Form of non-scientific healing

Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among the various attempts to capture the combination of alternative practices with those of mainstream medicine. Alternative therapies share in common that they reside outside of medical science and instead rely on pseudoscience. Traditional practices become "alternative" when used outside their original settings and without proper scientific explanation and evidence. Frequently used derogatory terms for relevant practices are new age or pseudo- medicine, with little distinction from quackery.

Some alternative practices are based on theories that contradict the established science of how the human body works; others resort to the supernatural or superstitious to explain their effect or lack thereof. In others, the practice has plausibility but lacks a positive risk-benefit outcome probability. Alternative medicine is distinct from scientific medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect. Research into alternative therapies often fails to follow proper research protocols (such as placebo-controlled trials, blind experiments and calculation of prior probability), providing invalid results.

Much of the perceived effect of an alternative practice arises from a belief that it will be effective (the placebo effect), or from the treated condition resolving on its own (the natural course of disease). This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point the condition will be at its worst and most likely to spontaneously improve. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (e.g. cyanide poisoning from amygdalin, or the intentional ingestion of hydrogen peroxide) or actively interfere with effective treatments.

The alternative sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments. Its marketing often advertises the treatments as being "natural" or "holistic", in comparison to those offered by medical science. Billions of dollars have been spent studying alternative medicine, with few or no positive results. Some of the successful practices are only considered alternative under very specific definitions, such as those which include all physical activity under the umbrella of "alternative medicine".

The terms alternative medicine, complementary medicine, integrative medicine, holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and new age medicine are used interchangeably as having the same meaning and are almost synonymous in most contexts.[1][2][3][4] Terminology has shifted over time, reflecting the preferred branding of practitioners.[5] For example, the United States National Institutes of Health department studying alternative medicine, currently named the National Center for Complementary and Integrative Health (NCCIH), was established as the Office of Alternative Medicine (OAM) and was renamed the National Center for Complementary and Alternative Medicine (NCCAM) before obtaining its current name. Therapies are often framed as "natural" or "holistic", implicitly and intentionally suggesting that conventional medicine is "artificial" and "narrow in scope".[6][7]

The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to medical science, although some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness.[9][10] Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not, e.g., the use of the expressions "Western medicine" and "Eastern medicine" to suggest that the difference is a cultural difference between the Asiatic east and the European west, rather than that the difference is between evidence-based medicine and treatments that do not work.[9]

Alternative medicine is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine,[n 1][n 2] but whose effectiveness has not been established using scientific methods,[n 1][n 3][13][14][15][9] or whose theory and practice is not part of biomedicine,[n 2][n 4][n 5][n 6] or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine.[9][13][19] "Biomedicine" or "medicine" is that part of medical science that applies principles of biology, physiology, molecular biology, biophysics, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice. Unlike medicine,[n 4] an alternative product or practice does not originate from using scientific methods, but may instead be based on hearsay, religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources.[n 3][9][11][13][19]

Some other definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare.[20] This can refer to the lack of support that alternative therapies receive from medical scientists regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum.[20] For example, a widely used definition devised by the US NCCIH calls it "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine".[22] However, these descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training;[23] alternative medicine is taught in more than half of US medical schools and US health insurers are increasingly willing to provide reimbursement for alternative therapies.

Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with mainstream functional medical treatment in a belief that it improves the effect of treatments.[n 7][11][26][27][28] For example, acupuncture (piercing the body with needles to influence the flow of a supernatural energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time.[29][30][31] Instead, significant drug interactions caused by alternative therapies may make treatments less effective, notably in cancer therapy.[32][33][34] Besides the usual issues with alternative medicine, integrative medicine has been described as an attempt to bring pseudoscience into academic science-based medicine,[35] leading to the pejorative term "quackademic medicine". Due to its many names, the field has been criticized for intense rebranding of what are essentially the same practices.[1]

CAM is an abbreviation of the phrase complementary and alternative medicine.[36][37][38] The 2019 World Health Organization (WHO) Global Report on Traditional and Complementary Medicine states that the terms complementary and alternative medicine "refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into the dominant health care system. They are used interchangeably with traditional medicine in some countries."[39]

The Integrative Medicine Exam by the American Board of Physician Specialties[40] includes the following subjects: Manual Therapies, Biofield Therapies, Acupuncture, Movement Therapies, Expressive Arts, Traditional Chinese Medicine, Ayurveda, Indigenous Medical Systems, Homeopathic Medicine, Naturopathic Medicine, Osteopathic Medicine, Chiropractic, and Functional Medicine.[40]

Traditional medicine refers to the pre-scientific practices of a certain culture, in contrast to what is typically practiced in cultures where medical science dominates.[citation needed] The 2019 WHO report defines traditional medicine as "the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness."[39]

Holistic medicine is another rebranding of alternative medicine. In this case, the words balance and holism are often used alongside complementary or integrative, claiming to take into account a "whole" person, in contrast to the supposed reductionism of medicine.[41][42]

Prominent members of the science[43][44] and biomedical science community[8] say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all.[8][43][44][45] Others say that alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another.[48]

Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo.[9][35][49][50] John Diamond wrote that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't",[44][51] a notion later echoed by Paul Offit: "The truth is there's no such thing as conventional or alternative or complementary or integrative or holistic medicine. There's only medicine that works and medicine that doesn't. And the best way to sort it out is by carefully evaluating scientific studiesnot by visiting Internet chat rooms, reading magazine articles, or talking to friends."[43]

Alternative medicine consists of a wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies.[22] Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based.[11][9][19][22] Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, superstition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods.[11][9][13][19] Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices.

Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine, is based on belief systems not grounded in science.[22]

Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine (TCM), Ayurveda in India, or practices of other cultures around the world.[22] Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted.

Traditional medicine is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work such as knowing that the practice is based on superstition.

Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine.[22]

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods.[22][78][79] Examples include healing claims for non-vitamin supplements, fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil, and ginseng.[80] Herbal medicine, or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products.[78] It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements".[78] Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents.[78]

A US agency, National Center on Complementary and Integrative Health (NCCIH), has created a classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy, colorpuncture and light therapy) and putative, which invokes physically undetectable or unverifiable energy.[84] None of these energies have any evidence to support that they affect the body in any positive or health promoting way.[6]

The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment.[9][85][86][87][88] It includes the histories of complementary medicine and of integrative medicine. Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing quackery.[85][86] Until the 1970s, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments.[88] In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine".[9][85][86][88][89]

Use of alternative medicine in the west began to rise following the counterculture movement of the 1960s, as part of the rising new age movement of the 1970s.[9][90][91] This was due to misleading mass marketing of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures (cultural relativism), and growing frustration and desperation by patients about limitations and side effects of science-based medicine.[9][86][88][87][89][91][92] At the same time, in 1975, the American Medical Association, which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation.[85]:xxi[92] By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine.[9][92][93][94] By 1983, mass marketing of "alternative medicine" was so pervasive that the British Medical Journal (BMJ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen".[92]

An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during the period of reorganization within medicine (19651999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase, changes in the medical marketplace had influenced the type of response in the journals.[95] Changes included relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the USA Office of Alternative Medicine (later National Center for Complementary and Alternative Medicine, currently National Center for Complementary and Integrative Health).[n 9]

Mainly as a result of reforms following the Flexner Report of 1910[97] medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic.[n 10] Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology.[99] Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine,[100] and engaging in complex clinical reasoning (medical decision-making).[101] Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies.[102]

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US.[103] Exceptionally, the School of Medicine of the University of Maryland, Baltimore, includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration).[104][105] Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD).[106] All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Exam (USMLE).[106]

There is a general scientific consensus that alternative therapies lack the requisite scientific validation, and their effectiveness is either unproved or disproved.[11][9][107][108] Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed. Selective publication bias, marked differences in product quality and standardisation, and some companies making unsubstantiated claims call into question the claims of efficacy of isolated examples where there is evidence for alternative therapies.[110]

The Scientific Review of Alternative Medicine points to confusions in the general population a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy) gets misattributed to an alternative medicine being taken; a person not diagnosed with science-based medicine may never originally have had a true illness diagnosed as an alternative disease category.[111]

Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative[112] and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate.[113] Ernst has concluded that 95% of the alternative therapies he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology, are "statistically indistinguishable from placebo treatments", but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine.[114][115]

In 2003, a project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis.[116] According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically.

As of 2005[update], the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. An analysis of the conclusions of only the 145 Cochrane reviews was done by two readers. In 83% of the cases, the readers agreed. In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effect, and 56.6% concluded insufficient evidence. An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. However, the CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database.

Alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) functional medical treatment.[n 7][11][26][27][28] Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment by making prescription drugs less effective, such as interference by herbal preparations with warfarin.[118][33]

In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials. In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results.[119]

Cancer researcher Andrew J. Vickers has stated:

Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective. The label "unproven" is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been "disproven".[120]

Anything classified as alternative medicine by definition does not have a healing or medical effect.[8][9][13][14][15] However, there are different mechanisms through which it can be perceived to "work". The common denominator of these mechanisms is that effects are mis-attributed to the alternative treatment.

A placebo is a treatment with no intended therapeutic value. An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery. The placebo effect is the concept that patients will perceive an improvement after being treated with an inert treatment. The opposite of the placebo effect is the nocebo effect, when patients who expect a treatment to be harmful will perceive harmful effects after taking it.

Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea.[121] A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect.[122][121] However, reassessments found the study to have flawed methodology.[122][123] This and other modern reviews suggest that other factors like natural recovery and reporting bias should also be considered.[121][123]

All of these are reasons why alternative therapies may be credited for improving a patient's condition even though the objective effect is non-existent, or even harmful.[118][35][50] David Gorski argues that alternative treatments should be treated as a placebo, rather than as medicine.[35] Almost none have performed significantly better than a placebo in clinical trials.[62][49][124][78] Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication.[118]

A patient who receives an inert treatment may report improvements afterwards that it did not cause.[121][123] Assuming it was the cause without evidence is an example of the regression fallacy. This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition.[123] The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result.

There are also reasons why a placebo treatment group may outperform a "no-treatment" group in a test which are not related to a patient's experience. These include patients reporting more favourable results than they really felt due to politeness or "experimental subordination", observer bias, and misleading wording of questions.[123] In their 2010 systematic review of studies into placebos, Asbjrn Hrbjartsson and Peter C. Gtzsche write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of blinding."[121] Alternative therapies may also be credited for perceived improvement through decreased use or effect of medical treatment, and therefore either decreased side effects or nocebo effects towards standard treatment.[118]

Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions.[125]

In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe,[126] cognitive biases that help maintain self-esteem and promote harmonious social functioning,[126] and the post hoc, ergo propter hoc fallacy.[126]

Alternative medicine is a profitable industry with large media advertising expenditures. Accordingly, alternative practices are often portrayed positively and compared favorably to "big pharma".[6]

The popularity of complementary & alternative medicine (CAM) may be related to other factors that Edzard Ernst mentioned in an interview in The Independent:

Why is it so popular, then? Ernst blames the providers, customers and the doctors whose neglect, he says, has created the opening into which alternative therapists have stepped. "People are told lies. There are 40 million websites and 39.9 million tell lies, sometimes outrageous lies. They mislead cancer patients, who are encouraged not only to pay their last penny but to be treated with something that shortens their lives." At the same time, people are gullible. It needs gullibility for the industry to succeed. It doesn't make me popular with the public, but it's the truth.[127]

Paul Offit proposed that "alternative medicine becomes quackery" in four ways: by recommending against conventional therapies that are helpful, promoting potentially harmful therapies without adequate warning, draining patients' bank accounts, or by promoting "magical thinking."[43] Promoting alternative medicine has been called dangerous and unethical.[n 11][129]

Authors have speculated on the socio-cultural and psychological reasons for the appeal of alternative medicines among the minority using them in lieu of conventional medicine. There are several socio-cultural reasons for the interest in these treatments centered on the low level of scientific literacy among the public at large and a concomitant increase in antiscientific attitudes and new age mysticism.[126] Related to this are vigorous marketing[130] of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics.[126][131] Alternative medicine is criticized for taking advantage of the least fortunate members of society.[6]

There is also an increase in conspiracy theories toward conventional medicine and pharmaceutical companies,[34] mistrust of traditional authority figures, such as the physician, and a dislike of the current delivery methods of scientific biomedicine, all of which have led patients to seek out alternative medicine to treat a variety of ailments.[131] Many patients lack access to contemporary medicine, due to a lack of private or public health insurance, which leads them to seek out lower-cost alternative medicine.[132] Medical doctors are also aggressively marketing alternative medicine to profit from this market.[130]

Patients can be averse to the painful, unpleasant, and sometimes-dangerous side effects of biomedical treatments. Treatments for severe diseases such as cancer and HIV infection have well-known, significant side-effects. Even low-risk medications such as antibiotics can have potential to cause life-threatening anaphylactic reactions in a very few individuals. Many medications may cause minor but bothersome symptoms such as cough or upset stomach. In all of these cases, patients may be seeking out alternative therapies to avoid the adverse effects of conventional treatments.[126][131]

According to recent research, the increasing popularity of the CAM needs to be explained by moral convictions or lifestyle choices rather than by economic reasoning.[133]

In developing nations, access to essential medicines is severely restricted by lack of resources and poverty. Traditional remedies, often closely resembling or forming the basis for alternative remedies, may comprise primary healthcare or be integrated into the healthcare system. In Africa, traditional medicine is used for 80% of primary healthcare, and in developing nations as a whole over one-third of the population lack access to essential medicines.[134]

In Latin America, inequities against BIPOC communities keep them tied to their traditional practices and therefore, it is often these communities that constitute the majority of users of alternative medicine. Racist attitudes towards certain communities disable them from accessing more urbanized modes of care. In a study that assessed access to care in rural communities of Latin America, it was found that discrimination is a huge barrier to the ability of citizens to access care; more specifically, women of Indigenous and African descent, and lower-income families were especially hurt.[135] Such exclusion exacerbates the inequities that minorities in Latin America already face. Consistently excluded from many systems of westernized care for socioeconomic and other reasons, low-income communities of color often turn to traditional medicine for care as it has proved reliable to them across generations.

Some have proposed adopting a prize system to reward medical research.[136] However, public funding for research exists. In the US increasing the funding for research on alternative medicine is the purpose of the US National Center for Complementary and Alternative Medicine (NCCAM). NCCAM has spent more than US$2.5 billion on such research since 1992 and this research has not demonstrated the efficacy of alternative therapies.[124][137][138][139][140][141] The NCCAM's sister organization in the NIC Office of Cancer Complementary and Alternative Medicine gives grants of around $105 million every year.[142] Testing alternative medicine that has no scientific basis has been called a waste of scarce research resources.[143][144]

That alternative medicine has been on the rise "in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and 'evidence-based' practice is the dominant paradigm" was described as an "enigma" in the Medical Journal of Australia.[145] A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%.[146]

In the United States, the 1974 Child Abuse Prevention and Treatment Act (CAPTA) required that for states to receive federal money, they had to grant religious exemptions to child neglect and abuse laws regarding religion-based healing practices.[147] Thirty-one states have child-abuse religious exemptions.[148]

The use of alternative medicine in the US has increased,[11][149] with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America.[149] According to a national survey conducted in 2002, "36 percent of U.S. adults aged 18 years and over use some form of complementary and alternative medicine."[150] Americans spend many billions on the therapies annually.[149] Most Americans used CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain.[132] In America, women were more likely than men to use CAM, with the biggest difference in use of mind-body therapies including prayer specifically for health reasons".[132] In 2008, more than 37% of American hospitals offered alternative therapies, up from 27 percent in 2005, and 25% in 2004.[151][152] More than 70% of the hospitals offering CAM were in urban areas.[152]

A survey of Americans found that 88 percent thought that "there are some good ways of treating sickness that medical science does not recognize".[11] Use of magnets was the most common tool in energy medicine in America, and among users of it, 58 percent described it as at least "sort of scientific", when it is not at all scientific.[11] In 2002, at least 60 percent of US medical schools have at least some class time spent teaching alternative therapies.[11] "Therapeutic touch" was taught at more than 100 colleges and universities in 75 countries before the practice was debunked by a nine-year-old child for a school science project.[11][77]

The most common CAM therapies used in the US in 2002 were prayer (45%), herbalism (19%), breathing meditation (12%), meditation (8%), chiropractic medicine (8%), yoga (56%), body work (5%), diet-based therapy (4%), progressive relaxation (3%), mega-vitamin therapy (3%) and Visualization (2%)[132][153]

In Britain, the most often used alternative therapies were Alexander technique, aromatherapy, Bach and other flower remedies, body work therapies including massage, Counseling stress therapies, hypnotherapy, meditation, reflexology, Shiatsu, Ayurvedic medicine, nutritional medicine, and Yoga.[154] Ayurvedic medicine remedies are mainly plant based with some use of animal materials. Safety concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities.[71][73]

According to the National Health Service (England), the most commonly used complementary and alternative medicines (CAM) supported by the NHS in the UK are: acupuncture, aromatherapy, chiropractic, homeopathy, massage, osteopathy and clinical hypnotherapy.[156]

Complementary therapies are often used in palliative care or by practitioners attempting to manage chronic pain in patients. Integrative medicine is considered more acceptable in the interdisciplinary approach used in palliative care than in other areas of medicine. "From its early experiences of care for the dying, palliative care took for granted the necessity of placing patient values and lifestyle habits at the core of any design and delivery of quality care at the end of life. If the patient desired complementary therapies, and as long as such treatments provided additional support and did not endanger the patient, they were considered acceptable."[157] The non-pharmacologic interventions of complementary medicine can employ mind-body interventions designed to "reduce pain and concomitant mood disturbance and increase quality of life."[158]

The alternative medicine lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine.[6] Some professions of complementary/traditional/alternative medicine, such as chiropractic, have achieved full regulation in North America and other parts of the world and are regulated in a manner similar to that governing science-based medicine. In contrast, other approaches may be partially recognized and others have no regulation at all. In some cases, promotion of alternative therapies is allowed when there is demonstrably no effect, only a tradition of use. Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them.[160]

Regulation and licensing of alternative medicine ranges widely from country to country, and state to state. In Austria and Germany complementary and alternative medicine is mainly in the hands of doctors with MDs,[36] and half or more of the American alternative practitioners are licensed MDs.[161] In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance.[162]

Government bodies in the US and elsewhere have published information or guidance about alternative medicine. The U.S. Food and Drug Administration (FDA), has issued online warnings for consumers about medication health fraud.[163] This includes a section on Alternative Medicine Fraud, such as a warning that Ayurvedic products generally have not been approved by the FDA before marketing.[164]

According to the Institute of Medicine, use of alternative medical techniques may result in several types of harm:

Forms of alternative medicine that are biologically active can be dangerous even when used in conjunction with conventional medicine. Examples include immuno-augmentation therapy, shark cartilage, bioresonance therapy, oxygen and ozone therapies, and insulin potentiation therapy. Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery, among other problems.[37][118][33] An example of these dangers was reported by Associate Professor Alastair MacLennan of Adelaide University, Australia regarding a patient who almost bled to death on the operating table after neglecting to mention that she had been taking "natural" potions to "build up her strength" before the operation, including a powerful anticoagulant that nearly caused her death.[166]

To ABC Online, MacLennan also gives another possible mechanism:

And lastly there's the cynicism and disappointment and depression that some patients get from going on from one alternative medicine to the next, and they find after three months the placebo effect wears off, and they're disappointed and they move on to the next one, and they're disappointed and disillusioned, and that can create depression and make the eventual treatment of the patient with anything effective difficult, because you may not get compliance, because they've seen the failure so often in the past.[167]

Conventional treatments are subjected to testing for undesired side-effects, whereas alternative therapies, in general, are not subjected to such testing at all. Any treatment whether conventional or alternative that has a biological or psychological effect on a patient may also have potential to possess dangerous biological or psychological side-effects. Attempts to refute this fact with regard to alternative therapies sometimes use the appeal to nature fallacy, i.e., "That which is natural cannot be harmful." Specific groups of patients such as patients with impaired hepatic or renal function are more susceptible to side effects of alternative remedies.[168][169]

An exception to the normal thinking regarding side-effects is Homeopathy. Since 1938, the U.S. Food and Drug Administration (FDA) has regulated homeopathic products in "several significantly different ways from other drugs."[170] Homeopathic preparations, termed "remedies", are extremely dilute, often far beyond the point where a single molecule of the original active (and possibly toxic) ingredient is likely to remain. They are, thus, considered safe on that count, but "their products are exempt from good manufacturing practice requirements related to expiration dating and from finished product testing for identity and strength", and their alcohol concentration may be much higher than allowed in conventional drugs.[170]

Alternative medicine may discourage people from getting the best possible treatment.[171] Those having experienced or perceived 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.[172] For this reason, critics argue that therapies that rely on the placebo effect to define success are very dangerous. According to mental health journalist Scott Lilienfeld in 2002, "unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments" and refers to this 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. In short, even innocuous treatments can indirectly produce negative outcomes.[173] Between 2001 and 2003, four children died in Australia because their parents chose ineffective naturopathic, homeopathic, or other alternative medicines and diets rather than conventional therapies.[174]

There have always been "many therapies offered outside of conventional cancer treatment centers and based on theories not found in biomedicine. These alternative cancer cures have often been described as 'unproven,' suggesting that appropriate clinical trials have not been conducted and that the therapeutic value of the treatment is unknown." However, "many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective.... The label 'unproven' is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been 'disproven'."[120]

Edzard Ernst has stated:

any alternative cancer cure is bogus by definition. There will never be an alternative cancer cure. Why? Because if something looked halfway promising, then mainstream oncology would scrutinize it, and if there is anything to it, it would become mainstream almost automatically and very quickly. All curative "alternative cancer cures" are based on false claims, are bogus, and, I would say, even criminal.[175]

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.

Complementary and alternative medicine (CAM) is not as well researched as conventional medicine, which undergoes intense research before release to the public.[176] Practitioners of science-based medicine also discard practices and treatments when they are shown ineffective, while alternative practitioners do not.[6] Funding for research is also sparse making it difficult to do further research for effectiveness of CAM.[177] Most funding for CAM is funded by government agencies.[176] Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable.[176] The research for CAM has to meet certain standards from research ethics committees, which most CAM researchers find almost impossible to meet.[176] Even with the little research done on it, CAM has not been proven to be effective.[178] Studies that have been done will be cited by CAM practitioners in an attempt to claim a basis in science. These studies tend to have a variety of problems, such as small samples, various biases, poor research design, lack of controls, negative results, etc. Even those with positive results can be better explained as resulting in false positives due to bias and noisy data.[179]

Alternative medicine may lead to a false understanding of the body and of the process of science.[171][180] Steven Novella, a neurologist at Yale School of Medicine, wrote that government-funded studies of integrating alternative medicine techniques into the mainstream are "used to lend an appearance of legitimacy to treatments that are not legitimate."[181] Marcia Angell considered that critics felt that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science-based medicine will adopt it regardless of whether it was considered "alternative" to begin with.[8] It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. Prominent supporters of this position are George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA) and the journal's interim editor-in-chief Phil Fontanarosa.[45]

Writing in 1999 in CA: A Cancer Journal for Clinicians Barrie R. Cassileth mentioned a 1997 letter to the US Senate Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. (This was supported by the National Institutes of Health (NIH).)[182]

In March 2009, a staff writer for the Washington Post reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine. They quoted one of these scientists, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, as saying "One of our concerns is that NIH is funding pseudoscience." They noted that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and had shown little or no effect.[181]

Writers such as Carl Sagan, a noted astrophysicist, advocate of scientific skepticism and the author of The Demon-Haunted World: Science as a Candle in the Dark (1996), have lambasted the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.

Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment.[183] Barrett has pointed out that there is a policy at the NIH of never saying something does not work, only that a different version or dose might give different results.[124] Barrett also expressed concern that, just because some "alternatives" have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine.[184]

Some critics of alternative medicine are focused upon health fraud, misinformation, and quackery as public health problems, notably Wallace Sampson and Paul Kurtz founders of Scientific Review of Alternative Medicine and Stephen Barrett, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch.[185] Grounds for opposing alternative medicine include that:

Many alternative medical treatments are not patentable,[192] which may lead to less research funding from the private sector. In addition, in most countries, alternative therapies (in contrast to pharmaceuticals) can be marketed without any proof of efficacy also a disincentive for manufacturers to fund scientific research.[193]

English evolutionary biologist Richard Dawkins, in his 2003 book A Devil's Chaplain, defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests."[194] Dawkins argued that if a technique is demonstrated effective in properly performed trials then it ceases to be alternative and simply becomes medicine.[195]

CAM is also often less regulated than conventional medicine.[176] There are ethical concerns about whether people who perform CAM have the proper knowledge to treat patients.[176] CAM is often done by non-physicians who do not operate with the same medical licensing laws which govern conventional medicine,[176] and it is often described as an issue of non-maleficence.[196]

According to two writers, Wallace Sampson and K. Butler, marketing is part of the training required in alternative medicine, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine.[62][197]

In November 2011 Edzard Ernst stated that the "level of misinformation about alternative medicine has now reached the point where it has become dangerous and unethical. So far, alternative medicine has remained an ethics-free zone. It is time to change this."[198]

Some commentators have said that special consideration must be given to the issue of conflicts of interest in alternative medicine. Edzard Ernst has said that most researchers into alternative medicine are at risk of "unidirectional bias" because of a generally uncritical belief in their chosen subject.[199] Ernst cites as evidence the phenomenon whereby 100% of a sample of acupuncture trials originating in China had positive conclusions.[199] David Gorski contrasts evidence-based medicine, in which researchers try to disprove hyphotheses, with what he says is the frequent practice in pseudoscience-based research, of striving to confirm pre-existing notions.[200] Harriet Hall writes that there is a contrast between the circumstances of alternative medicine practitioners and disinterested scientists: in the case of acupuncture, for example, an acupuncturist would have "a great deal to lose" if acupuncture were rejected by research; but the disinterested skeptic would not lose anything if its effects were confirmed; rather their change of mind would enhance their skeptical credentials.[201]

Research into alternative therapies has been criticized for "diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology."[50][35] Research methods expert and author of Snake Oil Science, R. Barker Bausell, has stated that "it's become politically correct to investigate nonsense."[124] A commonly cited statistic is that the US National Institute of Health had spent $2.5 billion on investigating alternative therapies prior to 2009, with none being found to be effective.[124]

In 1991 the Senate Appropriations Committee responsible for funding the National Institutes of Health (NIH) declared itself "not satisfied that the conventional medical community as symbolized at the NIH has fully explored the potential that exists in unconventional medical practices."[96]

Read more here:

Alternative medicine - Wikipedia

Many different areas make up the practice of complementary and alternative medicine (CAM). In addition, many parts of one field may overlap with the parts of another field. For example, acupuncture is also used in conventional medicine. In the U.S., CAM is used by about 38% of adults and 12% of children. Examples of CAM include:

Traditional alternative medicine. This field includes the more mainstream and accepted forms of therapy, such as acupuncture, homeopathy, and Oriental practices. These therapies have been practiced for centuries worldwide. Traditional alternative medicine may include:

Body. Touch has been used in medicine since the early days of medical care. Healing by touch is based on the idea that illness or injury in one area of the body can affect all parts of the body. If, with manual manipulation, the other parts can be brought back to optimum health, the body can fully focus on healing at the site of injury or illness. Body techniques are often combined with those of the mind. Examples of body therapies include:

Diet and herbs. Over the centuries, man has gone from a simple diet consisting of meats, fruits, vegetables, and grains, to a diet that often consists of foods rich in fats, oils, and complex carbohydrates. Nutritional excess and deficiency have become problems in today's society, both leading to certain chronic diseases. Many dietary and herbal approaches attempt to balance the body's nutritional well-being. Dietary and herbal approaches may include:

External energy. Some people believe external energies from objects or other sources directly affect a person's health. An example of external energy therapy is:

Mind. Even standard or conventional medicine recognizes the power of the connection between mind and body. Studies have found that people heal better if they have good emotional and mental health. Therapies using the mind may include:

Senses. Some people believe the senses, touch, sight, hearing, smell, and taste, can affect overall health. Examples of therapies incorporating the senses include:

Original post:

Types of Complementary and Alternative Medicine

Research Article

25 Oct 2022

Moroccan Medicinal Plants Used to Treat Cancer: Ethnomedicinal Study and Insights into Pharmacological Evidence

Naoufal El Hachlafi|Nesrine Benkhaira|...|Kawtar Fikri-Benbrahim

Cancer is one of the major medical challenges, with an unacceptably high death toll worldwide. In Morocco, medicinal plants continue to play a pivotal therapeutic role despite the development of modern sanitation systems. In the current study, an ethnobotanical survey was carried out at the Moroccan national institute of oncology, Rabat, and we aimed at (1) establishing an exhaustive inventory of indigenous knowledge of Moroccan medicinal plants used to manage cancer and (2) confirming the reported ethnopharmacological uses through bibliometric review. An ethnobotanical survey was conducted with 291 cancer patients at the Moroccan National Institute of Oncology, Rabat, during a period of 4 months, from February to May 2019, through semistructured interviews. Ethnobotanical indices, including informant consensus factor (FIC), use report (UR), relative frequency citation (RFC), botanical family use value (FUV), fidelity level (FL), and index of agreement on remedies (IAR), were employed in data analyses. The survey revealed that 39 medicinal plants belonging to 27 botanical families and 38 genera were used to treat cancer. The most used ethnospecies were Aristolochia longa with the highest RFC value (0.096), followed by Nigella sativa, Ephedra alata, Euphorbia resinifera, and Lavandula dentata, with RFC values of 0.072, 0.054, 0.044, and 0.044, respectively. In regard to the plant families, Lamiaceae contributed the highest number of plants with five species (FUV=0.034), followed by Asteraceae (4 species; FUV=0.020), and Fabaceae (4 species; FUV=0.020). The leaves are the most popular plant part used by the studied population against cancer; otherwise, decoction was the most commonly used method for remedy preparation and the highest FIC was noticed for uterine cancer treatment (0.86). Considering these findings, further investigations into the recorded plant species should be performed to assess phytochemical constituents and pharmaceutical benefits in order to identify their active compounds for any drug formulations.

Research Article

25 Oct 2022

Xiaoqinglong Decoction Enhances Autophagy to Antagonist Airway Inflammation Induced by Cold in Asthmatic Rats

Bin Wang|Xiaoxuan Fan|...|Peizheng Yan

Asthma is a common chronic respiratory disease characterized by wheezing and shortness of breath. Its risk factors include genetic and acquired factors. The acquired factors are closely related to the environment, especially cold conditions. Autophagy plays a regulatory role in asthma. Therefore, we hypothesized that asthma can be controlled by drug intervention at the autophagy level under cold conditions. The Xiaoqinglong decoction (XQLT) was freeze-dried. The compounds in the freeze-dried powder were identified and quantified using reference standards via the high-performance liquid chromatography method. Ovalbumin (OVA)-sensitized rats were subjected to cold stimulation. The effect of cold stimulation on autophagy levels was determined, and it was confirmed that cold stimulation affected autophagy. The effects and mechanisms of XQLT in an asthmatic rat model (OVA-sensitized rats stimulated with cold) were explored. The concentrations of paeoniflorin, liquiritin, trans-cinnamic acid, glycyrrhizic acid, 6-gingerol, schisandrol A, and asarinin in XQLT freeze-dried powder were 14.45, 3.85, 1.03, 3.93, 0.59, 0.24, and 0.091mg/g, respectively. Cold stimulation is an important cause of asthma. The inflammatory factors in bronchoalveolar lavage fluid and serum were increased in the model group, accompanied by a decline in autophagy level. The treatment with XQLT increased the expression of autophagy genes and decreased the expression of inflammatory factors. Histological studies showed that XQLT improved inflammatory infiltration and collagen fiber deposition in the lungs of rats. XQLT intervention increased autophagy in asthmatic rats. Autophagy plays a role in phagocytosis and reduces the accumulation of abnormal metabolites in the body to reduce airway inflammation and promote asthma recovery.

Research Article

25 Oct 2022

Hyperbaric Oxygen Therapy Promotes Hearing Gain with Increases in Serum IGF-1 and HSP70 in Patients with Idiopathic Sudden Sensorineural Hearing Loss

Yi Zhang|Xingyuan Jia|...|Jing Yang

Objective. Hyperbaric oxygen therapy (HBOT) has been recommended for the initial and salvage treatment of patients with idiopathic sudden sensorineural hearing loss (ISSHL), but its underlying mechanisms remain unclear. In this study, we investigated whether HBOT alters serum levels of insulin-like growth factor 1 (IGF-1) and heat shock protein 70 (HSP70) in patients with ISSHL. Then, we identified the relationship between hearing recovery and changes in serum IGF-1 and HSP70 levels. Methods. Moderately severe to profound unilateral ISSHL patients (n=70) and healthy control participants (n=30) were enrolled. The ISSHL patients were randomly assigned to receive medical therapy alone (MT group, n=35) or both HBOT and medical therapy (HBOT+MT group, n=35). Audiometric testing was performed before and after treatment. Serum IGF-1 and HSP70 levels were assessed by ELISA in ISSHL patients pre-and posttreatment and healthy controls. Results. Before treatment, compared with the healthy controls, serum IGF-1 and HSP70 were lower in ISSHL patients. After treatment, serum IGF-1 and HSP70 increased in both the HBOT+MT and MT groups, although they were significantly higher in the HBOT+MT group (). In the HBOT+MT group, these increases were associated with hearing gains. In addition, IGF-1 was strongly associated with HSP70 (r=0.621, ). No such association was found in the MT group (). Conclusion. Administering HBOT in addition to medical therapy can improve the hearing of patients with moderately severe to profound unilateral ISSHL. The improvement is related to the upregulation of IGF-1 and HSP70.

Research Article

22 Oct 2022

Gualou Guizhi Decoction Improves Glucose Metabolism and Alleviates Microglia-Associated Inflammation after Cerebral Ischemia

Jizhou Zhang|Jing Han|...|Chunquan Zhou

Background. The classical prescription Gualou Guizhi decoction (GL), a mixture of Radix Trichosanthis, Ramulus Cinnamomi, Radix Paeoniae Alba, Radix Glycyrrhizae, Zingiberis Rhizoma Recens, and Fructus Ziziphus Jujuba, was clinically used in the treatment of limb spasms after stroke and has achieved remarkable therapeutic effects. However, the underlying mechanism still needs to be further explored. Methods. Cerebral ischemia/reperfusion (CI/R) in Sprague-Dawley rats was induced by middle cerebral artery occlusion followed by filament removal. GL was intragastrically administered once daily for 7 or 14 consecutive days. The effect of GL on neurobehavioral impairment was evaluated. 18F-FDG micro-PET imaging was used to detect the effects of GL on glucose utilization in neural cells after CI/R. Immunohistochemical staining of glucose transporter 1 (Glut-1), glial fibrillary acidic protein (GFAP), and ionized calcium-binding adaptor molecule-1 (Iba-1) was further performed to show the effects of GL on cerebral glucose transport and the activation of inflammatory-related glial cells. Markers related to the microglial subtype were also assessed to investigate the effects of GL on microglia polarization. Results. Neurological deficits induced by CI/R were significantly improved by GL administration. GL restored the glucose uptake in the ischemic hemisphere. Glut-1, the major glucose transporter in the brain, was significantly increased after GL treatment. Moreover, GL mitigated the activation of astrocytes and microglia after CI/R. Furthermore, GL significantly decreased proinflammatory M1-type microglial markers TNF- and iNOS, while increasing anti-inflammatory M2 microglial markers CD206 and Arg-1. Conclusion. GL enhanced the uptake and utilization of glucose in neural cells after CI/R. It exerted significant anti-inflammatory effects by regulating the polarization of microglia. These results provided further evidence supporting the clinical application of GL in the treatment of cerebral ischemic stroke.

Research Article

22 Oct 2022

Acupuncture Inhibits Morphine Induced-Immune Suppress via Antioxidant System

Rong Jie Zhao|Dae Geon Lee|...|Bong Hyo Lee

Objectives. A powerful analgesic called Morphine causes addiction behaviors and immune suppression as a potential oxidative stressor. Acupuncture showed to inhibit oxidative stress-induced hepatic damage, regulate reactive oxygen species, and attenuate morphine addiction behaviors. Therefore, we investigated the potential effects of acupuncture on morphine-induced immune suppression. Materials and Methods. Rats received morphine intravenously through implanted catheters for 3, 7, or 21 days to determine the optimal condition for morphine-induced immune suppression. Second, we examined whether intravenous (iv.) or intraperitoneal (ip.) administration produced different results. Third, the effects of acupuncture in rats who received morphine for 21 days were investigated. Spleen and submandibular lymph node (S-LN) weights and natural killer (NK) cell activity were measured, and the white pulp diameter, total and cortical spleen thicknesses, and the number of lymphoid follicles in S-LNs were examined. The number of immunoreactive cells was also measured. Results. Decreased organ weights and increased atrophic changes were observed as morphine-induced immune suppression. However, dose-dependent increased immune suppression was not observed between 5.0mg/kg and 10.0mg/kg of morphine. And, 3-day withdrawal did not affect. Similar histopathological findings were observed in 5.0 and 10.0 ip. rats when compared to equal dosages of iv., respectively. The morphine induced-immune suppression evidenced by spleen and left S-LN weights, splenic NK cell activities, histopathological findings, and the immunoreactive cell number were normalized by acupuncture. Conclusion. These results indicate that acupuncture inhibits morphine-induced immune suppression, maybe via antioxidative action.

Research Article

22 Oct 2022

Electroacupuncture at Acupoint ST36 (Zusanli) Improves Intestinal Motility Dysfunction Via Increasing the Proportion of Cholinergic Neurons in Rat Ileal Myenteric Ganglia after Severe Acute Pancreatitis

Xueling Wang|Lingyun Lu|...|Qian Wen

Using a severe acute pancreatitis (SAP) rat model, the mechanism of electroacupuncture (EA) were studied on the intestinal function of pancreatitis. The SAP models were established by injecting 30% L-ornithine at hourly intervals, and were divided into two groups (14 in each): SAP model group, which was not treated, and EA group, which received EA at ST36 at a frequency of 1-2Hz and amplitude of 1mA for 30min twice a day. Fourteen rats were also included as the control group. After EA, the intestinal propulsion was measured. In the distal ileum myenteric plexus, the density of HuC/D and the proportion of cholinergic neurons were measured using immunohistochemistry. Compared to the SAP model group, the EA group demonstrated significant improvements in intestinal propulsion rates. Furthermore, after EA, the density of myenteric neurons in the ileum returned to normal levels and the proportion of cholinergic neurons was increased compared to the SAP model group. And finally, EA alleviated the damage to the pancreas. Thus, our results suggest that EA stimulation at ST36 can partly restore the enteric neuron function and improve intestinal motility dysfunction, therefore could ameliorate SAP. The enteric nervous system can participate in changes in intestinal motility by affecting cholinergic neurons.

Excerpt from:

Evidence-Based Complementary and Alternative Medicine | Hindawi

Herbal medicine uses plants, or mixtures of plant extracts, to treat illness and promote health. There is not enough reliable scientific evidence to use it as a treatment for cancer.

Summary

Herbal medicines are made from plants. They usecombinations of plant parts, for example leaves, flowers or roots. Each part of the plant can have a different medicinal use. Manufacturers use different ways of extracting the chemicals from the plant parts. They use fresh and dried plants to make the medicine.

Herbal medicine aims to restore your body, so that it can protect, regulate and heal itself. It is a whole body approach. It looks at your physical, mental and emotional wellbeing. It is sometimes called phytomedicine, phytotherapy or botanical medicine.

Manufacturers make many drugs from plants. But herbalists dont extract plant substances in the way the drug industry does. Herbalists believe that the remedy works due to the delicate chemical balance of the whole plant, or mixtures of plants, and the effects are not just due to one active ingredient.

The two most common types of herbal medicine used in the UK are Western and Chinese herbal medicine. Less common types include Tibetan or Ayurvedic medicine (Indian) and Unani Tibb.

Western herbal medicine focuses on treating the whole person rather than their illness. So, the herbalist looks at your:

Western herbal therapists usually make medicines from European and North American herbs. They also use some herbs from the Chinese and Indian traditions.

Herbalists use remedies made from whole plants or plant parts. They believe it helps your body to heal itself or to reduce the side effects of medical treatments.

Chinese herbal medicine is part of a whole system of medicine. The system is called Traditional Chinese Medicine (TCM).

TCM aims to restore the balance of your Qi (pronounced chee). TCM practitioners believe that Qi is the flow of energy in your body and is essential for good health.

Yin and yang refer to different qualities of Qi. When all of the yin and yang aspects of Qi are in harmony with one another, there is health, wellbeing and peace. Illness is due to a disturbance of the balance between yin and yang. Chinese herbalists use plants according to how they affect a part of the body or energy channel.

TCM includes:

TCM uses hundreds of medicinal substances from plants.Practitioners may use different parts of plants. They might use the leaves, roots, stems, flowers or seeds. Usually, they combine herbs and you take them as teas, capsules, tinctures, or powders.

Herbal medicine is one of the most used complementary and alternative therapies by people with cancer.

People have used herbal medicine for centuries to treat many different health conditions. They believe it is a natural way to help you relax and cope with anxiety and depression or to help with other conditions such as:

People might also use herbal medicine to help themselves to feel better or more in control of their situation.

During your first visit, the herbalist will ask you general questions about your health, lifestyle and diet. They will take a medical history and find out about any medication or supplements you are taking.

They will also do a physical examination. This might include taking your pulse and blood pressure and examining your skin, nails, tongue and eyes. They might also feel your abdomen.

The herbalist will then decide which remedies you need. They will usually make it while you wait.

The remedy might be:

Your herbalist may suggest that you go back for another appointment after a few weeks. How long you continue seeing them will depend on why you are using herbal medicine.

This depends on which herbal medicine you want to have.

It is important to check with your doctor first before taking any herbal remedies if you:

Many people assume that products are safe to use when marketed as natural or herbal.

Some herbal medicines are safe to use but others may have severe and potentially dangerous side effects if used incorrectly. Some herbal medicines can interact with prescription drugs and other cancer treatments you are having. Check with your cancer specialist before taking any herbal medicines.

Some herbaltreatments might affect the way your body processes cancer drugs. For example the National Cancer Institute (NCI) in America says that St Johns wort can cause your body to get rid of the drug, imatinib (Glivec), quicker. This means it could make the imatinib less effective at treating your cancer.

Some herbal medicines might increase the effect of cancer drugs. This means that you could have too much treatment.

Other herbal medicines can interfere with some drugs. For example, Asian ginseng and bilberry can increase the risk of bleeding after surgery.

Some herbal remedies may make your skin more sensitive to light. Do not take them while having radiotherapy.

Each type of herbal remedy might have side effects. Some are safe to use and do not have any noticeable side effects. But some plants are poisonous to humans and can have serious and severe side effects.

Always tell your doctor if you are using any type of herbal remedy. It might be helpful to ask your herbalist for a list of all the ingredients in your herbal remedy. Then if you do have any side effects, your doctor will know what you have taken.

You, your doctor or herbalist can report side effects. You can report it to the Medicines and Healthcare Regulatory Authority (MHRA). The MHRA is the UK regulatory body. It collects information about the side effects of drugs, including herbal medicines.

Let both your herbalist and doctor know immediately if you feel worse or ill while you are taking herbal medicine.

There is no reliable evidence from human studies that herbal remedies can treat, prevent or cure any type of cancer.

Some clinical trials seem to show that certain Chinese herbs may help people to live longer, might reduce side effects, and help to prevent cancer from coming back. This is especially when combined with conventional treatment.

But many of the studies are published in Chinese, and some of them don't list the specific herbs used. Some journal articles don't give enough detail on how the researchers did the studies.

It is difficult to know how reliable the research is and which herbs may be helpful. But there are trials looking into this.

There is no reliable evidence that herbal remedies can prevent cancer.

Chinese researchers did a cohort study in 2018. A cohort is a group of people, so cohort studies look at groups of people. The researchers follow the group over a period of time.

The researchers in this study looked at people with oesophageal (food pipe) cancer. And who might develop a second primary (new) cancer of the head and neck. The researchers followed the group over 10 years. One part of the group received Chinese Herbal Medicine (CHM) and the other part did not.

The results showed that the group of people who took CHM had fewer cases of a second primary cancer of the head and neck. This was when the researchers compared them to the group that did not take CHM. The researchers suggested that CHM might prevent a second primary cancer of the head and neck in people with oesophageal cancer. The results looked promising. But the people in the study received different types of CHM. This might make the results of the study less accurate.

There is evidence that some herbal remedies might prevent or relieve cancer symptoms. And that it might help with treatment side effects. But we need results from large clinical trials. This way we can know which herbs are safe to use alongside conventional cancer treatment.

ACochrane review of studies in 2018 looking at preventing a dry mouth in people having radiotherapy for head and neck cancer. They found that there was not enough evidence to say that Chinese Herbal Medicine (CHM) can prevent the feeling of dry mouth. This was in people who had radiotherapy with or without chemotherapy to the head and neck.

Another Cochrane review of studies in 2018found that there was not enough evidence to use CHM as a treatment for oesophageal cancer. But they said that it might help with quality of life. And that it might relieve some side effects caused by radiotherapy and chemotherapy.

A third Cochrane review of studies in 2018 looked at moxibustion. Moxibustion involves the burning of herbs above the skin at acupuncture pressure points.

The researchers found little evidence to say that it helped with side effects of radiotherapy and chemotherapy. Or that it helped with quality of life in people with cancer. But the researchers felt that the evidence was not clear enough to rule out some benefits or risks of this treatment. They suggested better quality studies.

Another review in 2020 looked at whether acupuncture and moxibustion could help with cancer related fatigue (tiredness). Some of the studies suggested that these types of Chinese medicine might help with fatigue. They say more research is needed with better quality studies.

Chinese researchers did a review study in 2019. The researchers looked at studies that used different types of CHM. The studies looked at how to relieve perimenopausal symptoms in women who had surgery, chemoradiotherapy or hormone treatment for breast cancer. Perimenopausal means the transition time to full menopause.

The researchers found that CHM might improve perimenopausal symptoms. But suggested better quality, precise and in-depth studies.

Some laboratory tests have found certain plants or plant extracts have anti-cancer qualities. Manufacturers made these into cancer drugs such as Taxol from the Pacific yew tree.

But, there is no scientific evidence from human trials that herbal medicine can treat or cure cancer. We need large trials to prove this.

Researchers did a laboratory study in 2019. They looked at the use of Chang-wei-qing (CWQ) as a treatment to prevent a certain type of bowel cancer. The researchers found that CWQ showed an anti-cancer (anti-tumour) effect. But this was a laboratory study, and we need more research.

Chinese researchers did a case study of 182 patients with pancreatic cancer. All of the patients received Chinese Herbal Medicine (CHM). It showed that people having herbal medicine might survive longer. This was a case study and isnt evidence to use it as a treatment. We need more research.

Chinese researchers did a review study in 2018. They looked at several studies on CHM. The researchers said that CHM showed positive results. This was as a therapy to use with other types of cancer treatment. They also said that CHM can help chemotherapy and radiotherapy to work better.

They felt that CHM can help to control certain cancer genes. And that it can influence the way cancer cells work. But they recommended more research to understand exactly how CHM works.

A Cochrane reviewin 2016looked at studies using a type of CHM called Ganoderma lucidum to treat cancer. The researchers found that there was not enough evidence to use Ganoderma lucidum as a treatment for cancer. But they suggested that it might be used alongside conventional cancer treatment to boost immunity. The researchers also said that future research should be of better quality studies.

Your first consultation with a herbalist will usually cost more than further appointments. Follow up appointments are generally shorter, so are likely to cost less.

You will also have to pay for the herbs your herbalist prescribes. These costs may vary from place to place in the UK.

Some herbal products in health food shops and pharmacies have to meet quality standards. They also need to provide information about their product. This includes the specific content and dose of the product and how safe it is.

In Europe, always buy products registered under the Traditional Herbal Remedies (THR) scheme. Remedies registered under the scheme have a THR mark and symbol on the packaging. THR products have been tested for quality and safety.

The Medicines and Healthcare products Regulatory Agency (MHRA) regulates the registration of herbal products in the UK.

Some unlicensed herbal products have been found to contain illegal substances and toxic herbs. The manufacturers have not listed this on the packaging of the product. The amount of the active ingredient can also vary widely between products.

It is safest to buy herbal remedies from a fully qualified herbal practitioner. They have had training to work out which medicines are appropriate for you. They can also trace where their herbs and plants come from.

It is understandable that you might want to try anything if you think it might help treat or cure your cancer. Only you can decide whether to use an alternative cancer therapy such as herbal medicine.

You could harm your health if you stop your cancer treatment for an unproven treatment.

Some websites might promote herbal medicine as part of treatment for cancer. But no reputable scientific cancer organisations support any of these claims.

You can get further information about herbal medicines from the following organisations.

The EHTPA covers a group of organisations representing Ayurveda, Chinese Herbal Medicine, Traditional Tibetan Medicine and Western Herbal Medicine within Europe. They are working together to develop a set of practice and training standards for herbal medicine.

EHTPA6 BarnfieldEppingCM16 6RL

Email:info@ehtpa.org

The BHMA aims to protect herbal medicine users, practitioners and manufacturers. It has an information service and can refer to locally qualified herbal practitioners.

PO Box 583ExeterDevonEX1 9GX

Tel: 0845 680 1134Email: secretary@bhma.info

151 Buckingham Palace RoadLondonSW1W 9SZ

Telephone: 020 3080 6000Email: info@mhra.gsi.gov.uk

The MHRA regulates medicines, medical devices and blood components for transfusion in the UK. This includes herbal products.

They have information about:

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Herbal medicine | Complementary and alternative therapy | Cancer ...