An alternative approach to conventional medicine and pharmaceutical allergy products involves the use of natural remedies, treatments and therapies – commonly referred to as Complementary and Alternative Medicine and known by the acronym CAM. Before attempting to define what exactly CAM is, we will try to put in perspective the popularity of this approach of treatment.
How Popular is Complementary and Alternative Medicine (CAM)?
Barnes et al. 2008 report on the U.S. 2007 national health survey of 23,393 adults and 9,417 children, revealed that approximately 4 out of 10 adults (38.3%) and one in nine children (11.8%) used some form of CAM. Children’s usage appeared to relate to whether parents used CAM i.e. approximately 5 times more likely if parents were CAM users.
Furthermore, CAM usage appeared to differ by race/ethnicity as follows:
- American Indian or Alaska Native adults (50.3% used CAM)
- White adults (43.1%)
- Asian adults (39.9%)
- Black adults (25.5%)
Nahin et al. 2009 estimated that CAM-related out-of-pocket spending by U.S. adults for 2007 equated to $33.9 billion, of which approximately:
Two-thirds was self-care related. The most popular category of CAM – used by both adults (17.7%) and children (3.9%) (Barnes et al. 2008) and which accounted for 44% spent on self-care products, classes and materials (Nahin et al. 2009) – went on ‘Nonvitamin, nonmineral, natural products’.
‘Nonvitamin, nonmineral, natural products’ as referred to by both the Barnes and Nahin studies, related to dietary supplements other than vitamins and minerals and included “herbs or herbal medicine (as single herbs or mixtures), other botanical products such as soy or flax, and dietary substances such as enzymes and glandular material.” (Nahin et al. 2009).
Barnes et al. 2008 included the following items within this category:
Chondroitin, Coenzyme Q-10, Combination herb pill, Cranberry (pills, gelcaps), Creatine, DHEA (dehydroepiandrosterine), Echinacea, Fiber or psyllium, Fish oil or omega 3 or DHA, Flaxseed oil or pills, Garlic supplements, Ginkgo biloba, Ginseng, Glucosamine, Goldenseal, Grape seed extract, Green tea pills, Lutein , Melatonin, Milk thistle, MSM (methysulfonylmethane), Prebiotics or probiotics, Saw palmetto and Soy supplements or isofavones.
In addition, Barnes et al. 2008 noted that the most commonly used items within this category were fish oil/omega-3/DHA for adults and echinacea for children. Other popular items for adults were glucosamine, echinacea, flaxseed oil or pills and ginseng, whereas for children, it was fish oil/omega-3/DHA, a combination herb pill and flaxseed oil or pills.
One-third went on around 354 million visits to practitioners by just over 38 million adults. Of those visits, approximately 3/4 were related to manipulative and body-based therapies (chiropractic, massage and movement therapies).
What is Complementary and Alternative Medicine (CAM)?
Advocates for using CAM feel that it offers a diverse array of approaches and treatments that are beneficial to maintaining good health, fighting disease and boosting the immune system. Furthermore, supporters maintain that some treatments can help reduce the frequency and severity of an allergic response and help treat allergy symptoms effectively.
As was pointed out previously in Dog Allergies Treatment, Complementary and Alternative Medicine (CAM) refers to:
“Various loosely categorized health and medicinal related systems, practices, products and treatments that are perceived to be outside the remit of conventional medicine.”
Unfortunately, providing a tighter definition is problematic given a number of potential issues which are outlined below.
Issues Associated With Complementary and Alternative Medicine (CAM)
- Terminology.
A complicating factor relates to the different interpretations applied to the terms ‘natural’ or ‘natural products’, ‘complementary’, ‘alternative’ and ‘supplements’ by advocates of natural medicine.
Some people restrict ‘natural’ purely to ingredients or therapies that are unadulterated in any shape or form e.g. treatments prepared using only fresh ingredients grown organically and without the use of pesticides etc. Such individuals may object to those that consider ‘natural products’ to include the use of various ‘supplements’ because many supplements are manufactured on a commercial scale and some contain synthesized or non-natural additives and ingredients.
Others use ‘natural’ freely and interchangeably with both ‘complementary’ and ‘alternative’ medicine. Furthermore, there are those individuals that use the term ‘complementary’ to be synonymous with ‘alternative’ but reserve the term ‘natural’ exclusively for herbs and herbal medicine.
- Categorization.
Differences of opinion amongst natural practitioners and related organizations as to what constitutes a ‘de facto standard’ regarding how to categorize and systematize CAM.
Natural medicine, practice or treatment may fit equally well into more than one category e.g. acupuncture/acupressure can be viewed as an alternative medical system (i.e. traditional Chinese medicine) but also as an example of an energy healing therapy and mind-body practice or manipulative-body practice. This issue parallels the problems concerning categorizing natural ingredients.
- ‘Hydra’ effect – One answer yields two more questions…
The broad and evolving nature of CAM results in the dynamic interplay between CAM and conventional medicine. The issue of who or what determines the point at which a particular medication, treatment or therapy is no longer considered CAM but rather conventional medicine, leads to much heated debate between advocates and skeptics of CAM. For example, there are those skeptics who feel that there can be no ‘3rd way’ or validity/legitimacy to either the terms or practices referred to as complementary or alternative medicine i.e. something either works and can be proven scientifically to do so, or otherwise it does not work.
When coupled with the issues of terminology and categorization noted above, the dynamic and amorphous nature of CAM can result in a situation that can be likened to the mythical Hydra’s head; attempting to provide a reasoned answer to one question will often raise numerous other issues that in turn yield a plethora of further questions. For example, are natural medicines and treatments just a myth – a form of snake oil, quackery or pseudoscience – or do they have genuine medical worth, what is bioavailability and why do some proponents of supplements avoid mentioning it, and what are the risks of using complementary and alternative medicine (CAM)? etc.
Addressing the Issues Associated With Complementary and Alternative Medicine (CAM)
The above issues will be addressed sequentially in various articles as indicated below:
Firstly, CAM Related Terms – Complementary, Alternative, Natural Product, Dietary Supplement, Integrative Medicine will consider key questions concerning CAM terminology that frequently give rise to confusion, namely:
- CAM – What do Complementary and Alternative Mean?
- Is CAM and Integrative/Integrated Medicine the Same?
- What is a Natural Product?
- What is a Dietary Supplement?
- Why are Dietary Supplements so Popular?
- Are all Dietary Supplements CAM?
Next, the issue of categorization will be tackled in Types of Complementary and Alternative Medicine (CAM). The approach shown represents but one from a myriad of possibilities.
Finally, the issue of the ‘Hydra’ effect will then be covered by ongoing articles, for example:
- Natural Remedies, Supplements and the Issue of Bioavailability
- Natural Medicine and Treatments – Fact or Fiction?
- Risks of Using Complementary and Alternative Medicine (CAM) – Why ‘Natural’ in ‘Natural Medicine’ Does Not Guarantee Safety.
