What is Alternative Medicine?
Alternative medicine is an alternate to conventional or orthodox
treatment of a disease. Complementary medicine is an adjunct
or complement to, rather than a substitute for, conventional
treatment. Integrative medicine embodies the concepts of alternative
and complementary medicine, becoming a partner with conventional
treatment for the best possible management of patients.
According to a survey of those in the United States who say
they use alternative therapy, 48 percent stated it was not harmful
and it helped, 36 percent stated that conventional medications
were not efficacious, 33 percent said alternative medicine was
more natural and 23 percent said they had side effects from their
regular medications.
An Eisenberg interview of approximately 2,000 people with recent
Canadian studies of 18,000 people in 1197 show that 42 percent
of adults have used alternative or complementary medicine, with
630 million alternative therapy visits (exceeding the total visits
to primary care physicians), $27 billion spent on visits and
out-of-pocket expenditures for herbal therapies, megavitamins,
etc., and $21 billion for U.S. physician services in the same
year.
However, those in the United States practice integrative medicine
less frequently than those in Canada and Europe. Those who were
referred to integrative medicine practitioners are as follows:
Canada, 50 to 60 percent; Germany, 95 percent; the Netherlands,
97 percent; New Zealand, 70 to 77 percent; United Kingdom (general
practice), 97 percent; and the United States, 30 to 35 percent.
Diabetics and CAM Use
In a 1996 medical expenditure panel survey of a nationally representative
sample of the United States (a non-institutionalized civilian
population) was analyzed. A total of 21,571 individuals were
surveyed. The overall response rate for 1996 was 77.7 percent.
Individuals with diabetes, cancer and hypertension were more
likely to use complementary alternative medicine (CAM) than their
counterparts with no chronic medical condition in the general
population. The five most commonly used CAM therapies in individuals
with diabetes, in order of importance, are nutritional advice
and lifestyle change, spiritual healing, herbal remedies, massage
therapy and medication usage/training.
Similarity, individuals with diabetes were more likely to report
discussing the use of CAM with their regular physician and being
referred by their physician to a CAM provider. The major implication
of this study is that individuals with diabetes seem to use CAM
as a complement rather than an alternative to conventional treatment.
A Few Definitions
Herbal Medicine: The use of medication using plants and the
compounds contained therein. Potential problems must be noted,
and during routine examination, you must document the usage of
herbs in general. Considerations:
- Dosage may be erratic
- Contaminated plants, harmful toxins, etc.
- Interaction with other medications.
Nutraceuticals: Active, organic compounds found in food or synthesized
in the laboratory that enhances the body's homeostatic mechanism.
Micronutrients: Essential vitamins, fatty acids, minerals and
amino acids that are necessary for life. Benefit/risk ration:
There are more benefits in prescribing Micronutrients with minimum
risk.
Drugs that deplete micronutrients: digitalis; captopril and
enalapril; furosemide, beta blockers and calcium channel blockers;
use of antibiotic; nitrogen and chloride; statin drugs, beta
blockers and phenothiazine C0Q10; metaformin (glucophage) decreases
vitamin B-12 and folic acid absorption; glipizide (glucotrol),
glimepiride (amaryl) and glyburide (glynase) deplete C0Q10; magnesium
and vitamin B; zinc deficiency; thiamin; magnesium and vitamin
B; vitamin E; and Vitamin C, iron and magnesium.
In summary, elderly patients using alternative and complementary
medicine should use it under the supervision of a trained physician
who has knowledge of herbs and nutraceuticals. Patients must
let their physician know about herbs they are consuming because
there are lots of drugs that interact with herbs causing harmful
effects.
Patients should not pick up any herbs or nutrient supplements
from the counter without discussing with a health professional.
More doctors will learn and educate themselves if there is a
demand from the public. Let your voice be heard.
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