex differential is seen in the use of mind-body therapies including prayer specifically for health reasons . If prayer was counted as an alternative therapy, the figure rose to 62.1%. 25% of people who use CAM do so because a medical professional suggested it . A British telephone survey by the BBC of 1,209 adults in 1998 shows that around 20% of adults in Britain had used alternative medicine in the past 12 months.

Advocates of alternative medicine hold that the various alternative treatment methods are effective in treating a wide range of major and minor medical conditions, and contend that recently published research (Michalsen, 2003; Gonsalkorale, 2003; Berga, 2003) proves the effectiveness of specific alternative treatments .

Evidence-based medicine (EBM) applies the scientific method to medical practice, and aims for the ideal that healthcare professionals should make “conscientious, explicit, and judicious use of current best evidence” in their everyday practice. Although advocates of alternative medicine acknowledge that the placebo effect may play a role in the benefits that some receive from alternative therapies, they point out that this does not diminish their validity. They believe that alternative medicine may provide health benefits through patient empowerment, by offering more choices to the public. Researchers who judge treatments using the scientific method are concerned by this viewpoint, since it fails to address the possible inefficacy of alternative treatments.

As long as alternative treatments are used alongside conventional treatments, the majority of medical doctors find most forms of complementary medicine acceptable. Consistent with previous studies, the CDC recently reported that the majority of individuals in the United States (i.e., 54.9%) used CAM in conjunction with conventional medicine.

The issue of alternative medicine interfering with conventional medical practices is minimized when it is turned to only after conventional treatments have been exhausted. Many patients feel that alternative medicine may help in coping with chronic illnesses for which conventional medicine offers no cure, only management. Classifying treatments need to be based on the objectively verifiable criteria of the scientific method evidence-based medicine, i.e. scientifically proven evidence of efficacy (or lack thereof), and not on the changing curricula of various medical schools or social sphere of usage .

Since many alternative remedies have recently found their way into the medical mainstream, there cannot be two kinds of medicine – conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted .

It is argued that there is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is “Eastern” or “Western”, is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. As believers in science and evidence, we must focus on fundamental issues—namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy . The Cochrane Collaboration and Edzard Ernst agree that all treatments, whether “mainstream” or “alternative”, ought to be held to standards of the scientific method.

Many forms of alternative medicine are rejected by conventional medicine because the efficacy of the treatments has not been demonstrated through double-blind randomized controlled trials; in contrast, conventional drugs reach the market only after such trials have proved their efficacy. A person may attribute symptomatic relief to an otherwise ineffective therapy due to the placebo effect, the natural recovery from or the cyclical nature of an illness (the regression fallacy), or the possibility that the person never originally had a true illness . CAM proponents point out this may also apply in cases where conventional treatments have been used. To this, CAM critics point out that this does not account for conventional medical success in double blind clinical trials.

People should be free to choose whatever method of healthcare they want, but stipulate that people must be informed as to the safety and efficacy of whatever method they choose. People who choose alternative medicine may think they are choosing a safe, effective medicine, while they may only be getting quack remedies. Grapefruit seed extract is an example of quackery when multiple studies demonstrate its universal antimicrobial effect is due to synthetic antimicrobial contamination .

Those who have had success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. For this reason, critics contend that therapies that rely on the placebo effect to define success are very dangerous. Scientifically unsupported health practices can lead individuals to forgo effective treatments and this can be referred to as “opportunity cost”. Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. More research must be undertaken to prove the effectiveness of complimentary therapies before they can be incorporated in formal medical practice. Sufficient evidence is required for biological or clinical plausibility in order to justify the investment of time and energy in exploring the merits of alternative medicine. After all, human life is precious and no chances can be taken to comprise the health of any individual.

Complementary and Integrative Medicine

  • 5 Things You Should Know about Yoga (National Center for Complementary and Integrative Health)
  • Ayurvedic Medicine (National Center for Complementary and Integrative Health)
  • Biofeedback (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Complementary Health Practices for U.S. Military, Veterans, and Families (National Center for Complementary and Integrative Health)
  • Frequently Asked Questions about Music Therapy (American Music Therapy Association)
  • Homeopathy: An Introduction (National Center for Complementary and Integrative Health)
  • Hypnosis (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Hypnosis for Health: Can Trances Work? (National Institutes of Health) Also in Spanish
  • Magnets for Pain Relief (National Center for Complementary and Integrative Health)
  • Massage Therapy: What You Knead to Know (National Institutes of Health)
  • Meditation (National Center for Complementary and Integrative Health)
  • MedlinePlus: Herbs and Supplements Also in Spanish
  • Music for Your Health (American Association of Clinical Endocrinologists)
  • Naturopathy (National Center for Complementary and Integrative Health)
  • Osteopathic Manipulative Treatment (American Osteopathic Association)
  • Pet Therapy: Man’s Best Friend as Healer (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Relaxation Techniques for Health (National Center for Complementary and Integrative Health)
  • Tai Chi and Qi Gong (National Center for Complementary and Integrative Health)
  • Tai Chi and Your Health: A Modern Take on an Ancient Practice (National Institutes of Health) Also in Spanish
  • Time to Talk: 6 Things To Know About Massage Therapy for Health Purposes (National Center for Complementary and Integrative Health)
  • Traditional Chinese Medicine: An Introduction (National Center for Complementary and Integrative Health)
  • What Is Hot Yoga (Bikram)? (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Yoga for Health: Positioning Your Body and Mind (National Institutes of Health) Also in Spanish
  • Yoga: What You Need to Know (National Center for Complementary and Integrative Health)

A critical integrative review of complementary medicine education research: key issues and empirical gaps

  1. 1.

    Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002–2012. Natl Health Stat Rep. 2015;79:1.

    • Google Scholar
  2. 2.

    Nguyen LT, Davis RB, Kaptchuk TJ, Phillips RS. Use of complementary and alternative medicine and self-rated health status: results from a national survey. J Gen Intern Med. 2011;26(4):399–404.

    • PubMed
    • Article
    • Google Scholar
  3. 3.

    Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report. 2008(12):1–23.

  4. 4.

    Burke SR, Myers R, Zhang AL. A profile of osteopathic practice in Australia 2010–2011: a cross sectional survey. BMC Musculoskelet Disord. 2013;14(1):227.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  5. 5.

    Harris P, Cooper K, Relton C, Thomas K. Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update. Int J Clin Pract. 2012;66(10):924–39.

    • CAS
    • PubMed
    • Article
    • Google Scholar
  6. 6.

    Frass M, Strassl RP, Friehs H, Mullner M, Kundi M, Kaye AD. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner J. 2012;12(1):45–56.

    • PubMed
    • PubMed Central
    • Google Scholar
  7. 7.

    Reid R, Steel A, Wardle J, Trubody A, Adams J. Complementary medicine use by the Australian population: a critical mixed studies systematic review of utilisation, perceptions and factors associated with use. BMC Complement Altern Med. 2016;16(1):176.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  8. 8.

    Wardle J, Steel A, Adams J. A review of tensions and risks in naturopathic education and training in Australia: a need for regulation. J Altern Complement Med. 2012;18(4):363–70.

    • PubMed
    • Article
    • Google Scholar
  9. 9.

    Myers SP, Xue CC, Cohen MM, Phelps KL, Lewith GT. The legitimacy of academic complementary medicine. Med J Aust. 2012;197(2):69–70.

    • PubMed
    • Article
    • Google Scholar
  10. 10.

    ECNH. Endeavour College of Natural Health Australia2017

  11. 31.

    Liebenberg H, Chetty Y, Prinsloo P. Student access to and skills in using technology in an open and distance learning context. Int Rev Res Open Distrib Learn. 2012;13(4):250–68.

    • Google Scholar
  12. 32.

    Anderson T, Dron J. Learning Technology through Three Generations of Technology Enhanced Distance Education Pedagogy. European Journal of Open, Distance and e-learning. 2012;15(2).

  13. 33.

    Parkes M, Stein S, Reading C. Student preparedness for university e-learning environments. Internet High Educ. 2015;25:1–10.

    • Article
    • Google Scholar
  14. 34.

    Downing JJ, Dyment JE. Teacher educators’ readiness, preparation, and perceptions of preparing preservice teachers in a fully online environment: an exploratory study. Teach Educ. 2013;48(2):96–109.

    • Article
    • Google Scholar
  15. 35.

    McKee CW, Tew WM. Setting the stage for teaching and learning in American higher education: making the case for faculty development. New Dir Teach Learn. 2013;2013(133):3–14.

    • Article
    • Google Scholar
  16. 36.

    Black-Fuller L, Taube S, Koptelov A, Sullivan S. Smartphones and pedagogy: digital divide between high school teachers and secondary students. US-China Educ Rev. 2016;6(2):124–31.

    • Google Scholar
  17. 37.

    Lefoe G, Philip R, O’Reilly M, Parrish D. Sharing quality resources for teaching and learning: A peer review model for the ALTC Exchange in Australia. Aust J Educ Technol. 2009;25(1).

  18. 38.

    Phillips D, Forbes H, Duke M. Teaching and learning innovations for postgraduate education in nursing. Collegian (Australia: Royal College of Nursing). 2013;20(3):145–51.

    • Article
    • Google Scholar
  19. 39.

    Adams T, Demaiter EI. Skill, education and credentials in the new economy: the case of information technology workers; 2008.

    • Google Scholar
  20. 40.

    Ensminger DC, Surry DW, Porter BE, Wright D. Factors contributing to the successful implementation of technology innovations. J Educ Technol Soc. 2004;7(3):61–72.

    • Google Scholar
  21. 41.

    Loh KP, Ghorab H, Clarke E, Conroy R, Barlow J. Medical Students’ knowledge, perceptions, and interest in complementary and alternative medicine. J Altern Complement Med. 2013;19(4):360–6.

    • PubMed
    • Article
    • PubMed Central
    • Google Scholar
  22. 42.

    Kim DY, Park WB, Kang HC, Kim MJ, Park KH, Min BI, et al. Complementary and alternative medicine in the undergraduate medical curriculum: a survey of Korean medical schools. J Altern Complement Med (New York, NY). 2012;18(9):870–4.

    • Article
    • Google Scholar
  23. 43.

    Sansgiry SS, Mhatre SK, Artani SM. Use of and attitude toward complementary and alternative medicine: understanding the role of generational influence. Altern Ther Health Med. 2012;19(3):10–5.

    • Google Scholar
  24. 44.

    Adams J, Broom A. The status of complementary and alternative medicine (CAM) in biomedical education: towards a critical engagement. Handbook Sociol Med Educ. 2009.

  25. 45.

    Adams J. An exploratory study of complementary and alternative medicine in hospital midwifery: models of care and professional struggle. Complement Ther Clin Pract. 2006;12(1):40–7.

    • PubMed
    • Article
    • Google Scholar
  26. 46.

    Hanna L-A, Hall M, McKibbin K. Pharmacy students’ knowledge, attitudes, and use of complementary and alternative medicines. Curr Pharm Teach Learn. 2013;5(6):518–25.

    • Article
    • Google Scholar
  27. 47.

    Al-Dulaimy SNY, Hassali MAA, Awaisu A. An evaluation of senior pharmacy students’ perceptions and knowledge of complementary and alternative medicine at a Malaysian university. J Aust Traditional-Medicine Soc. 2012;18(1):41.

    • Google Scholar
  28. 48.

    Harris IM, Kingston RL, Rodriguez R, Choudary V. Attitudes towards complementary and alternative medicine among pharmacy faculty and students. Am J Pharm Educ. 2006;70(6):129.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  29. 49.

    Adams J, Tovey P. Complementary and alternative medicine in nursing and midwifery: towards a critical social science. Routledge; 2014.

  30. 50.

    Buchan S, Shakeel M, Trinidade A, Buchan D, Ah-See K. The use of complementary and alternative medicine by nurses. Br J Nurs. 2012;21(10):672–5.

    • PubMed
    • Article
    • PubMed Central
    • Google Scholar
  31. 51.

    Lindquist R, Snyder M, Tracy MF. Complementary & alternative therapies in Nursing. New York: Springer Publishing Company; 2013.

  32. 52.

    Adams J, Tovey P. Nurses’ use of professional distancing in the appropriation of CAM: a text analysis. Complement Ther Med. 2001;9(3):136–40.

    • CAS
    • PubMed
    • Article
    • PubMed Central
    • Google Scholar
  33. 53.

    Helms JE. Complementary and alternative therapies: a new frontier for nursing education? J Nurs Educ. 2006;45(3):117.

    • PubMed
    • PubMed Central
    • Google Scholar
  34. 54.

    McCabe P. Nursing and naturopathy at La Trobe: the challenge of multiparadigm education. Int J Nurs Pract. 2001;7(5):361.

    • CAS
    • PubMed
    • Article
    • PubMed Central
    • Google Scholar
  35. 55.

    Templeman K, Robinson A, McKenna L. Integrating complementary medicine literacy education into Australian medical curricula: student-identified techniques and strategies for implementation. Complement Ther Clin Pract. 2015;21(4):238–46.

    • PubMed
    • Article
    • PubMed Central
    • Google Scholar
  36. 56.

    Dannenfeldt G, Stewart J, McHaffie J, Gibson-van Marrewijk K, Stewart K, Hipkins R. Addressing obstacles to success: implementing change in science delivery; 2009.

    • Google Scholar
  37. 57.

    Baker N. Build it and they will use it: A case study in getting bang for your buck in educational technology choices. In EdMedia+ Innovate Learning. Association for the Advancement of Computing in Education (AACE); 2014. pp 72–76.

  38. 58.

    Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs. 2005;52(5):546–53.

    • PubMed
    • Article
    • PubMed Central
    • Google Scholar
  39. 59.

    Milanese SF, Grimmer-Somers K, Souvlis T, Innes-Walker K, Chipchase LS. Is a blended learning approach effective for learning in allied health clinicians? Phys Ther Rev. 2014;19(2):86.

    • Article
    • Google Scholar
  40. 60.

    Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–9.

    • Article
    • Google Scholar
  41. 61.

    Munn Z, Moola S, Riitano D, Lisy K. The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag. 2014;3(3):123–8.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  42. 62.

    O’Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med. 2014;89(9):1245–51.

    • PubMed
    • Article
    • Google Scholar
  43. 63.

    Souto RQ, Khanassov V, Hong QN, Bush PL, Vedel I, Pluye P. Systematic mixed studies reviews: updating results on the reliability and efficiency of the mixed methods appraisal tool. Int J Nurs Stud. 2015;52(1):500–1.

    • PubMed
    • Article
    • Google Scholar
  44. 64.

    Grace S, Vemulpad S, Beirman R. Primary contact practitioner training: a comparison of chiropractic and naturopathic curricula in Australia; 2007.

    • Google Scholar
  45. 65.

    Viksveen P, Steinsbekk A. Undergraduate homeopathy education in Europe and the influence of accreditation. Homeopathy. 2011;100(4):253–8.

    • PubMed
    • Article
    • Google Scholar
  46. 66.

    Rowe T. North American homeopathic educational survey. Am J Homeopath Med. 2009;102(2):65–74.

    • Google Scholar
  47. 67.

    McCabe P. Education in naturopathy and western herbal medicine in Australia: results of a survey of education providers. Complement Ther Clin Pract. 2008;14(3):168–75.

    • PubMed
    • Article
    • Google Scholar
  48. 68.

    Viksveen P, Steinsbekk A, Rise MB. What is a competent homeopath and what do they need in their education? A qualitative study of educators’ views. Educ Health (Abingdon, England). 2012;25(3):172–9.

    • Article
    • Google Scholar
  49. 69.

    Grace S, Vemulpad S, Beirman R. Training in and use of diagnostic techniques among CAM practitioners: an Australian study. J Alternat Complement Med. 2006;12(7):695–700.

    • Article
    • Google Scholar
  50. 70.

    Frenkel M, Ben-Arye E, Geva H, Klein A. Educating CAM practitioners about integrative medicine: an approach to overcoming the communication gap with conventional health care practitioners. J Altern Complement Med (New York, NY). 2007;13(3):387–91.

    • Article
    • Google Scholar
  51. 71.

    Toupin AK, Gaboury I. A survey of Canadian regulated complementary and alternative medicine schools about research, evidence-based health care and interprofessional training, as well as continuing education. BMC Complementary And Alternative Medicine 2013; Available from: Academic OneFile, Ipswich, MA 2013.

  52. 72.

    Steel A, Hemmings B, Sibbritt D, Adams J. Research challenges for a complementary medicine higher education institution: results from an organisational climate survey. Eur J Integr Med. 2015;7(5):442–9.

    • Article
    • Google Scholar
  53. 73.

    Zwickey H, Schiffke H, Fleishman S, Haas M, Cruser dA, LeFebvre R, et al. Teaching evidence-based medicine at complementary and alternative medicine institutions: strategies, competencies, and evaluation. J Altern Complement Med. 2014;20(12):925–31.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  54. 74.

    Long CR, Ackerman DL, Hammerschlag R, Delagran L, Peterson DH, Berlin M, et al. Faculty development initiatives to advance research literacy and evidence-based practice at CAM academic institutions. J Altern Complement Med. 2014;20(7):563–70.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  55. 75.

    Joshi H, Singh G, Patwardhan K. Ayurveda education: evaluating the integrative approaches of teaching Kriya Sharira (Ayurveda physiology). J Ayurveda Integr Med. 2013;4(3):138.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  56. 76.

    Chen Y-L, Hou MC, Lin S-C, Tung Y-J. Educational efficacy of objective structured clinical examination on clinical training of traditional Chinese medicine – a qualitative study. Complement Ther Clin Pract. 2015;21:147–53.

    • CAS
    • PubMed
    • Article
    • Google Scholar
  57. 77.

    Forman LJ, Pomerantz SC. Computer-assisted instruction: a survey on the attitudes of osteopathic medical students. J Am Osteopath Assoc. 2006;106(9):571–8.

    • PubMed
    • Google Scholar
  58. 78.

    Grant A, O’Reilly M. From herb garden to wiki: responding to change in naturopathic education through scholarly reflection. J Scholarsh Teach Learn. 2012;12(4):76–85.

    • Google Scholar
  59. 79.

    Schwartz J. Faculty perception of and resistance to online education in the fields of acupuncture, chiropractic, and massage therapy. Int J Ther Massage Bodywork. 2010;3(3):20–31.

    • PubMed
    • PubMed Central
    • Google Scholar
  60. 80.

    Wardle JL, Adams J, Lui CW, Steel AE. Current challenges and future directions for naturopathic medicine in Australia: a qualitative examination of perceptions and experiences from grassroots practice. BMC Complement Altern Med. 2013;13:15.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  61. 81.

    Mills E, Hollyer T, Saranchuk R, Wilson K. Teaching evidence-based complementary and alternative medicine (EBCAM); changing behaviours in the face of reticence: a cross-over trial. BMC Med Educ. 2002;2(1):2.

    • PubMed
    • PubMed Central
    • Article
    • Google Scholar
  62. 82.

    Zhang K, Zheng J. Analysis on application of PBL in teaching of Zhenjiuxue (science of acupuncture and moxibustion) and establishment of a new education model. Zhongguo Zhen Jiu. 2013;33(5):469–72.

    • PubMed
    • PubMed Central
    • Google Scholar
  63. 83.

    Ruhe V, Stumpf S, Jabbour MJ. Competency-based education in acupuncture and oriental medicine. Am Acupuncturist. 2014;68:21–31.

    • Google Scholar
  64. 84.

    ACIH. Academic Collaborative for Integrative Health: ACIH 2018 January 1, 2012; 2012.

    • Google Scholar
  65. 119.

    Jones R, Fox C, Levin D. National Educational Technology Trends: 2011. Transforming Education to Ensure All Students Are Successful in the 21st Century. State Educational Technology Directors Association. 2011.

  66. 120.

    Verma S, Paterson M, Medves J. Core competencies for health care professionals: what medicine, nursing, occupational therapy, and physiotherapy share. J Allied Health. 2006;35(2):109–15.

    • PubMed
    • PubMed Central
    • Google Scholar

Complementary, Alternative, or Integrative Health: What’s In a Name?

We’ve all seen the words “complementary,” “alternative,” and “integrative,” but what do they really mean?

This fact sheet looks into these terms to help you understand them better and gives you a brief picture of the mission and role of the National Center for Complementary and Integrative Health (NCCIH) in this area of research. The terms “complementary,” “alternative,” and “integrative” are continually evolving, along with the field, but the descriptions of these terms below are how we at NIH currently define them.

Complementary Versus Alternative

According to a 2012 national survey, many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches that are not typically part of conventional medical care or that may have origins outside of usual Western practice. When describing these approaches, people often use “alternative” and “complementary” interchangeably, but the two terms refer to different concepts:

  • If a non-mainstream practice is used together with conventional medicine, it’s considered “complementary.”
  • If a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative.”

Most people who use non-mainstream approaches also use conventional health care.

In additional to complementary and alternative, you may also hear the term “functional medicine.” This term sometimes refers to a concept similar to integrative health (described below), but it may also refer to an approach that more closely resembles naturopathy (a medical system that has evolved from a combination of traditional practices and health care approaches popular in Europe during the 19th century).

Integrative Health

Integrative health care often brings conventional and complementary approaches together in a coordinated way. It emphasizes a holistic, patient-focused approach to health care and wellness—often including mental, emotional, functional, spiritual, social, and community aspects—and treating the whole person rather than, for example, one organ system. It aims for well-coordinated care between different providers and institutions.

The use of integrative approaches to health and wellness has grown within care settings across the United States. Researchers are currently exploring the potential benefits of integrative health in a variety of situations, including pain management for military personnel and veterans, relief of symptoms in cancer patients and survivors, and programs to promote healthy behaviors.

Integrative Approaches for Pain Management for Military Personnel and Veterans

  • Chronic pain is a common problem among active-duty military personnel and veterans. NCCIH, the U.S. Department of Veterans Affairs, and other agencies are sponsoring research to see whether integrative approaches can help. For example:
    • An NCCIH-funded study is developing an innovative, collaborative treatment model involving chiropractors, primary care providers, and mental health providers for veterans with spine pain and related mental health conditions.
    • Other NCCIH-funded studies are testing the effects of adding mindfulness meditation, self-hypnosis, or other complementary approaches to pain management programs for veterans. The goal is to help patients feel and function better and reduce their need for pain medicines that can have serious side effects.
  • For more information on pain management for military personnel and veterans, see NCCIH’s Complementary Health Practices for U.S. Military, Veterans, and Families webpage.

Integrative Approaches for Symptom Management in Cancer Patients and Survivors

  • Cancer treatment centers with integrative health care programs may offer services such as acupuncture and meditation to help manage symptoms and side effects for patients who are receiving conventional cancer treatment. Although research on the potential value of these integrative programs is in its early stages, some studies have had promising results. For example, NCCIH-funded research has suggested that:
    • Massage therapy may lead to short-term improvements in pain and mood in patients with advanced cancer.
    • Yoga may relieve the persistent fatigue that some women experience after breast cancer treatment, according to the results of a preliminary study.
    • Tai chi or qi gong have shown promise for managing symptoms such as fatigue, sleep difficulty, and depression in cancer survivors.
  • For more information, see NCCIH’s fact sheet on cancer.

Integrative Approaches and Health-Related Behaviors

  • Healthy behaviors, such as eating right, getting enough physical activity, and not smoking, can reduce people’s risks of developing serious diseases. Research is looking at whether complementary and integrative approaches may have a role in promoting healthy behaviors. For example:
    • Preliminary research suggests that yoga and meditation-based therapies may help smokers quit.
    • In a study funded by the National Cancer Institute, complementary health practitioners (chiropractors, acupuncturists, and massage therapists) were successfully trained to provide evidence-based smoking cessation interventions to their patients.
    • An NCCIH-funded study is testing whether a mindfulness-based program that involves the whole family can improve weight loss and eating behavior in overweight adolescents.
  • For more information, see the NCCIH Quitting Smoking and Weight Control webpages.

Types of Complementary Health Approaches

Complementary health approaches include natural products and mind and body practices.

Natural Products

This group includes a variety of products, such as herbs (also known as botanicals), vitamins and minerals, and probiotics. They are widely marketed, readily available to consumers, and often sold as dietary supplements.

According to the 2012 National Health Interview Survey (NHIS), which included a comprehensive survey on the use of complementary health approaches by Americans, 17.7 percent of American adults had used a dietary supplement other than vitamins and minerals in the past year. These products were the most popular complementary health approach in the survey. (See chart.) The most commonly used natural product was fish oil.

Researchers have done large, rigorous studies on a few natural products, but the results often showed that the products didn’t work for the conditions studied. Research on others is in progress. While there are indications that some may be helpful, more needs to be learned about the effects of these products in the human body, and about their safety and potential interactions with medicines and other natural products.

Mind and Body Practices

Mind and body practices include a large and diverse group of procedures or techniques administered or taught by a trained practitioner or teacher. The 2012 NHIS showed that yoga, chiropractic and osteopathic manipulation, and meditation are among the most popular mind and body practices used by adults. According to the 2017 NHIS, the popularity of yoga has grown dramatically in recent years, from 9.5 percent of U.S. adults practicing yoga in 2012 to 14.3 percent in 2017. The 2017 NHIS also showed that the use of meditation increased more than threefold from 4.1 percent in 2012 to 14.2 percent in 2017.

Other mind and body practices include acupuncture, relaxation techniques (such as breathing exercises, guided imagery, and progressive muscle relaxation), tai chi, qi gong, hypnotherapy, Feldenkrais method, Alexander technique, Pilates, Rolfing Structural Integration, and Trager psychophysical integration.

The amount of research on mind and body approaches varies widely depending on the practice. For example, researchers have done many studies on acupuncture, yoga, spinal manipulation, and meditation, but there have been fewer studies on some other practices.

Other Complementary Health Approaches

Some complementary approaches may not neatly fit into either of these groups—for example, the practices of traditional healers, Ayurvedic medicine, traditional Chinese medicine, homeopathy, naturopathy, and functional medicine.

NCCIH’s Role

NCCIH is the Federal Government’s lead agency for scientific research on complementary and integrative health approaches.

NCCIH’s Mission and Vision

The mission of NCCIH is to define, through rigorous scientific investigation, the usefulness and safety of complementary and integrative health interventions and their roles in improving health and health care.

NCCIH’s vision is that scientific evidence informs decision making by the public, by health care professionals, and by health policymakers regarding the use and integration of complementary and integrative health approaches.

To learn more, visit the NCCIH Facts-at-a-Glance and Mission webpage.

Defining Complementary and Alternative Medicine

Complementary and alternative medicine, or CAM, is a category of medicine that includes a variety of treatment approaches that fall outside the realm of conventional medicine. An increasing amount of research is being done to establish the safety and efficacy of alternative medicine. But compared with traditional “Western” therapies such as drugs, research on alternative medicine is still limited.

Complementary and Alternative Medicine: What’s the Difference?

It is important to understand the difference between complementary medicine and alternative medicine — the two approaches are often lumped together but are, in fact, distinct.

Complementary medicine refers to healing practices and products that work in conjunction with traditional medicine. For example, a cancer patient receiving chemotherapy may also undergo acupuncture to help manage chemo side effects like nausea and vomiting. Alternative medicine differs in that it is not used as a complement to, but rather as a substitute for traditional therapy. An example would be a cancer patient who forgoes recommended chemotherapy and instead chooses to treat the disease with specific dietary changes.

There is a third category that also often gets lumped in with conventional and alternative medicine — integrative medicine. Integrative medicine draws from both complementary medicine and alternative medicine and combines these with traditional Western therapies, says Donald Abrams, MD, director of clinical programs for the Osher Center for Integrative Medicine at the University of California, San Francisco.

Complementary and Alternative Medicine: Who’s Using It?

The National Center for Complementary and Alternative Medicine (NCCAM) recently surveyed Americans on their use of complementary and alternative medicine. The survey, which gathered information from more than 20,000 adults and nearly 10,000 children, found that about 40 percent of adults and 12 percent of children use some form of complementary and alternative medicine.

Women, people ages 40 to 60, and adults with higher levels of education and income tended to use complementary and alternative therapies more frequently. There have been considerable increases in the number of people using common forms of complementary and alternative medicine, such as yoga, meditation, acupuncture, and massage therapy.

Complementary and Alternative Medicine: What Are the Categories?

The National Center for Complementary and Alternative Medicine (NCCAM) recognizes five main categories of complementary and alternative medicine:

  • Mind-body medicine. Mind-body medicine includes treatments that focus on how our mental and emotional status interacts and affects the body’s ability to function. Examples include meditation and various therapies expressed through art and music.
  • Whole medical systems. This category refers to complete systems of medical theory and practice, many of which go back thousands of years and have roots in non-Western cultures. Examples include traditional Chinese medicine and Ayurveda, a therapy that originated in India. Whole medical systems from the West include homeopathy and naturopathy.
  • Manipulative and body-based practices. Relying on the physical manipulation of the body, this practice is intended to improve specific symptoms and overall health. Examples of these practices include chiropractic and osteopathy.
  • Energy medicine. This form of alternative medicine uses energy fields to promote healing. Biofield therapies affect energy fields that are said to encircle the human body — forms include Reiki and qi gong. Bioelectromagnetic-based therapies, such as magnet therapy, involve the manipulation of electromagnetic fields.
  • Biologically based practices. Since the focus is on herbs, nutrition, and vitamins, dietary supplements and herbal medicine are perhaps the most common forms of biologically based complementary and alternative medicine. A growing interest in these kinds of therapies is leading to more research, but many of these biologically based practices have yet to be thoroughly tested.

If you are considering using complementary or alternative therapy, make sure you consult with your regular doctor and do some research before your first session.

  • See All Alternative Health Articles

General cancer information

What are complementary therapies?

Complementary therapies are used alongside conventional medical treatments prescribed by your doctor. They can help people with cancer to feel better and may improve your quality of life. They may also help you to cope better with symptoms caused by the cancer or side effects caused by cancer treatment.

A good complementary therapist won’t claim that the therapy will cure your cancer. They will always encourage you to discuss any therapies with your cancer doctor or GP.

There are many different types of complementary therapy, including:

  • aromatherapy
  • acupuncture
  • herbal medicine
  • massage therapy
  • visualisation
  • yoga

Many health professionals are supportive of people with cancer using complementary therapies. There are some health professionals that have been reluctant for their patients to use them. This is usually because many therapies have not been scientifically tested in the same way as conventional treatments.

Research has been carried out to see how well complementary therapies work for people with cancer. And there is some still in progress. But we need more to find out how best to use complementary therapies.

What are alternative therapies?

Alternative therapies are used instead of conventional medical treatment. People with cancer have various reasons for wanting to try alternative therapies.

There is no scientific or medical evidence to show that alternative therapies can cure cancer. Some alternative therapies are unsafe and can cause harmful side effects. Or they may interact with your conventional medical treatment. This could increase the risk of harmful side effects or may stop the conventional treatment working so well. Giving up your conventional cancer treatment could reduce your chance of curing or controlling your cancer.

Some alternative therapies sound promising but the claims are not supported by scientific evidence and can give some people false hope.

Examples of alternative cancer therapies include:

  • laetrile
  • shark cartilage
  • Gerson therapy

Other terms used to describe CAM therapies

There are several different terms commonly used to describe complementary or alternative therapies. If you’re not familiar with them, it can be confusing. You may see therapies described as:

This generally means treatments that aren’t normally used by doctors to treat cancer. In other words, any treatment that is not thought of as part of conventional medicine.

CAM is a term which covers both complementary and alternative medical therapies.

These terms are generally used to describe the use of conventional medicine and complementary therapies together. The terms are commonly used in the USA but are becoming more widely used in the UK.

In cancer care, integrated medicine usually includes making sure that you have access to all of the following:

  • conventional medical treatments
  • different types of complementary therapies such as massage, reflexology, relaxation, herbal medicine and acupuncture
  • counselling services and support groups
  • up to date information about your cancer and its treatment

Health professionals usually use the term traditional medicine to mean a therapy or health practice that has developed over centuries within a particular culture. It’s usually formed around a particular belief system.

This term can be confusing because in the western part of the world conventional medicine could be considered to be a traditional medicine. But this term is not usually used in this way. It generally refers to therapies or treatments that developed in the eastern part of the world such as Ayurvedic medicine and traditional Chinese Medicine.

Operational definition of complementary medicine

This list includes the therapies that Cochrane Complementary Medicine classifies as complementary, alternative or integrative (CAM). The table is in alphabetical order and may be browsed alphabetically or searched using Find from the browser. The development of this operational definition is described in a 2011 paper in Alternative Therapies in Health and Medicine. Some notes about this operational definition are below.

First, in order to be as comprehensive as possible, this table includes multiple categories that overlap (e.g., Chinese traditional medicine and acupuncture), and multiple terms for the same therapy (e.g., phototherapy and light therapy). For single therapies with multiple names or multiple spellings, we have given the most commonly used variant first and listed additional variants separated with a slash. However the number of individual CAM therapies (e.g., individual herbs) was impossible to capture in a single table suitable for posting. The table may also omit CAM therapies of which we are unaware. This listing therefore cannot be considered to be exhaustive, and is subject to expansion and elaboration over time.

We should also note that for many therapies, the indication for the treatment determines whether the therapy is considered CAM or not. For example, chelation therapy is considered conventional in the treatment of heavy metal poisoning but ‘alternative’ in the treatment of atherosclerosis. We have indicated with a parenthetical note the cases in which a therapy with both conventional and CAM uses would be excluded from the CAM category. Because vitamins, minerals and other nutrients are often used in conventional medicine, we developed general rules for considering vitamins and other supplements as CAM or not. We excluded the following types of treatments:

  1. vitamins and other supplements that are administered parenterally in hospital settings;
  2. dietary supplementation for treatment or prevention of medically diagnosed deficiency states or disorders; and
  3. vitamin or mineral supplements for preventing or treating disease in countries where vitamin or mineral deficiency is widespread.

Finally, we should note that we decided to exclude from our CAM list the following types of therapies:

  1. exercise therapies, with the exception of mind-body exercise (e.g. tai chi, yoga) or exercise that is designed to prevent mental or emotional problems (e.g., exercise for depression); and
  2. psychotherapy, with the exception of unconventional psychotherapies (e.g. Morita therapy).
  • Açaí / Euterpe oleracea
  • Acupressure
  • Acupuncture
  • Acustimulation / acupoint stimulation
  • African prune / Prunus Africana / Pygeum africanum)
  • Aiyishu (a Chinese herbal medicine)
  • Alexander technique
  • Alpha-linolenic acid (ALA) (an omega-3 fatty acid) supplements
  • Amino acid supplements (see nutrition exclusions above)
  • Angelica
  • Anma (a type of Asian bodywork)
  • Anthroposophic medicine
  • Antioxidant supplements
  • Arachidonic acid (AA or ARA) (an omega-6 fatty acid) supplements
  • Aromatherapy
  • Art therapy
  • Artichoke leaf
  • Astragalus / Milkvetch (a Chinese herbal medicine)
  • Auricular acupuncture / ear acupuncture
  • Ayurveda / Ayurvedic medicine (a type of Indian (East Asian) traditional medicine)
  • Bach flower remedies
  • Baduanjin
  • Balneotherapy
  • Bee stings / bee venom
  • Beta-sitosterol (a component of saw palmetto)
  • Bibliotherapy
  • Bioenergetics
  • Biofeedback
  • Biofield therapies
  • Biofunctional diagnostic testing
  • Biotin (Vitamin B7) supplements (see nutrition exclusions above)
  • Botanical supplements
  • Bovine cartilage
  • Breathing exercises in mind-body medicine (e.g., breathwork) (exclude for physical therapy, eg treatment of cystic fibrosis)
  • Calcium supplements (many people would not include for prevention of osteoarthritis)
  • Calendula
  • Calorie restriction (not for weight loss)
  • Carnitine supplements
  • Cayenne
  • Chelation therapy (exclude for treatment of medically diagnosed heavy metal poisoning (eg, mercury or lead) and for medically diagnosed excess iron (eg, thalassemia))
  • Chinese herbal medicine
  • Chiropractic manipulation
  • Chitosan supplements
  • Chondroitin sulfate
  • Clinical ecology
  • Cold laser therapy
  • Colon cleansing / colon irrigation
  • Color therapy / chromotherapy
  • Coriolus Versicolor (a mushroom extract)
  • Cranberry
  • Craniosacral massage / Craniosacral therapy
  • Dance therapy
  • Danshen (a Chinese herbal medicine)
  • Deep tissue bodywork
  • Dehydroepiandrosterone (DHEA) supplements (see nutrition exclusions above)
  • Dengzhanhua preparations (a Chinese herbal medicine)
  • Devil’s claw
  • Devil’s nettle
  • Devil’s root / Siberian ginseng / acanthopanax senticosus / ci wu jia
  • Dianxianning pill (a Chinese herbal medicine)
  • Dietary supplements (see nutrition exclusions above)
  • Dihomogammalinolenic acid (DGLA) (an omega-6 fatty acid) supplements
  • Dimethylaminoethanol / dimethylethanolamine / Deanol (DMAE)
  • Docosahexaenoic acid (DHA) (an omega-3 fatty acid) supplements
  • Doman Delacato patterning therapy
  • Echinacea
  • EDTA (ethylenediaminetetraacetic acid) when used in chelation therapy (see Chelation therapy above for exclusions)
  • Eicosapentaenoic acid (EPA) (an omega-3 fatty acid) supplements
  • Electrical stimulation therapy / Electrotherapy when used for pain
  • Electroacupuncture
  • Electroacupuncture according to Voll (a diagnostic method)
  • Electromagnetic stimulation therapy / Electromagnetic therapy (exclude electromagnetic field therapy for delayed- and non-union fractures)
  • Elemental diet
  • Energy field work
  • Environmental therapeutics (includes light therapies)
  • Essiac formula
  • Estrogen (exclude for treatment of natural or surgical menopause) supplements
  • Evening primrose oil
  • Expressive writing therapy / journaling therapy
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Feldenkrais
  • Feng shui
  • Feverfew
  • Fish oil (omega-3 fatty acids) supplements
  • Flor∙Essence formula / flower essences
  • Folic acid / folate (Vitamin B9) supplements (many people would not include for prevention of neural tube defects)
  • Free and Easy Wanderer (a Chinese herbal medicine)
  • Gamma-linolenic acid (GLA) (an omega-6 fatty acid) supplements
  • Garlic
  • Gerovital H3 (primary ingredient is procaine hydrochloride)
  • Gerson therapy
  • Gestalt therapy
  • Ginger
  • Ginkgo biloba
  • Ginseng
  • Glucosamine supplements
  • Glutamine supplements
  • Gluten-free diet
  • Green tea / Camellia sinensus)
  • Guiling pa’an wan (a Chinese herbal medicine)
  • Hair analysis
  • Helminth therapy / trichuris suis ova / Trichuris trichiura ova
  • Hemp oil
  • Herbal medicine / herbalism
  • High-fiber diet
  • Hippotherapy / equine-assisted therapy (exclude when physical therapy only)
  • Holistic therapy / holistic medicine
  • Homeopathy
  • Homoharringtonine (HHT) (a plant alkaloid)
  • Honey
  • Horse chestnut
  • Horticultural therapy
  • Huangqi (a Chinese herbal medicine)
  • Huperzine A (a Chinese herbal medicine)
  • Hydrazine sulfate
  • Hydrotherapy
  • Hyperbaric oxygen therapy (exclude for treatment of burns, wounds or infections, radiation injury, embolism, decompression disorders or carbon monoxide poisoning)
  • Hypnosis / hypnotherapy
  • Imagery / guided imagery
  • Iridology
  • Iron supplements
  • Jin Li Da liquor (a Chinese herbal medicine)
  • Kampo (a type of traditional Japanese medicine)
  • Kava
  • Ketogenic diet
  • Kneipp therapies
  • Krestin / PSK / PSP (Coriolus Versicolor extracts)
  • Laetrile
  • Laser acupuncture
  • Laughter therapy
  • Lentinan (derived from Shitake)
  • Light therapy / phototherapy (exclude for treatment of skin conditions and neonatal bilirubin disorders)
  • Linoleic acid (an omega-6 fatty acid) supplements
  • L-isoleucine (an amino acid) supplements
  • Liuwei dihuang pill (a Chinese herbal medicine)
  • L-leucine (an amino acid) supplements
  • Low fat diets
  • Low-level laser therapy
  • Low protein diets
  • Low-glycemic index diets
  • L-threonine (an amino acid) supplements
  • L-valine (an amino acid) supplements
  • Macrobiotic diet
  • Magnesium supplements (see nutrition exclusions above)
  • Magnetic therapy / magnetic field therapy / biomagnetic therapy
  • Marijuana, marihuana / cannabis / cannabinoids / C. sativa / C. indica (exclude for purely psychoactive uses)
  • Massage therapy (exclude perineal massage or uterine massage associated with childbirth)
  • Meditation
  • Mediterranean diet
  • Melatonin
  • Mesotherapy
  • Methylcobalamin and other cobalamins (Vitamin B12) (see nutrition exclusions above)
  • Milk thistle
  • Mindfulness
  • Moxibustion
  • Music therapy / sound therapy
  • Myofascial release
  • N-Acetylcysteine (NAC) (from the amino acid L-cysteine)
  • Naprapathy
  • Nature therapy
  • Naturopathy / naturopathic medicine
  • Neuromuscular therapy
  • Niacin / Nicotinamide/ Niacinamide (Vitamin B3) supplements (see nutrition exclusions above)
  • Omega-3 fatty acids
  • Osteopathic manipulation
  • Ozone therapy
  • Pantothenic acid (Vitamin B5) supplements (see nutrition exclusions above)
  • Passiflora
  • Peppermint
  • Phytoestrogens
  • Phytomedicines / Phytotherapy
  • Pilates
  • Plant medicines
  • Play therapy
  • Prayer
  • Prebiotics
  • Probiotics
  • Procaine (only when used for aging)
  • Prolotherapy
  • Propolis
  • Protein supplements
  • Psychodynamic psychotherapy
  • Psychotherapies incorporating mindfulness (e.g., Acceptance and Commitment Therapy) or spirituality
  • Puerarin (a Chinese herbal medicine)
  • Pulsed electromagnetic field therapy (see Electromagnetic therapy)
  • Pyridoxine / Pyridoxal / Pyridoxamine (Vitamin B6) supplements (see nutrition exclusions above)
  • Qi Gong / chi-kung
  • Radiesthesia
  • Reflexology
  • Reflexotherapy
  • Reiki
  • Relaxation techniques
  • Riboflavin (Vitamin B2) supplements (see nutrition exclusions above)
  • Rolfing®Structural Integration
  • S-Adenosyl methionine (SAM-e)
  • Safflower Yellow injection (a Chinese herbal medicine)
  • Salacia oblonga
  • Salvia (miltiorrhiza)(injection) (a Chinese herbal medicine)
  • Sanchi preparations (a Chinese herbal medicine)
  • Saw palmetto / serenoa repens
  • Selenium supplements (see nutrition exclusions above)
  • Shamanistic medicine / Shamanism
  • Shark cartilage
  • Shengmai / shenmai (a Chinese herbal medicine)
  • Shenqi Fuzheng (a Chinese herbal medicine)
  • Shensu / shenfu (a Chinese herbal medicine)
  • Shexiang (injection) (a traditional Chinese medicine]
  • Shiatsu
  • Shitake
  • Shuanghuanglian (a Chinese herbal medicine)
  • Sidda medicine (a type of Indian (East Asian) traditional medicine)
  • Soy / soybeans
  • Speleotherapy
  • Spinal manipulation
  • Spiritual healing
  • St. John’s wort (Hypericum perforatum L.)
  • Structural integration
  • Suxiao jiuxin wan (a Chinese herbal medicine)
  • Tai chi / tai ji
  • Testosterone
  • Therapeutic touch / healing touch
  • Thiamine (Vitamin B1) supplements (see nutrition exclusions above)
  • Third wave psychotherapy (see psychotherapies incorporating mindfulness or spirituality)
  • Tianmadingxian capsule (a Chinese herbal medicine)
  • Traditional African healing
  • Traditional Arabic medicine
  • Traditional Chinese medicine
  • Traditional Indian medicine
  • Traditional Japanese medicine
  • Traditional Korean medicine
  • Traditional Tibetan medicine
  • Transcranial direct current stimulation (tDCS)
  • Transcranial magnetic stimulation (TMS) / repetitive Transcranial magnetic stimulation (rTMS) (not strictly CAM when used for depression)
  • Transcutaneous electrical nerve stimulation (TENS or TNS)
  • Trigger point myotherapy
  • Tui na
  • Unani medicine / Yunani medicine (a type of Arabic or Indian (East Asian) traditional medicine)
  • Valerian
  • Vega testing
  • Vegan diet
  • Vegetarian diet
  • Visualization techniques
  • Vitamin A supplements (see nutrition exclusions above)
  • Vitamin B or Vitamin B complex supplements (see nutrition exclusions above)
  • Vitamin C supplements (see nutrition exclusions above)
  • Vitamin D supplements (see nutrition exclusions above)
  • Vitamin E supplements (see nutrition exclusions above)
  • Vitamin K supplements (see nutrition exclusions above)
  • Vojta method / Reflexlocomotion
  • White willow bark
  • Whole-body vibration therapy
  • Xiaxingci granule (a Chinese herbal medicine)
  • Yarrow / Achillea millefolium extract
  • Yoga therapy
  • Zero balancing
  • Zhixian I pill (a Chinese herbal medicine)
  • Zinc supplements (see nutrition exclusions above)
  • Zishen Tongli Jianonang (a Chinese herbal medicine)
  • Zone therapy

Are There Risks?

Yes. That’s the case for all types of medicine, traditional Western included. But alternative medicine can be very dangerous if it’s used in place of traditional treatments. It can even be life-threatening. That’s partly because you’re not getting proven treatments for your condition.

But many forms of complementary medicine — like meditation — don’t have many side effects and can be used safely.

Some herbs, supplements, and vitamins also have potential side effects These substances aren’t regulated by the government in the same way that drugs are. And, although many claim to be “natural,” this doesn’t always mean they’re safe. Ingredients, dosing, and manufacturing processes can vary widely from product to product.

Here are some specific dangers linked with natural products:

  • St. John’s Wort. This herb is used to treat depression. But it can reduce how effective some drugs are. Among these are certain cancer medications, immunosuppressants, and antiretrovirals.
  • Kava Kava. Some people use this herb to ease anxiety. But it may cause liver damage.
  • Vitamin C. If you take this in high doses, it could affect how well chemotherapy and radiation work in treating cancer.
  • Herbal Products Used in Chinese and Ayurvedic Medicine. Some of these may contain heavy metals, like lead or arsenic.
  • Dietary Supplements. These can interfere with different cancer treatments. For instance, some of them might cause your skin to become sensitive if you take them while getting radiation. This is one reason why oncologists usually tell you to avoid taking them if you’re undergoing treatment.
  • Chiropractic Treatment. In very rare cases where this natural therapy has been used on the spine, it’s ended in a stroke. More common side effects, like headaches, are mild and don’t last long.

— — Question: What is the difference between complementary and alternative therapies?

Answer: There’s a profound difference between alternative and complementary medicine. Alternatives, particularly in cancer medicine, are especially dangerous because they are usually offered as literal alternatives to mainstream care. These are products and activities and regimens that are promoted to be used instead of chemotherapy, surgery, and radiation. They are, by definition, unproved. If they were proved, they would not be alternative; we’d all be using them. They generally are biologically invasive, very expensive, and, and harmful — in and of themselves but also because they keep patients from getting needed care in, in a timely fashion.

Complementary remedies are entirely different. They are not promoted as cancer cures. They are used to enhance quality of life, to reduce pain, to reduce other symptoms, to make patients generally feel better, stronger, and calmer. And most importantly they are used in an adjunctive fashion along with, not instead of, mainstream therapy.

Next: Are alternative therapies as effective as chemotherapy and/or radiation therapy?

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The field of health care has a lot of new players these days – and many of them have little or nothing to do with conventional medicine. There’s complementary medicine, alternative medicine, whole medical systems, mind-body medicine, integrative medicine, etc. These fields are inundated with New Age practitioners, so it’s a good idea to learn what they are and what to watch out for.

The National Institutes of Health explain that there are major differences between complementary and alternative medicine (often referred to as CAM).

Complementary medicine is used together with conventional medicine. For example, some forms of complementary therapy are used along with pharmaceuticals to help ease pain such as hypnosis and acupuncture, massage therapy, naturopathic medicine and herbal remedies. It’s important to be aware that complementary medicine is not taught in Western medical schools or hospitals for a variety of cultural, social, economic or scientific reasons, which prevent them from being adopted by mainstream Western medicine.

Alternative medicine, on the other hand, is used in place of conventional medicine. For instance, a special diet may be used to treat cancer instead of chemo. Examples include dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, and spiritual healing. These practices are also not recognized by the Western medical community.

To follow are descriptions of several major types of complementary and alternative medicine:

Integrative medicine combines treatments from conventional medicine and complementary and alternative medicine for which there is evidence of safety and effectiveness.

Whole Medical Systems are built upon complete systems of theory and practice, many of which evolved apart from, and earlier than, conventional Western medicine. Examples would be Ayurvedic and various forms of traditional Chinese medicine (i.e., qi gong, acupuncture) as well as homeopathic and naturopathic remedies.

Mind-Body Medicine employs a variety of techniques based on the notion of the mind’s capacity to affect bodily function and symptoms. Some of these techniques, such as cognitive behavioral therapy, have become part of mainstream medicine, while others, such as biofeedback, autogenic training, etc. remain in the realm of CAM.

Biologically-Based Practices use substances found in nature, such as herbs, foods and vitamins to treat the body. These include dietary supplements and herbal products and using foods such as shark cartilage to treat cancer.

Manipulative and Body-Based Practices are based on manipulation or movement of select body parts, such as chiropractics, osteopathic manipulations, and massage.

Then there’s the most controversial of all – Energy Medicine. Energy therapies generally involve the use of one of two types of energy fields:

1) Biofield therapies are intended to affect energy fields that allegedly surround or penetrate the human body (known as chi, ki, prana, life force, etc.). The existence of these forms of energy have never been scientifically proven. Hundreds of practices are associated with this type of therapy such as Reiki, Therapeutic Touch, tai chi, yoga, the martial arts, etc.
2) Bioelectromagnetic based therapies involve the unconventional use of electro-magnetic fields, such as pulsed, magnetic, alternating or direct current fields. An example would be magnetic therapy.

To follow is a partial list of some of the most common forms of CAM:

Alexander technique,
Ayurveda (Ayurvedic medicine),
chiropractic medicine,
diet therapy,
holistic nursing,
massage therapy,
nutritional therapy,
osteopathic manipulative therapy (OMT),
Qi gong (internal and external Qiging),
spiritual healing,
Tai Chi,
traditional Chinese Medicine (TCM), and

Many of these practices involve religious beliefs and practices that are not compatible with Christianity, such as all forms of medicine that are based on alleged energy forces, including Tao-based traditional Chinese medicine and the Hindu-based yoga and Ayurvedic medicine.

As far as Catholics using CAM, we also need to be concerned about straying into the realm of superstitious medicine. This happens when we resort to CAM instead of “ordinary means” (i.e., established conventional medicine) to treat an ailment.

“Catholic moral teaching requires that we use ordinary means to save a life or to treat a malady,” writes Kevin G. Rickert, Ph.D. in Homiletics and Pastoral Review. “When a person is confronted with a life threatening condition, or some less serious illness (especially a communicable disease), which can be easily treated by ordinary means, there is a moral obligation to do so. Extraordinary means, on the other hand, are never required but instead remain optional.

“Unscientific medical cures are neither ordinary nor extraordinary, because they are not real means at all. As such, they are neither required nor permitted. The main problem with these kinds of “cures” is that they don’t really work; they are irrational, and as such they are contrary to the natural law.”

The problem is that many New Age healers refuse to submit to unbiased evidence-based science to determine if their methods are efficacious and instead cling to these theories either because their livelihood depends upon it or because “many who are ignorant of the scientific method actually believe that their unscientific method works,” Dr. Rickert says.

This is what is called “superstitious medicine,” and if one puts their full faith in it to treat a serious illness such as diabetes or heart disease, while refusing the best science of the day, they fall into the trap of deception and error.

As Dr. Rickert explains, “In this case, I subject my mind to deception, and at the same time, I neglect my obligation to employ ordinary means; in so doing, I subject my body to illness and my loved ones to potential hardships.”

The following sites provided by the FDA may prove helpful in answering questions about CAM and many popular supplements:

For more information on various types of CAM, visit

“Tips for the Savvy Supplement User: Making Informed Decisions and Evaluating Information” visit (

For updated safety information on supplements visit (

If you have experienced an adverse effect from a supplement, you can report it to the FDA’s MedWatch program, which collects and monitors such information (1-800-FDA-1088 or

What are complementary and alternative treatments?

The complementary and alternative medicines assessed for the report have been given an effectiveness score of between 1 and 5 and a safety score of green, amber or red.

How was effectiveness measured?

Effectiveness is measured by improvements in:

  • pain
  • movement
  • general well-being.

Based on the evidence available from clinical trials and other supporting information, each complementary medicine has been put in one of five categories:

  1. No evidence overall to suggest that the compound works or only a little evidence which is outweighed by much stronger evidence that it doesn’t work.
  2. Only a little evidence to suggest the compound might work. Evidence often comes from a single study which has reported positive results, so there are important doubts about whether or not it works.
  3. Some promising evidence to suggest that the compound works. Evidence will be from more than one study but there may also be some studies showing that it doesn’t work, so we’re still uncertain whether compounds in this category work or not.
  4. Some consistency to the evidence from more than one study to suggest that the compound works. There are still doubts from the evidence that it works, but on balance it’s more likely to be effective than not.
  5. Consistent evidence across several studies to suggest that this compound is effective.

These classifications are based on the results of studies overall, so a medicine has been classified as effective if:

  • a greater proportion of people taking this medicine improved compared with, for example, those taking placebo
  • roughly the same proportion of people improved compared to another group taking a conventional drug which is known to be effective.

It doesn’t mean that everyone taking the medicine will improve.

For medicines which we think aren’t effective, the proportion of people reporting improvement when taking these medicines was the same as people taking the placebo, for example.

Sometimes we describe differences in improvement as ‘significant’. This means that we’re fairly sure that the differences between groups didn’t happen just by chance. It doesn’t necessarily mean that the differences are large.

Data is interpreted in this way for conventional medicines – the evidence for conventional treatments doesn’t reach level 5 in all the conditions for which they’re prescribed.

How was safety measured?

We’ve also categorised all compounds according to their safety (assuming that they’re taken within the range of recommended doses – compounds which are well tolerated at the recommended doses may have serious side-effects when taken at higher doses.)

We’ve classified the compounds using a traffic-light system:

Green: Mainly minor and infrequent reported side-effects. Users should check possible side-effects in the product information leaflet.

Amber: Commonly reported side-effects (even if they’re mainly minor symptoms) or more serious side-effects.

Red: Serious reported side-effects. Users should consider carefully before deciding whether to take these medicines.

Some compounds have very little information on side-effects so we’ve not been able to classify them. These compounds have been given an amber rating alongside the statement, ‘No information’.

It’s important to remember that most conventional medicines have side-effects, but we generally have more information to work out what these effects are and how often they happen.

How was the quality of the trial measured?

The quality of RCTs can vary, which affects how reliable the results are. The trials included in the report were judged based on a scoring system called the Jadad scale, which scores from 1 (very poor quality) to 5 (very good quality). To make it easier to use, we’ve collapsed the scale into two categories:

  • low quality (Jadad score below 3)
  • good/high quality (Jadad score 3 or above).

We’ve marked trials with low quality with the symbol‡. These studies were given a lower weighting when we came to our conclusions.

If you want to read more about this information, we’ve published the following papers:

  • Macfarlane GJ, El-Metwally A, De Silva V, Ernst E, Dowds GL, Moots RJ on behalf of the Arthritis Research UK Working Group on Complementary and Alternative Medicines. Evidence for the efficacy of complementary and alternative medicines in the management of rheumatoid arthritis: a systematic review. Rheumatology (Oxford). 2011; 50(9):1672–83.
  • De Silva V, El-Metwally A, Ernst E, Lewith G, Macfarlane GJ on behalf of Arthritis Research UK Working Group on Complementary and Alternative Medicines. Evidence for the efficacy of complementary and alternative medicines in the management of osteoarthritis: a systematic review. Rheumatology (Oxford). 2011; 50(5):911–20.
  • De Silva V, El-Metwally A, Ernst E, Lewith G, Macfarlane GJ on behalf of Arthritis Research UK Working Group on complementary and alternative medicines. Evidence for the efficacy of complementary and alternative medicines in the management of fibromyalgia: a systematic review. Rheumatology (Oxford). 2010; 49(6):1063–68.

Navigating health care today can be a scary adventure. If you’re at Desta Health, odds are that you’re already looking for “out of the box” solutions. The names that we use to describe “non-standard” medicine in the United States can be daunting at best.

We’re going to provide a brief introduction to the following practices; Alternative Medicine, Complementary Medicine, and Integrative Medicine. These practices offer many similarities as well as differences but all serve to provide non-standard options for patients, outside of mainstream medicine. Nearly 40% of Americans are using health care approaches outside of standard allopathic medicine. Let’s take a look at these terms.

Alternative Medicine

The National Institute of Health’s (NIH) National Center for Complementary and Alternative Medicine (NCCAM) defines alternative medicine as “using a non-mainstream approach in place of conventional medicine”. True alternative medicine is not very common because as the definition states, it completely replaces conventional medicine. An example of this would be a patient with cancer who refuses all conventional intervention and prefers to treat only with an ancient Chinese herb. Some alternative medicine approaches may include the following: homeopathy, hypnosis, yoga, guided imagery, massage, spinal manipulation, meditation, herbal and natural medicines, and acupuncture. If these modalities are combined in some way with conventional allopathic medicine, then it’s no longer considered “Alternative Medicine.”

Complementary Medicine

The National Institute of Health’s (NIH) National Center for Complementary and Alternative Medicine (NCCAM) defines complementary medicine as “using a non-mainstream approach together with conventional medicine.” Complementary medicine combines alternative medicine with conventional medicine. In this example, the same cancer patient decides to undergo radiation treatment (conventional) as well as acupuncture and a special diet (alternative above, but complementary here due to the combination with conventional medicine). This patient’s treatment plan represents complementary medicine.

Integrative Medicine

Integrative medicine is similar to that of complementary medicine and often the terms are used interchangeable. The Duke Center for Integrative Medicine defines the practice as “medical care that brings patient and practitioner together in a dynamic partnership dedicated to optimizing the patient’s health and healing. This approach focuses on the whole person, recognizing that the subtle interactions of mind, body, spirit and community have a direct impact on vitality and well-being.”

Integrative medicine manages medical problems using some conventional medicine but also takes a more broad approach; treating the patient’s symptoms as well as the whole person, treating acute problems while anticipating risk and future problems and prevention. This practice of medicine is very much a partnership. The physician and patient partner as a team to achieve goals and manage problems. The goal of true Integrative Medicine is to use evidence-based or evidence-informed options to select the best possible total treatment plan.

Putting It All Together

Another term we often hear is “Complementary and Alternative Medicine” or “CAM.” For our purposes, CAM can often describes some combination of the above. Because the term can be confusing, we feel that the above terms “Alternative” (just non-standard), “Complementary” (standard allopathic medicine plus non-standard approaches), and “Integrative” (equal weight between standard and non-standard approaches favoring what is best for the patient) are more useful.

The Benefits of Integrating Non-Conventional Medicine

Many of these alternative medicine practices have been used for centuries. Acupuncture, meditation, and yoga have been practiced across the world for hundreds of years. Use of homeopathic treatments as well as natural and herbal medicines have also served as important elements of health care for centuries. It makes sense to combine these treatments with conventional medicine. Conventional medicine has made outstanding discoveries in the last few decades especially in acute care areas, but let’s not forget the traditional healing systems in which many of our non-standard treatments are found.

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