CAM proponents aggressively market their approaches with the assurance, often absolute and without qualification, that their methods never cause harm. And perhaps the most common response to critiques of CAM from people who consider themselves mildly skeptical of it but who do not have strong opinions about it is “Well, it probably doesn’t work, but at least it’s harmless.” So it appears that the notion CAM is safe, whether effective or not, seems widely established. Unfortunately, it’s often not true. Any therapy that has any actual influence on the body’s processes will also have the potential for unintended effects, some of which may do harm. And even therapies which have no effect, such as homeopathy, can be indirectly harmful in delaying diagnosis or real treatment.
The following links and articles are resources illustrating some of the harm CAM methods can do, directly and indirectly. It is by no means comprehensive, and it certainly is not a scientific assessment of the risks and benefits of any particular therapy. The purpose is simply to make it clear that it is by no means difficult to find evidence of harm caused by almost any CAM therapy, so when we evaluate these approaches we must balance any possible benefits they have against any possible risks, regardless of the exaggerated claims for safety their proponents often make.
General CAM Use:
Association between CAM use and decreased success of IVF in Holland.
Association between CAM use and decreased survival in cancer patients in Norway.
General collection of anecdotes about people harmed, directly or indirectly, by CAM use.
SBM– Risks of various CAM therapies.
Bostrom, H. Rostrom, S. Quality of alternative medicine–complications and avoidable deaths. Qual Assur Health Care. 1990;2(2):111-7.
Acupuncture
Cho YP, Jang HJ, Kim JS, Kim YH, Han MS, Lee SG. Retroperitoneal abscess complicated by acupuncture: case report. J Korean Med Sci. 2003 Oct;18(5):756-7.
Choo DC, Yue G Acute intracranial hemorrhage in the brain caused by acupuncture. Headache 2000 May;40(5):397-8.
Chung SJ, Kim JS, Kim JC, Lee SK, Kwon SU, Lee MC, Suh DC. Intracranial dural arteriovenous fistulas: analysis of 60 patients. Cerebrovasc Dis 2002 Feb;13(2):79-88
Cole M, Shen J, Hommer D. Convulsive syncope associated with acupuncture. Am J Med Sci 2002 Nov;324(5):288-9
Ernst E, Sherman K. Is acupuncture a risk factor for hepatitis? Systematic review of epidemiological studies. J Gastroenterol Hepatol. 2003 Nov;18(11):1231-6.
Ernst E, White AR. Prospective studies of the safety of acupuncture: a systematic review. Am J Med 2001 Apr 15;110(6):481-5
Iwadate K, Ito H, Katsumura S, Matsuyama N, Sato K, Yonemura I, Ito, Y. An autopsy case of bilateral tension pneumothorax after acupuncture. Leg Med (Tokyo). 2003 Sep;5(3):170-4.
Kirchgatterer A, Schwarz CD, Holler E, Punzengruber C, Hartl P, Eber B Cardiac Tamponade Following Acupuncture. Chest 2000 May;117(5):1510-1511
Laing AJ, Mullett H, Gilmore MF. Acupuncture-associated Arthritis in a Joint with an Orthopaedic Implant J Infect 2002 Feb;44(1):43-4
Nambiar P, Ratnatunga C. Prosthetic valve endocarditis in a patient with Marfan’s syndrome following acupuncture. J Heart Valve Dis 2001 Sep;10(5):689-90
Peuker E Case report of tension pneumothorax related to acupuncture. Acupunct Med. 2004 Mar;22(1):40-3.
Saw A, Kwan MK, Sengupta S. Necrotising fasciitis: a life-threatening complication of acupuncture in a patient with diabetes mellitus. Singapore Med J. 2004 Apr;45(4):180-2.
Sun CA, et al. Transmission of hepatitis C virus in taiwan: prevalence and risk factors based on a nationwide survey. Sun J Med Virol 1999 Nov;59(3):290-6
Witt CM, Pach D, Brinkhaus B, Wruck K, Tag B, Mank S, Willich SN. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed. 2009 Apr;16(2):91-7. Epub 2009 Apr 9
Woo PC, Leung KW, Wong SS, Chong KT, Cheung EY, Yuen KY. Relatively alcohol-resistant mycobacteria are emerging pathogens in patients receiving acupuncture treatment. J Clin Microbiol 2002 Apr;40(4):1219-24
Yamashita H, Tsukayama H, White AR, Tanno Y, Sugishita C, Ernst E. Systematic review of adverse events following acupuncture: the Japanese literature. Complement Ther Med 2001 Jun;9(2):98-104
Chiropractic:
SBM–Neck Manipulation:Risk vs Benefit
SBM–Chiropractic’s Pathetic Response to Stroke Concerns
SBM–Chiropractic and Stroke: Evaluation of One Paper
:
Vitamin C can interfere with chemotherapy.
Vitamin E can increase cancer risk.
Herbal Preparations, Including Ayurvedic and Traditional Chinese Medicine (TCM) Herbs
Aliye Uc, MD, Warren P. Bishop, MD, and Kathleen D. Sanders, MD, Camphor hepatoxicity. South Med J 93(6):596-598, 2000,
Berberine. Inbaraj JJ, Kukielczak BM, Bilski P, Sandvik SL, Chignell CF. Photochemistry and photocytotoxicity of alkaloids from Goldenseal (Hydrastis canadensis L.) Chem Res Toxicol 2001 Nov;14(11):1529-34
Burkhard PR, Burkhardt K, Haenggeli CA, Landis T. Plant-induced seizures: reappearance of an old problem. J Neurol 1999 Aug;246(8):667-70
Coon JT, Ernst E. Panax ginseng: A Systematic Review of Adverse Effects and Drug Interactions. Drug Saf 2002;25(5):323-44 Drug Saf 2002;25(5):323-44
Cupp MJ Herbal remedies: adverse effects and drug interactions. Am Fam Physician 1999 Mar 1;59(5):1239-45
Debelle FD, Vanherweghem JL, Nortier JL. Aristolochic acid nephropathy: a worldwide problem. Kidney Int. 2008 Jul;74(2):158-69. Epub 2008 Apr 16.
Emery DP, Corban JG Camphor toxicity. J Paediatr Child Health 1999 Feb;35(1):105-6
Ernst E Adverse effects of herbal drugs in dermatology. Br J Dermatol 2000 Nov;143(5):923-
Fugh-Berman A Herb-drug interactions. Lancet 2000 Jan 8;355(9198):134-8
Huang WF, Wen KC, Hsiao ML. Adulteration by synthetic therapeutic substances of traditional Chinese medicines in Taiwan. J Clin Pharmacol. 1997 Apr;37(4):344-50
Lai MN, Lai JN, Chen PC, Tseng WL, Chen YY, Hwang JS, Wang JD. Increased risks of chronic kidney disease associated with prescribed Chinese herbal products suspected to contain aristolochic acid. Nephrology (Carlton). 2009 Apr;14(2):227-34.
Lawrence JD. Potentiation of warfarin by dong quai. Page RL 2nd, Pharmacotherapy 1999 Jul;19(7):870-6
Means C. Selected herbal hazards. Vet Clin North Am Small Anim Pract 2002 Mar;32(2):367-82
Norred CL, Finlayson CA Hemorrhage after the preoperative use of complementary and alternative medicines. AANA J 2000 Jun;68(3):217-20
O’Connor A, Horsley CA. Yates, KM “Herbal Ecstasy”: a case series of adverse reactions. N Z Med J 2000 Jul 28;113(1114):315-7
Pittler MH. Ernst, E Risks associated with herbal medicinal products. Wien Med Wochenschr 2002;152(7-8):183-9
Poppenga RH. Risks associated with the use of herbs and other dietary supplements. Vet Clin North Am Equine Pract. 2001 Dec;17(3):455-77, vi-vii
Pies R Adverse neuropsychiatric reactions to herbal and over-the-counter “antidepressants”. J Clin Psychiatry 2000 Nov;61(11):815-20
Prakash S, Hernandez GT, Dujaili I, Bhalla V. Lead poisoning from an Ayurvedic herbal medicine in a patient with chronic kidney disease. Nat Rev Nephrol. 2009 May;5(5):297-300.
Raman P, Patino LC, Nair MG. Evaluation of metal and microbial contamination in botanical supplements. J Agric Food Chem. 2004 Dec 29;52(26):7822-7
Ruschitzka F, Meier PJ, Turina M, Luscher TF, Noll G Acute heart transplant rejection due to Saint John’s wort. Lancet 2000 Feb 12;355(9203):548-9
Saper RB, Phillips RS, Sehgal A, Khouri N, Davis RB, Paquin J, Thuppil V, Kales SN. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA. 2008 Aug 27;300(8):915-23.
Shad JA, Chinn CG, Brann OS Acute hepatitis after ingestion of herbs. South Med J 1999 Nov;92(11):1095-7
Smolinske SC J Am Med Womens Assoc 1999 Fall;54(4):191-2 Dietary supplement-drug interactions.
Yang HY, Wang JD, Lo TC, Chen PC. Increased mortality risk for cancers of the kidney and other urinary organs among Chinese herbalists. J Epidemiol. 2009;19(1):17-23. Epub 2009 Jan 22.
Zhang SY, Robertson D. A study of tea tree oil ototoxicity. Audiol Neurootol 2000 Mar-Apr;5(2):64-8
Kidney failure from aristolochia in TCM herbals preparations.
Lead, mercury and arsenic in herbal preparations.
Lead in ayurvedic preparations.
Tea Tree Oil Can be toxic to cats.
Toxic metals in Brazilian herbal preparations.
Contamination of herbal products with undisclosed pharmaceuticals.
Anecdotes and Victims Groups
General collection of anecdotes about people harmed, directly or indirectly, by CAM use.
Chiropractic Treatment and Stroke
Books
Natural Causes: Death, Lies and Politics in America’s Vitamin and Herbal Supplement Industry by Dan Hurley.A detailed look and the politics, economics, and risks of the dietary supplement, vitamin, and herbal medicine industries
Trick or Treatment: The Undeniable Facts about Alternative Medicine by S. Singh and E. Ernst
An outstanding review of many CAM practices from and evidence-based perspective which includes assessment of the risks, particularly for acupuncture, homeopathy, chiropractic, and herbal medicines.
The Desktop Guide to Complementary and Alternative Medicine: An Evidence-based Approach Edited by E. Ernst, M. Pittler, B. Wider An exhaustive and authoritative review of the evidence and risks for many CAM treatments, including detailed references.
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Superb! Thank you so much.
Excellent post!
Will save this for the excellent range of resources.
The view that “it’s no harm since they do nothing anyway” is spot on. Many advocates of CAM are actively diverting patients away from real medicine. Just look at the Sherr vitamin C fiasco.