According to a study* published in the Journal of the American Medical Association (JAMA, 11/11/98), four out of ten people in the United States used alternative medicine therapies in 1997. This, according to the prestigious publication, represents an increase of 50 percent over the number of visits made to alternative practitioners in 1990 and exceeded the number of visits to U.S. primary care physicians. Even more dramatic, Americans

According to the study reported in JAMA, the top 16 alternative therapies include: relaxation techniques, herbal medicine, massage, chiropractic, spiritual healing by others, megavitamins, self-help, imagery, commercial diet, folk, lifestyle diet, energy healing, homeopathy, hypnosis, biofeedback and acupuncture.

People reported using the alternative techniques most often for chronic conditions including back and neck problems, anxiety, arthritis and headaches. The study found that 42 percent of all alternative therapy is used for existing illness while 58 percent is for prevention and/or health maintenance. 

A sure sign that alternative medicine is not a passing fad is the fact that an increasing number of U.S. in surance companies and managed care organizations are now offering coverage of these therapies and services, and a large number of American medical schools are now offering courses in alternative therapies. In 1992, the National Institutes of Health (NIH) created its Office of Alternative Medicine to study popular techniques and modalities that fall outside the realm of conventional treatment.

One of the factors that has contributed to the increase in use of non-traditional therapies has been the gnawing dissatisfaction of patients with a health care system that has become increasingly depersonalized and remote. 

People complain about being treated as a part of an assembly line or as an "internal organ" rather than as the person attached to it. Another concern expressed is that, all too often, after taking expensive pharmacological treatments, they have simply traded symptoms for side-effects. 

Patients with chronic illnesses especially express this frustration and say it is necessary for them to regain control over their disease. They believe there might be something beyond the limits of conventional medicine that could offer a cure or at least a more humane treatment -- all they have to do is find it.

At the heart of the alternative medicine "boom" appears to be the importance of the patient’s unique relationships, values, attitudes, beliefs, spirituality and emotions, with the center being the unwavering belief in the body’s ability to heal itself. Closely related is the focus on the belief that all aspects of a person -- body, mind and spirit -- are interrelated and should be treated as a "whole." The key concept of many alternative therapies revolves around balance -- balance between a person’s physical and spiritual self, life and environment.

One of the therapies that has recorded the greatest increase in usage is herbal medicine -- the use of various parts of plants to treat symptoms and promote health.

Herbs have been around for centuries and have a long history in medicine; in fact, about 25 percent of all our prescription medications are derived from them. People think that because herbs are natural, they can be taken at will. That is completely incorrect. The problem is that herbs contain chemical components that can produce dangerous -- even fatal -- reactions with certain medications. 

The Eisenberg researchers reported that less than 40 percent of patients disclose their use of alternative therapies to their doctors. This, they say, is cause for concern because many people take prescription and herbal remedies concurrently.

One in five people who take prescription medications also take herbs, high-dose vitamin supplements -- or both -- the report states; a practice that may be putting an estimated 15 million adults at risk each year for potential unintended interactions between prescriptions and herbal remedies.

Many people say that herbal remedies for routine ailments like colds, hay fever and the flu don’t affect them as strongly and seem to help without the "mediciney" feeling side effects. These botanical remedies are packaged as capsules, tablets, concentrated extracts, teas, tinctures and salves.

All this natural medicine may be relatively new to Americans, but Europeans have long considered botanicals an important complement to conventional medicine. In Germany, for example, doctors routinely prescribe herbal preparations for insomina, colds, depression and even for heart problems. Half the antidepression prescriptions written by German doctors are for Saint-John’s-wort -- an herb now under active study as an AIDS drug.

Today, there are pharmacologic experts on herbal medicine at leading universities throughout the country. Many are convinced that the proper use of herbs can add a positive dimension to health care. They argue that herbal medicine is like any other kind of medicine; it should be used with discretion. Let’s find out what really works, they say, and get rid of what doesn’t. 

Interestingly enough, there are a lot of people today who don’t have a second thought about swallowing a hand-full of herbal capsules but who won’t take a single aspirin. It is this faith in botanical or herbal remedies that has both medical doctors and naturalists alike concerned.

There are more than 600 botanical remedies sold in the U.S. Only sixteen or so of these are allowed to make medicinal claims by the FDA. On the other hand, the FDA lists nine herbs that can cause serious problems, including kidney failure and stroke: chaparral, comfrey, germander, jin bu huan, lobelia, magnolia, ma huang, stephania, and yohimbe.

The potential for drug interactions with herbs is not so obvious, but the problem is finally receiving considerable attention in the popular media. 

Since research has shown that patients who use alternative medicine tend to combine it with conventional therapies, the two may not be that far apart phisolophically. Both medical doctors and practitioners of alternative therapies share the Hippocratic ideal: First, do no harm.

Most people agree that those who decide to use nontraditional therapies should obtain as much information as possible about the treatment and the people who will be providing it, and that certainly includes herbs or botanical therapies. Start with the fact that "natural" doesn’t necessarily mean "safe." Herbs and vitamins might be safe, but they can still cause potential dangerous side effects. Don’t experiment without checking with your doctor.

Be honest and advise your physician and any specialists you may see about any alternatives you may be considering. 

Obtaining an accurate diagnosis and having a candid discussion of proven treatment options is the best place to start before "self-medicating" with botanicals or herbs. These treatments should not be used at all if the patient is pregnant or contemplating pregnancy.

Physicians should, on the other hand, ask about the use of herbal therapies and diet supplements, note them on the patient’s chart, and discuss any potential herbal-pharmaceutical interactions. 

Herbal treatments should not be used for more than several weeks or in larger-than-recommended doses. And, in cases where side effects are experienced, all herbal remedies should be discontinued at once. 

The table below lists some of the 
popular herbs, what they are used for, 
and cautions about their use.