Proponents of CAM often claim that one major advantage to their methods is the absence of side effects seen with conventional medical treatments. This makes little sense since there is no “free lunch” in physiology, and an intervention that affects one part of the system is going to have effects on other parts as well. Those practitioners who claim a “holistic” approach ought to realize this. If the treatment has absolutely no side effects, it’s probably because it isn’t doing anything at all.
And there is plenty of evidence that some CAM treatments can be harmful. While certain therapies, like homeopathy or reiki, may have little direct harm, they can still discourage patients from seeking and complying with more effective, evidence-based therapies. And the very CAM therapies most likely to turn out to have real benefits, herbal preparations, are also the most likely to cause unintended harmful effects, which is why they need to be properly studied before being used in practice.
A recent article in the Annals of Allergy, Asthma and Immunology surveyed primarily low-income inner city patients with chronic asthma to identify use of herbal treatments and any apparent association with how well their disease was controlled. What they found was that a moderate number of patients (25%) used herbal remedies for their asthma. Only about 39% of these people told their doctors about the use or herbal remedies, which raises the concern for unanticipated drug interactions. And about 20% of the herbal medicine users (about 5% of the total number of patients) used herbal treatments in place of their prescribed therapies.
Not surprisingly, the folks who used herbal preparations had a lower quality of life score and were significantly less likely to be complaint with their prescribed treatment regime than those patients who did not use herbal products. The authors also reported a trend towards poorer asthma control scores among herbal users. but this did not achieve statistical significance so it may not be a real finding.
The authors were careful to point out, correctly, that the association cannot identify a causal connection between quality of life and herbal remedy use. The poorer compliance with prescribed therapy can reasonably be suspected to be the causal factor, but it is impossible from this study to rule out a direct harmful effect from the herbal remedies or the possibility that people are seeking these remedies because they are not having an acceptable response to conventional therapy and that their poor compliance came after turning towards the CAM therapy.
However, there was also a correlation between use of herbal treatments and certain beliefs about conventional therapy, including concern about possible side effects and difficulty in following the prescribed treatment regime. This suggests that anxiety about the conventional treatment might be associated with susceptibility to the promises of safe and easy relief often used to market herbal therapies. This paper illustrates the dangers of such marketing strategies, which play into patient concerns which may be perfectly legitimate but which then offer alternatives which do not provide the relief the patient is seeking.