Natural doesn’t mean safe. And CAM is neither.

From the FMS Global and UK News Desk of Jeanne Hambleton

Courtesy of Pulse, CMP Medica. All rights reserved.

Professor Edzard Ernst Blog – 06 Apr 09

It is surprising how easily people fall for the argument that complementary or alternative therapies are safe, because they are natural. Yet on both counts, this argument is false.

One of the strongest selling points for complementary or alternative therapies is the notion that they are natural – and anything natural is, of course, safe is not it?

It is surprising how easily people fall for this nonsense – even GPs. And who can blame them? If we hear something a hundred times, we tend to believe it. This is called brainwashing! I can think of a lot of things that are natural and outright dangerous: an earthquake, a flash of lightning, a landslide, a tsunami, etc, etc, etc.

What is natural about sticking needles into people’s skin? What is natural about serial dilution as in homeopathy? What is natural about cracking bones as in chiropractic?
But seriously, most complementary or alternative treatments are neither natural nor totally safe. The answer is, not a lot!

But these treatments could still be safe. The trouble is however, that this notion is not true either. Sure, most of these treatments probably have less adverse effects than the powerful drugs of mainstream medicine, but risk-free? No.

One problem with assessing therapeutic risks reliably is that you need to actively look for adverse effect. The information rarely falls into your lap. So who is looking?

The answer is nobody.

Apart from the yellow card scheme which does cover adverse effects of herbal treatments, there is no mechanism in complementary or alternative medicine that would record adverse effects, not even serious ones.

Some years ago, I wrote to all UK professional organisations of complementary medicine asking them how they monitor adverse effects in their area of healthcare. The answers were almost entirely uniform: we do not need post marketing surveillance because we do not cause harm; this is only an issue in mainstream medicine.

So, is it fair then to say that we know of no risks because, so far, nobody has looked out for them? Not quite. We do know a little bit about risks of complementary or alternative medicine because, like sailing past the tip of an iceberg during bright daylight, we could not help noticing. But systematic knowledge akin to the one in conventional healthcare is usually not available.

For instance, we know of approximately 700 patients who suffered severe injuries, mostly vascular accidents, after spinal manipulation. Despite this impressive figure – a drug with this track record would probably have been banned long ago – most chiropractors insist that a causal link has not been established.


Why ‘belief’ in complementary medicine is misguided

Courtesy of Pulse, CMP Medica. All rights reserved.
Professor Edzard Ernst Blog – 23 Mar 09

Professor Edzard Ernst begins his blog by challening ‘belief’ in complementary and alternative medicine and answers the question ‘how come you are a professor of CAM and do not seem to be in favour of it?’

Have you ever heard anyone say, I believe in Aspirin, in bone marrow transplants, or in surgery? Probably not.

Have you ever heard someone proclaim to believe in homeopathy, energy healing or reflexology? I am sure you have. CAM – complementary and alternative medicine – is an emotive subject where belief reigns supreme over science.

But healthcare should not be about belief, it should be about facts: “Science commits suicide when it adopts a creed” (Thomas Huxley).

With this blog, I will try to regularly provide interesting facts, figures and views on CAM.

Such information might be handy when your patients come with printouts from the internet – there are currently around 50 million websites on “alternative medicine”, and the vast majority are dangerously misleading – or with cuttings from the daily papers. in Britain, newspapers carry roughly 3 times more articles on CAM than on conventional medicine.

About 20% of your patients use some form of CAM and most of them will not volunteer this information to their GP. Therefore, GPs should know more about CAM.

For or against CAM?

The question I hear regularly is “how come you are a professor of CAM and do not seem to be in favour of it?”

I usually answer that a toxicologist’s task is not to dish out poisons to patients. People then tend to give me a blank smile, and I realize that I have probably failed to get my point across.

And yet, it is a simple point: I do not see myself as a promoter of CAM, nor am I an opponent of it. My task is merely to research the subject and subsequently present the findings. This I have done for 15 years. It resulted in over 1000 articles in the peer-reviewed literature. Through this work, many issues have become quite clear.

CAM is currently dominated by belief and by misinformation. Some of this misinformation puts patients’ health (or savings) at risk. So I often feel compelled to speak out and try to put the record straight. This does not always make for cosy friendships, and some people may even feel attacked. Yet I am not in the “attacking business” – merely in the “truth telling business”.

Convinced? No? Perhaps I can give an example relevant for general practice. In our book, ‘The Oxford Handbook of Complementary Medicine’, my three co-authors and I try to clearly point out what the evidence for a wide range of CAMs shows.

In the chapter on hypertension, for instance, we state that, according to reliable studies, biofeedback lowers systolic and diastolic blood pressure. We also tell our readers what to expect of around 30 other CAM treatments that have been tested for antihypertensive effects. Lastly we point out that the best clinical evidence available to date indicates that chiropractic might cause more harm than good for this indication.

I hope that this example demonstrates that I am neither for or against CAM. All I want is sound evidence, transparency and single standards in medicine. And this I will try to provide here.


Complementary therapies do not save NHS money

Courtesy of Pulse, CMP Medica. All rights reserved.

By Nigel Praities – 30 Mar 09

Complementary therapies can improve quality of life but there is little evidence they reduce NHS costs, new research concludes.

The first study to review all the evaluations of NHS complementary therapy services showed positive changes in the health status of patients but mixed evidence on cost.

The University of Bristol researchers collated data from 21 evaluations of 14 NHS services and found SF36 general health scores were increased in all studies where they were measured, with increases ranging from 0.5 to 8.9.

Figures on costs were variable, with a study of a homeopathy service showing total prescription savings of nearly £9,000, but others showing no change or increases in costs of around 50 pence per patient.

Dr Lesley Wye, lead author and research fellow in primary health at the University of Bristol, said: ‘The health status data seems to suggest that people using these services are feeling better, that they notice some sort of a difference.

‘But in terms of NHS cost it was all over the place. Some of them showed the cost went up, some went down and some it stayed the same,’ she said.

The researchers warned there was a need for ‘greater rigour’ in how the NHS measures the success of complementary therapies, with more data on health outcomes and a better evaluation of costs.

Dr Catherine Zollman, a GP who provides several complementary therapies at her practice in Bristol, said the study showed how difficult it was to collect data on the benefits of complementary therapies, but that this did not mean they were not useful for some patients.

‘I think it depends on the patient and the condition, but I think there are certain pockets where the NHS could make really big savings,’ she said.

The study was published this month in BMC Complementary and Alternative Medicine journal.

Pulse, CMP Medica. All rights reserved

About jeanne hambleton

Journalist-wordsmith, former reporter, columnist, film critic, editor, Town Clerk and then fibromite and eventer with 5 conferences done and dusted. Interested in all health and well being issues, passionate about research to find a cure and cause for fibromyalgia. Member LinkedIn. Worked for 4 years with FMA UK as Regional Coordinator for SW and SE,and Chair for FMS SAS the Sussex and Surrey FM umbrella charity and Chair Folly Pogs Fibromyalgia Research UK - finding funding for our "cause for a cure" and President and co ordinator of National FM Conferences. Just finished last national annual Fibromyalgia Conference Weekend. This was another success with speakers from the States . Next year's conference in Chichester Park Hotel, West Sussex, will be April 24/27 2015 and bookings are coming in from those who raved about the event every year. I am very busy but happy to produce articles for publication. News Editor of FMS Global News on line but a bit behind due to conference. A workaholic beyond redemption! The future - who knows? Open to offers with payment. Versatile and looking for a regular paid column - you call the tune and I will play the pipes.
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