Just how safe is alternative medicine? Here, in the second part
of our series, Professor Edzard Ernst and scientist Simon Singh
explain how "natural" doesn't necessarily mean
"safer".
Most people view alternative medicine as a safe option.
On the other hand, conventional medicine is often criticised
because of the side-effects of pharmaceutical drugs or the risks
associated with surgery.
But does alternative medicine generate more good than harm?
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Ten percent of acupuncture patients experience an adverse
reaction to their treatment
Read more...
We saw last week that chiropractic therapy carries a range of
risks - so, too, do other alternative therapies.
Studies have shown that acupuncture treatments can result in
slight pain, bleeding or bruising.
These adverse reactions are only minor and transient, but they
occur in roughly 10 per cent of patients so are relatively
common.
Slightly more serious side-effects include fainting, dizziness
and vomiting, but these are less common and usually associated with
anxious patients who may have a fear of needles.
Although most patients may accept such risks as an unsurprising
consequence of being pierced with needles, there are two serious
adverse effects to consider.
The first is infection. There have been several documented cases
of patients contracting diseases such as hepatitis.
The journal Hepatology documented how 35 out of 366 patients
contracted hepatitis B from an acupuncture clinic in America.
The infection was caused by re-using needles that have not been
properly sterilised, and part of the problem may be due to the
Chinese tradition of storing needles in alcohol solutions, which is
not sufficient to protect against hepatitis viruses.
The second is that needles might puncture a major nerve or
organ.
For example, needling at the base of the skull can lead to brain
damage, and there are more than 60 reported cases of punctured
lungs.
Most worrying of all, there is a report of an acupuncturist
inserting a needle in the chest of an Austrian patient which
pierced her heart and killed her.
Normally, needling at this point is entirely safe because the
sternum protects the heart, but one in 20 people have a hole in
that bone which cannot be felt or seen.
Although acupuncture carries some common and serious risks, it
is important to stress that the common risks are not at all serious
and the serious risks are not at all common - they need to be seen
in the context of the millions of treatments given each year.
Moreover, the serious risks can be minimised by visiting a
medicallytrained acupuncturist who has a full knowledge of anatomy
and uses disposable needles.
On the other hand, the evidence for the efficacy of acupuncture
ranges from zero for a range of conditions to borderline for some
types of pain relief and nausea.
Hence, it's only worth considering for pain relief and
nausea - and only then if you feel the supposed benefits outweigh
the small risks.
Homeopathy is another treatment generally seen as totally
harmless but it is, in fact, associated with risks.
The evidence is that the benefits of homeopathy are purely
placebo, which is hardly surprising bearing in mind that the final
medicine often contains no active ingredient.
One might assume, therefore, that homeopathic remedies must be
harmless.
Unfortunately, homeopathy - and similar therapies - can have
surprising and dangerous side-effects.
These have nothing to do directly with any particular
homeopathic remedy, but rather are an indirect result of what
happens when therapists replace doctors as sources of medical
advice.
The widespread anti-immunisation stance among alternative
therapists is one example.
There are numerous reports of patients with serious conditions
(cancer, Aids) suffering harm after following irresponsible advice
from alternative practitioners.
This problem was clearly demonstrated by the death of Sylvia
Millecam, a Dutch TV star.
In 1999 her GP noticed a small lump in her breast and referred
her to a radiologist, but the tests were inconclusive.
Instead of visiting a surgeon for further investigation, she
underwent electro-acupuncture.
Even when it was absolutely clear that she had breast cancer,
Millecam rejected conventional medicine and visited 28 alternative
practitioners over two years, each one claiming to be able to help
her.
The pointless treatments she received included homeopathy, salt
therapy and psychic healing.
The cancer spread and Millecam was admitted to hospital in
August 2001, but it was too late.
She died four days later, aged 45.
A medical panel concluded that she had received "unfounded
methods of treatment" and that her alternative therapists had
denied her "a reasonable chance of recovery" and caused
"unnecessary suffering".
ACUPUNCTURE
WHAT IS IT? The process of puncturing the skin
with needles to improve health.
This is said to restore the flow of Ch'i, the energy or life
force that flows through our body.
Illness is due to imbalances or blockages in the flow of
Ch'i.
DOES IT WORK?
Over the past three decades a huge number of clinical trials have tested acupuncture's efficacy.
Over the past three decades a huge number of clinical trials have tested acupuncture's efficacy.
The high-quality research papers fail to show that acupuncture
works for a whole range of conditions, except as a placebo.
Research does support its use for some pain - pelvic and back
pain during pregnancy, lower back pain, headaches and nausea.
ALTERNATIVE EXERCISE THERAPIES
WHAT ARE THEY?
Approaches that use regular movements for improving health and wellbeing.
Approaches that use regular movements for improving health and wellbeing.
Traditional forms include tai chi (China) and yoga (India).
Modern variations include Pilates, which integrates breathing,
proper body mechanics and strengthening exercises, as well as
stabilising the pelvis and trunk.
DO THEY WORK?
Although there is less research into alternative exercises than into common sports or physiotherapy, some encouraging conclusions have started to emerge.
Although there is less research into alternative exercises than into common sports or physiotherapy, some encouraging conclusions have started to emerge.
For example, yoga, which encompasses a whole lifestyle including
diet and meditation, has been shown to be effective in reducing
cardiovascular risks.
Tai chi improves balance, prevents falls in the elderly,
enhances cardiovascular fitness, increases joint flexibility,
prevents osteoporosis in post-menopausal women and improves quality
of life in patients suffering from chronic heart failure.
There is, however, no significant evidence that alternative
exercise therapies convey any additional benefits compared to many
forms of conventional exercise.
A well-trained, experienced tutor is important, as alternative
exercise therapies can carry the sort of risks associated with any
exercise that puts the body under strain.
HOMEOPATHY
WHAT IS IT?
Remedies are based on the principle of "like cures like" - the patient is given substances which cause the same sort of symptoms to treat their illness.
Remedies are based on the principle of "like cures like" - the patient is given substances which cause the same sort of symptoms to treat their illness.
Ideally homeopaths look for the remedy that offers a perfect
match with the patient's symptoms.
The remedies can be based on animal sources (e.g. ground
honeybee), animal secretions (snake poison, wolf milk), mineral
sources (from salt to gold) or even diseased material (pus, vomit,
tumours, faeces) and 'imponderables' (e.g. Xrays).
They are diluted so much that it's unlikely that a single
molecule of the original ingredient remains.
However, homeopaths argue the remedy has some memory of the
original ingredient which somehow influences the body.
Homeopathy is said to be effective for a range of conditions,
from headaches to arthritis.
It is one of the fastest-growing forms of alternative
medicine.
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