Which CAM therapies merit study?

[Guest guest]

Docs:

Interesting but typical medical perspective on CAM therapies by

Offit, M.D. For those of you registered with WebMD, here is the link

to the video:

http://www.medscape.com/viewarticle/763604?src=mp & spon=38

Lyndon McGill, D.C.

EvolvHealth Wellness Advisory Council Member

Salem, Oregon

www.SalemSpineClinic.com

www.EvolvingDaily.com

Which Complementary and Alternative Therapies Merit Study?

A. Offit, MD

Posted: 05/17/2012

Hi. My name is Offit. I am speaking to you today from the Vaccine

Education Center at the Children's Hospital of Philadelphia.

I thought I would talk about a viewpoint piece that appeared in

the most recent issue of the Journal of the American Medical

Association.[1] It involved studying

complementary and alternative medicines, specifically focusing on

the National Center for Complementary and Alternative Medicine.

This center was born as the Office of Alternative Medicine, in

1992, by the influence of 2 Iowa politicians. One was Tom Harkin,

who believed that bee pollen had cured his hay fever. The other

was Berkley Bedell, who believed that cow colostrum had cured his

Lyme disease. Their notion was that alternative medicines, if

studied, would move into the mainstream.

Since the founding in 1992, the National Center for Complementary

and Alternative Medicine (NCCAM) has received about $1.6 billion

of federal money to study a variety of things. What they have

studied has been disappointing. They spent hundreds of thousands

of dollars to see whether prayer treated AIDS; to see whether

prayer could promote wound healing after breast reconstruction

surgery; to see whether coffee enemas could treat pancreatic

cancer; to see whether magnets (in mattresses or otherwise) could

improve carpal tunnel syndrome, migraines, or arthritis; in

addition to whether lemon or lavender scents could improve

arthritis. I think the disappointing part of these studies is that

they are not based on any biological principle. In fact, they seem

to hark back to a much more distant time, before we really

understood the pathophysiologic basis of diseases and were able to

direct treatments towards them.

You could argue that negative studies are of some value, even

when they are not based on any sound biological principle. For

example, when Wakefield claimed that the measles, mumps,

and rubella vaccine caused autism, or when there were fears that

thimerosal and ethyl mercury-containing preservative in vaccines

caused autism, they, too, were not based on any biological

principle. But in any case, those negative studies were useful in

being able to reassure parents that their concerns or fears about

those vaccines were ill founded and that studies showed that

vaccines do not cause autism.

One could then argue that these negative studies are of some

value, but that does not seem to be true in regard to

complementary and alternative medicine. Many studies have shown

that megavitamins are not what they are claimed to be. In fact, a

number of studies have shown that megavitamins can increase one's

risk for heart disease or cancer or shorten a person's life.

Studies have shown that chondroitin sulfate and glucosamine do not

treat arthritis, or that St. 's wort does not treat

depression, or that ginkgo does not improve memory, or that garlic

does not lower low-density lipoprotein cholesterol, yet we are

still looking at alternative and complementary medicine, a $34

billion-a-year business. I think few people are aware of those

studies, so it hasn't really changed behavior.

For these reasons, I think that NCCAM should reevaluate its

portfolio. One could argue that just because an alternative

medicine does not work better than placebo, that doesn't mean that

placebos don't work; or, said another way, that alternative

medicines can act as placebos. If NCCAM wants to study the placebo

response or the physiologic basis of the placebo response, I think

that is of value. But I do think that studies that have bases

that, frankly, border on mysticism are not of value. Thank you for

your attention.

References

Offit PA. Studying complementary and alternative

therapies. JAMA. 2012;307:1803-1804. Abstract

Medscape Infectious Diseases © 2012 WebMD, LLC