News from the Office of Womens Health
What is Complementary and Alternative
Complementary and alternative medicine (CAM)also referred to as
integrative medicineincludes a broad range of healing
philosophies, approaches, and therapies. A therapy is generally called
complementary when it is used in addition to conventional
treatments; it is often called alternative when it is used instead
of conventional treatment. (Conventional treatments are those that are
widely accepted and practiced by the mainstream medical community.) Depending
on how they are used, some therapies can be considered either complementary or
alternative. Complementary and alternative therapies are used in an effort to
prevent illness, reduce stress, prevent or reduce side effects and symptoms, or
control or cure disease. Some commonly used methods of complementary or
alternative therapy include mind/body control interventions such as
visualization or relaxation, manual healing including acupressure and massage,
homeopathy, vitamins or herbal products, and acupuncture.
Scientific evaluation is important in understanding if and when
complementary and alternative therapies work. A number of medical centers are
evaluating complementary and alternative therapies by developing scientific
studies to test them. Conventional therapies have generally been studied for
safety and effectiveness through a rigorous scientific process, including
clinical trials with large numbers of patients. Often, less is known about the
safety and effectiveness of complementary and alternative methods and some have
not undergone rigorous evaluation. Others, once considered unorthodox, are
finding a place in medicinenot as cures, but as complementary therapies
that may help patients feel better and recover faster. Some approaches have
been studied and found ineffective or potentially harmful.
Patients considering complementary and alternative medicine should discuss
this decision with their health care provider, as they would any therapeutic
approach, because some complementary and alternative therapies may interfere
with their standard treatment or may be harmful when used with conventional
treatment. Always be sure to notify your health care provider of any
complementary or alternative therapies you have taken or are taking.
When considering complementary and alternative therapies, patients should
ask their health care providers the following questions:
- What benefits can be expected from this therapy?
- What are the risks associated with this therapy?
- Do the known benefits outweigh the risks?
- What side effects can be expected?
- Will the therapy interfere with conventional treatment?
- Will the therapy be covered by health insurance?
Classification of Alternative Medicine Practices
This classification system was designed by the National Center for
Complementary and Alternative Medicine at the National Institutes of Health
(NIH) to assist in prioritizing applications for research grants in
complementary and alternative medicine (CAM). Following is a list of seven
categories recognized by NIH, along with some examples of the more well-known
practices within each category.
Mind-body medicine involves behavioral, psychological, social, and spiritual
approaches to health. Examples include yoga, tai chi, biofeedback, hypnosis,
meditation, spiritual healing and art therapy.
Alternative Medical Systems
This category involves complete systems of theory and practice that have
been developed outside of the Western biomedical approach. Examples include
acupuncture, homeopathy, herbal medicine, Auyervedic medicine, naturopathy and
Lifestyle and Disease Prevention
This category involves theories and practices designed to prevent the
development of illness, identify and treat risk factors, or support the healing
and recovery process. Lifestyle and disease prevention is concerned with
integrated approaches for the prevention and management of chronic disease in
general or the common determinants of chronic disease. To be classified as CAM,
the changes in lifestyle must be based on a nonorthodox system of medicine, be
applied in unconventional ways, or be applied across non-Western diagnostic
This category includes natural and biologically-based practices, interventions,
and products. Many overlap with conventional medicines use of dietary
supplements. Examples include phytotherapy and herbalism (ginko biloba,
echinacea, green tea); special diet therapies (Pritikin, macrobiotic); and
nutritional and food supplements used for preventive or therapeutic purposes
(melatonin, co-enzyme Q10, niacinamide).
Manipulative and Body-Based Systems
This category refers to systems that are based on manipulation and/or movement
of the body. Examples include chiropractic medicine, massage therapy,
acupressure, reflexology, colonics, hydrotherapy.
Biofield medicine involves systems that use subtle energy fields in and around
the body for medical purposes. Examples include Reiki, therapeutic touch.
Bioelectromagnetics refers to the unconventional use of electromagnetic fields
for medical purposes.
National Center for Complementary and Alternative Medicine
Alternative Medicine-- What Consumers
Public interest in alternative medicine has
given new life to a number of healing approaches and has created quite a stir
among many conventional health practitioners. Research on the effectiveness of
alternative therapies has grown, as has the number of practitioners of
"unconventional" medicine. Highly esteemed academic and research
institutions, such as Harvard University and the National Institutes of Health,
are studying the effects that alternative treatments have on healing. And
procedures such as chiropractic increasingly are finding their way onto lists
of health services that insurance companies will pay for.
Alternative medicine - sometimes also
referred to as holistic medicine, complementary or integrative medicine,
mind-body medicine, or unconventional medicine - takes many forms. Some of the
more well-known alternative therapies include acupuncture, aromatherapy,
biofeedback, chiropractic, homeopathy, massage therapy, and naturopathy.
As more health care consumers choose
alternative practices to complement or replace their existing medical care,
it is critical that they become educated and discriminating about their
options. Here are some things to keep in mind when considering alternative
- Learn your options, keeping in mind that alternative health healing
covers everything from fads to promising and proven therapies.
- Seek referrals from family members, friends and other health care
providers. Consider interviewing more than one provider.
- Seek the advice of your physician or other qualified health provider
before starting any new treatment or procedure involving your health.
- Don't delay seeking medical care - or disregard taking medical
advice - because of something you may read or hear about alternative medicine.
- Understand that indiscriminate use of some of the alternative
therapies and procedures could be harmful to your health.
- Consider the source of information you review. Many Web sites are
maintained by adherents of particular alternative approaches. They are going to
be very enthusiastic about their methods. Conduct a reality check. Seek
information with balanced views.
- Consider alternative medicine a supplement to - not a replacement
for - conventional medicine.
Alternative and Complementary Medicine Web Sites
These links are provided as an educational resource and are not intended to
take the place of the advice of a physician or health care provider nor does
their inclusion here constitute any endorsement by the Illinois Department of
Public Health. Do not seek any alternative therapy without first consulting
your physician or health care provider.=
The National Center for Complementary and
MedlinePlus Alternative Medicine
National Women's Health Information Center
Healthfinder Alternative Medicine topics
U.S. Food and Drug Administration
National Institutes of Health Environmental Health Information Service
The American Botanical Council
Alternative Medicine News
Editors note: In Illinois ,the Department of Professional Regulation
licenses chiropractors and acupuncturists. For information, contact that agency
320 W. Washington St.
Springfield, IL 62786
TTY (hearing impaired use only) 217-524-6735
Guide to Dietary Supplements
A local health food store offers yet another brand of edible items: bottled
herbs like cat's claw, dandelion root and blessed thistle. Vitamins and
minerals in varying doses. Herbal and nutrient concoctions whose labels carry
claims about relieving pain, "energizing" and "detoxifying"
the body, or providing "guaranteed results."
This store sells dietary supplements, some of the hottest selling items on
the market today. Surveys show that more than half of the U.S. adult population
uses these products. In 1996 alone, consumers spent more than $6.5 billion on
dietary supplements, according to Packaged Facts Inc., a market research firm
in New York City. But even with all the business they generate, consumers still
ask questions about dietary supplements: Can their claims be trusted? Are they
safe? Does the Food and Drug Administration approve them? Many of these
questions come in the wake of the 1994 Dietary Supplement Health and Education
Act, or DSHEA, which set up a new framework for FDA regulation of dietary
supplements. It also created an office in the National Institutes of Health to
coordinate research on dietary supplements, and it called on President Bill
Clinton to set up an independent dietary supplement commission to report on the
use of claims in dietary supplement labeling.
What Is a Dietary Supplement?
Traditionally, dietary supplements referred to products made of one or more
of the essential nutrients, such as vitamins, minerals, and protein. But DSHEA
broadens the definition to include, with some exceptions, any product intended
for ingestion as a supplement to the diet. This includes vitamins; minerals;
herbs, botanicals and other plant-derived substances; and amino acids and
concentrates, metabolites, constituents and extracts of these substances. It's
easy to spot a supplement because DSHEA requires manufacturers to include the
words "dietary supplement" on product labels.
Dietary supplements come in many forms, including tablets, capsules,
powders, softgels, gelcaps, and liquids. Though commonly associated with health
food stores, dietary supplements also are sold in grocery, drug and national
discount chain stores, as well as through mail-order catalogs, TV programs, the
Internet, and direct sales. One thing dietary supplements are not is drugs. A
drug, which sometimes can be derived from plants used as traditional medicines,
is intended to diagnose, cure, mitigate, treat, or prevent diseases. Before
marketing, drugs must undergo clinical studies to determine their
effectiveness, safety, possible interactions with other substances, and
appropriate dosages, and the FDA must review these data and authorize the
drugs' use before they are marketed. FDA does not authorize or test dietary
supplements. A product sold as a dietary supplement and touted in its labeling
as a new treatment or cure for a specific disease or condition would be
considered an unauthorized--and thus illegal--drug. Another thing dietary
supplements are not are replacements for conventional diets, nutritionists say.
Supplements do not provide all the known--and perhaps unknown--nutritional
benefits of conventional food.
Before starting a dietary supplement, it's always wise to check with a
medical doctor. It is especially important for people who are:
- pregnant or breastfeeding
- chronically ill
- under 18
- taking prescription or over-the-counter medicines. Certain supplements can
boost blood levels of certain drugs to dangerous levels.
Are you considering alternative therapies?
The decision to use complementary and alternative treatments is an important
one. Following are topics to consider before selecting an alternative therapy.
Assess the Safety and Effectiveness of the Therapy
Generally, safety means that the benefits outweigh the risks of a treatment
or therapy. A safe product or practice is one that does no harm when used under
defined conditions and as intended. Effectiveness is the likelihood of benefit
from a practice, treatment, or technology applied under typical conditions by
the average practitioner for the typical patient. You may want to ask the
health care practitioner about the safety and effectiveness of the therapy or
treatment he or she uses. Tell the practitioner about any alternative or
conventional treatments or therapies you may already be receiving, as this
information may be used to consider the safety and effectiveness of the entire
For general, nonscientific information, thousands of articles on health
issues and complementary and alternative medicine are published in books,
journals, and magazines every year. Ask the practitioner about specific new
research that may support or not support the safety and effectiveness of the
treatment or therapy. Ask about the advantages and disadvantages, risks, side
effects, expected results, and length of treatment that you can expect. Speak
with people who have undergone the treatment. Controlled scientific trials
usually provide the best information about a therapys effectiveness and
should be sought whenever possible.
Examine the Practitioner's Expertise
Health consumers may want to take a close look into the background,
qualifications, and competence of any potential health care practitioner,
whether a physician or a practitioner of alternative and complementary
healthcare. First, contact a state or local regulatory agency with authority
over practitioners who practice the therapy or treatment you seek. Appropriate
state licensing is the only way to ensure that the practitioner is competent
and provides quality services. Second, talk with those who have had experience
with this practitioner or a local consumer affairs department. Find out about
the confidence in and competence of the practitioner in question, and whether
there have ever been any complaints from patients. Third, talk with the
practitioner in person. Ask about the practitioners approach to treatment
and patients. Find out how open the practitioner is to communicating with
patients about technical issues, possible side effects, and potential problems.
Look for a practitioner who is easy to talk to. You should feel comfortable
Consider the Service Delivery
The quality of the service delivery, or how the treatment or therapy is
given and under what conditions, is an important issue. Visit the
practitioners office, clinic, or hospital. Ask the practitioner how many
patients he or she typically sees in a day or week, and how much time the
practitioner spends with the patient. Look at the conditions of the office or
clinic. Can the service be obtained only in one place, requiring travel to that
place? These issues may serve as warning signs of poor service.
Consider the Costs
Costs are an important factor to consider as many complementary and
alternative treatments are not currently reimbursed by health insurance. Many
patients pay directly for these services. Ask your practitioner and your health
insurer which treatments or therapies are reimbursable. Find out what several
practitioners charge for the same treatment to better assess the
appropriateness of costs. Regulatory agencies and professional associations
also may provide cost information.
Consult Your Healthcare Provider
Most importantly, discuss all issues concerning treatments and therapies
with your health care provider whether a physician or practitioner of
complementary and alternative medicine. Competent health care management
requires knowledge of both conventional and alternative therapies for the
practitioner to have a complete picture of your treatment plan.
In the last few months, there have been some changes in the Office of
In November 1999, Conny Mueller Moody joined the office as chief of the
Division of Womens Health Services. She administers the Illinois Breast
and Cervical Cancer Program and does legislative analysis for the office. Conny
was formerly a senior health policy analyst for the Departments Office of
Health Protection where she developed policy papers on topics such as managed
care, infectious diseases and food safety.
In March, Lois Vogel became chief of the Division of Technical Support. Her
responsibilities include the offices promotion plan and outreach efforts,
including teleconferences, seminars and workshops. Lois also oversees the
Womens Health Initiative Grant process. She came to the Office of
Womens Health from the IDPH Training and Resource Center where she
developed and led training sessions on a variety of human resources topics.
We have a new look and a new name. Formerly Friend-to-friend,
Womens Health Beat newsletter is published quarterly by the
ILLINOIS DEPARTMENT OF PUBLIC HEALTH.