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David Baxter

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Alternative medicine: Evaluate claims of treatment success
By Mayo Clinic Staff
Oct 26, 2007

Educating yourself about alternative medicine helps you determine whether its treatments are worth exploring. Follow these suggestions to help you assess the claims.

Alternative medicine treatments ranging from herbal remedies to acupuncture have become more popular as people seek greater control of their own health. But while they do give you more options, these treatments aren't always proven safe or effective. When considering any alternative treatments, be a savvy consumer. Be open-minded yet skeptical of medical claims. Many treatments, both conventional and unconventional, have risks and side effects.

Alternative medicine ? practices that aren't typically used in conventional medicine ? is generally thought of as being used instead of conventional methods. When alternative practices are used in addition to the conventional therapies, they are called complementary medicine. Together, these treatments are sometimes referred to as complementary and alternative medicine (CAM).

With any alternative treatment you consider, find out if the potential benefits outweigh the risks. It's a good idea to talk to your doctor and do research on your own before trying any treatment. Be especially aware of possible side effects of herbs and dietary supplements, which can cause problems with medications ? and aren't as well tested or regulated as are conventional treatments.

Also find out exactly what the treatment will cost. Assess the credentials of anyone who advocates alternative medicine. Gather information from a variety of sources and evaluate the information carefully.

Avoiding Internet misinformation: Use the Three D's
The Internet offers an ideal way to discover the latest in alternative medicine treatments. Web sites can be updated at any time to keep up with new products, therapies and advances in the field. But beware ? the Internet is also one of the greatest sources of misinformation. Carefully investigate each alternative medicine site you visit. Considering these three features can help you weed out the good products from the bad:

Dates. Search for the most recent information you can find. Reputable Web sites include a date for each article they post. Older material may not include recent findings, such as newly discovered side effects or advances in the field.

Documentation. Check for the source of information.

  • Web sites created by major medical centers, universities and government agencies are the most credible.
  • Some Web sites post a logo from the Health on the Net (HON) Foundation. Sites that display this logo have agreed to abide by the HON Code of Conduct, which regulates reliability and credibility of information.
  • Notice whether articles refer to solid scientific studies.
  • Look for a board of qualified professionals who review information before it's published.
  • Be wary of commercial sites or personal testimonials that push a single point of view or sell miracle cures.
  • Stay away from sites that don't clearly distinguish between scientific evidence and advertisements.
Double-checking. Visit several health sites and compare the information they offer. And before you follow any medical advice, ask your doctor for guidance. If you search all over a Web site for supporting evidence or you can't find evidence to back up the manufacturer's claims, be wary of the information.

Beware of scams and health fraud
Scammers have perfected ways to convince you that their alternative medicine products are the best. These opportunists often target people who are overweight or who have medical conditions for which there is no cure, such as multiple sclerosis, diabetes, Alzheimer's disease, cancer, HIV/AIDS and arthritis. Remember ? if it sounds too good to be true, it probably is. Certain words and phrases can be warning signs of potentially fraudulent alternative medicine products. The Food and Drug Administration (FDA) recommends that you watch out for the following claims or practices:

  • Red flag words. The advertisements or promotional materials usually include words such as "satisfaction guaranteed," "miracle cure" or "new discovery." If the product were in fact a cure, it would be widely reported in the media and your doctor would recommend it.
  • Pseudomedical jargon. Though terms such as "purify," "detoxify" and "energize" may sound impressive and may even have an element of truth, they're generally used to cover up a lack of scientific proof. Watch out for these words.
  • Cure-alls. The manufacturer claims that the product can treat a wide range of symptoms, or cure or prevent a number of diseases. No single product can do all this.
  • Anecdotal evidence. Testimonials are no substitute for solid scientific documentation. If the product is scientifically sound, it's actually to the manufacturer's advantage ? and ultimately yours ? to promote the scientific evidence.
  • False accusations. The manufacturer of the product accuses the government or a medical profession of suppressing important information about their product's benefits. Neither the government nor any medical profession has any reason to withhold information that could help people.
Look for solid scientific studies
If you read about studies in journal articles, assess the quality of the research. Look for words such as "double-blind," "controlled" and "randomized." Doctors consider these types of studies to contain the most valuable information. Here are some common terms you'll encounter in research articles:

  • Clinical studies. These involve studies on human beings - not animals. They generally come after studies that demonstrate the safety and effectiveness of the treatment in animals and in the lab. Studies done solely in test tubes and petri dishes can't prove benefit to humans.
  • Randomized, controlled trials. Participants in these trials usually are divided into groups. One group receives the treatment under investigation. Another group may be a control group ? participants receive standard treatment, no treatment or an inactive substance called a placebo. Participants are assigned to these groups on a random basis. This helps ensure that the groups will be similar.
  • Double-blind studies. In these studies, neither the researchers nor the human subjects know who will receive the active treatment and who will receive the placebo.
Look for peer-reviewed journals ? those that only publish articles reviewed by an independent panel of medical experts. Also look for replicated studies, ones that have been repeated by different investigators with generally the same results.

One or two small studies, whether the results are positive or negative, usually aren't enough to make a definite decision about whether to use or skip a specific treatment. Unfortunately, there are a limited number of quality studies on many alternative medicine treatments. Keep in mind that while solid research studies are the best way to evaluate whether a treatment is safe and effective, a lack of solid evidence doesn't always mean these treatments don't work ? but it does mean they haven't been proved.

Research studies on alternative medicine are being conducted every year. As research continues, many of the answers about whether these treatments are safe or effective will become clearer. Much of the funding for these studies comes from the National Institutes of Health's National Center for Complementary and Alternative Medicine, which is also a good resource to examine when investigating alternative medicine treatments.

Evaluate providers
When selecting an alternative treatment provider, evaluate your options. Simply choosing a name from a telephone directory is risky if you have no other information about the provider. You might try checking with:

  • Medical centers. At many medical centers, CAM practioners are working collaboratively with conventional physicians.
  • State regulators. Check your state government listings for agencies that regulate and license health care providers. These agencies may list practitioners in your area and offer a way to check credentials.
  • National associations. National associations and their local affiliates can usually provide you with the names of certified practitioners in your area. To find the addresses and phone numbers of these associations, visit your local library or use the Internet to find association Web sites. But be careful ? official-sounding organizations aren't always reputable. Talk with your doctor or another trusted health care professional for advice.
  • Friends and family. If you know someone who's received the treatment you're considering, he or she can offer advice. Ask about his or her experiences with specific providers. Call the provider to request an interview.
Many treatments, both conventional and unconventional, have risks and side effects. With any treatment you consider, find out if the potential benefits outweigh the risks. Also find out exactly what the treatment will cost.

Dietary supplements: 'Natural' doesn't always mean safe
Herbal remedies, vitamins and minerals, considered dietary supplements by the FDA, don't have the same rigorous testing and labeling process as over-the-counter and prescription medications. Yet, some of these substances, including products labeled as "natural," have drug-like effects that can be dangerous. Even some vitamins and minerals can cause problems when taken in excessive amounts. While some changes to federal labeling guidelines have helped protect consumers by requiring manufacturers to evaluate the identity, purity, strength, and composition of dietary supplements, some companies have until 2010 to meet the new labeling requirements. And even stricter guidelines aren't a guarantee these products are entirely safe or effective. Before taking a dietary supplement, carefully investigate potential benefits and side effects.

  • Talk to your doctor before taking a dietary supplement. This is especially if you are pregnant, nursing a baby, or if you have a chronic medical condition such as diabetes or heart disease.
  • Avoid drug interactions. Prescription and over-the-counter medications can interact with certain dietary supplements. For example, the anticoagulant Coumadin (a prescription medication), ginkgo biloba (an herbal supplement) and Vitamin E can all thin the blood. Taking these products together can increase your risk of internal bleeding or other problems.
  • Tell your doctor about any supplements you take before surgery. Some supplements can cause problems during surgery such as changes in heart rate or blood pressure or increased bleeding. You may need to stop taking these supplements at least two to three weeks before your procedure.
Don't forgo conventional treatment
Ideally the various forms of treatments you select should work together with the care of your conventional doctor. You may find that certain alternative treatments help you maintain your health and relieve some of your symptoms. But continue to rely on conventional medicine to diagnose a problem and treat diseases. Don't change your conventional treatment ? such as your dose of prescribed medication ? without talking to your doctor first. For your safety, tell your doctor about all alternative treatments you use.
 

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Have you noticed that infomercials for many alternative / natural remedies will have a spokesperson called "doctor" extolling the virtues of the product.

Usually the person's credentials are shown in very small print at the bottom of the screen difficult to read,

These people are not usually medical doctors, as it is generally considered unethical for a practicing physician to endorse commercial products.

Some of these products will claim to have clinical trials to support their claims of efficacy, but as the article warns, the credentials of the study must be scrutinized.

Valid scientific studies are published in well known journals where the data can be peer reviewed.

Just because a study is claimed to be published is no guarantee of its validity. Unscrupulous manufacturers have been known to publish studies in their own, self funded publications, unknown to anyone but the manufacturer.

When considering alternative therapies, the buyer must be sceptical until solid scientific evidence can be provided.
 

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