**3.9 Alternative/Complementary Medicine:**

Definition of alternative medicine

Description of the most common types of alternative medicine in use
today

Description of the most common types of herbal remedies

Pharmacological effects of the most common self-medicated prescribed
drugs

Symptoms, signs and performance effects of the commonly used herbal
remedies

Symptoms, signs and performance effects of alternative medicine
therapies

DEFINITION OF ALTERNATIVE MEDICINE

A simple definition cannot describe all that is now considered
\"alternative medicine.\" Alternative medicine is made up of techniques,
modalities, and medical systems that are, for the most part, often
unfamiliar to the majority of the public. They are, therefore, as a
whole, an \"alternative\" to what most Americans are using when they
need health care.

Much of what is labeled alternative medicine comes to us from other
cultures or from ancient healing traditions. For example, the use of
herbs as medicine is an ancient practice found all over the world.
Acupuncture comes specifically from ancient China and has been
documented as being in use as early as 5000 years ago. There are
numerous therapies considered alternative. Several of the
[many]{.underline} "alternative" therapies that may be more recognized
are listed and described below.

**DESCRIPTION OF THE MOST COMMON TYPES OF ALTERNATIVE MEDICINE**

**Acupuncture**  Thin needles are inserted superficially on the skin at
locations throughout the body. These points are located along "channels"
of energy. Stimulation of the points can be applied by burning
(moxibustion), electric current (electroacupuncture), or pressure
(acupressure). Healing is proposed by the restoration of a balance of
energy flow called Qi. Another explanation suggests that, possibly, the
stimulation activates endorphin receptors.

**Applied Kinesiology**  A form of treatment that uses nutrition,
physical manipulation, vitamins, diets, and exercise to restore and
energize the body. Weak muscles are proposed to be a source of
dysfunctional health.

**Aromatherapy**  A form of herbal medicine that uses various oils from
plants. Route of administration can be through absorption in the skin or
inhalation. The action of antiviral and antibacterial agents is proposed
to aid in healing. The aromatic biochemical structures of certain herbs
are thought to act in areas of the brain related to past experiences and
emotions (e.g., limbic system).

**Biofeedback  **A mind-body therapy procedure in which sensors are
placed on the body to measure muscle, heart rate, and sweat responses or
neural activity. Information is provided by visual, auditory, or
body-muscle cell activation so as to teach either to increase or
decrease physiologic activity which, when reconstituted, is proposed to
improve health problems (i.e., pain, anxiety, or high blood pressure).
In some cases, relaxation exercises complement this procedure.

**Cell Therapy**  Healthy cellular material from fetuses, embryos, or
organs of animals is directly injected into human patients to stimulate
healing in dysfunctional organs. It may also include blood transfusions
or bone marrow transplantations.

**Chelation Therapy**  Involves the removal through intravenous infusion
of a chelating agent (synthetic amino acid ethylenediamine tetraacetic
acid \[EDTA\]) of metal, toxins, lead, mercury, nickel, copper, cadmium,
and plaque as a way to treat certain diseases (e.g., cardiovascular).
Ancillary treatments include the use of vitamins, changes in diet, and
exercise.

**Cognitive Therapy**  Psychological therapy in which the major focus is
on altering and changing irrational beliefs through a type of "socratic"
dialogue and self-evaluation of certain illogical thoughts. Conditioning
and learning are important components of this therapy.

 **Craniosacral Therapy**  A form of gentle manual manipulation used for
diagnosis and for making corrections in a system made up of
cerebrospinal fluid, cranial and dural membranes, cranial bones, and
sacrum. This system is proposed to be dynamic with its own physiologic
frequency. Through touch and pressure, tension is proposed to be reduced
and cranial rhythms normalized, leading to improvement in health and
disease.

**Dance Therapy**  A movement-based therapy that aids in promoting
feeling and awareness. The goal is to integrate body, mind, and
self-esteem. It uses different parts of the body such as fingers,
wrists, and arms to respond to music.

**Diathermy**  The use of high-frequency electrical currents as a form
of physical therapy and in surgical procedures. The term diathermy,
derived from the Greek words dia and therma, literally means "heating
through." The three forms of diathermy used by physical therapists are
short-wave, ultrasound, and microwave.

**Dimethylaminoethanol (DMAE)**  Pharmacologic therapy that uses a
natural substance found in certain foods and the human brain. It is a
precursor to the transmitter acetylcholine. It is proposed to have a
stimulant effect on the central nervous system if used as a supplement.

**Electrochemical Treatment (ECT**)  A method using direct current to
treat cancer. It involves inserting platinum electrodes into tumors and
applying a constant voltage of less than 10 V to produce a 40- to 80-mA
current between the anodes and cathodes for 30 minutes to several hours.

**Electroencephalographic Normalizatio**n  Gross neural activity is
recorded from the scalp as an electroencephalogram (EEG) to assist in
"restoring a balance in health" by training patients to produce more
uniform and consistent EEG frequencies throughout certain or all areas
of the brain (occipital, frontal, temporal, and parietal).

**Environmental Medicine**  The practice of medicine in which the major
focus is on cause-and-effect relationships in health. Evaluations are
made of factors such as eating and living habits and types of air
breathed. Testing in the patient's own environment is performed to
determine what precipitators are present that may be related to disease
or other health problems. A treatment protocol is developed from this
information.

**Eye Movement Desensitization and Reprocessing (EMDR**)  A technique
that proposes to remove painful memories by behavioral techniques.
Rhythmic, multisaccadic eye movements are produced by allowing the
patient to track and follow a moving object while imaging a stressful
memory or event. By using deconditioning, including verbal interaction
with the therapist, the painful memory is extinguished and health
improved.

**Feldenkrais Method**  A bodywork technique in which its founder used
the integration of physics, judo, and yoga. The practitioner directs
sequences of movement using verbal or hands-on techniques or teaches a
system of self-directed exercise to treat physical impairments through
the learning of new movement patterns.

**Hallucinogens ** The use of lysergic acid diethylamide (LSD) to
produce at certain doses anticraving for certain illicit drugs such as
cocaine, or ibogaine, a stimulant, to assist in developing tolerance and
decreasing symptoms of dependence**.**

**Hatha** **Yoga**  The branch of yoga practice that involves physical
exercise, breathing practices, and movement. These exercises are
designed to have a salutary effect on posture, flexibility, and
strength, and are intended ultimately to prepare the body to remain
still for long periods of meditation.

**Herbal Medicine**  Herbs are used to treat various health conditions.
Herbal medicine is a major form of treatment for more than 70% of the
world's population. (See below)

**Homeopathy**  A form of treatment in which substances (minerals, plant
extracts, chemicals, or disease-producing germs), which in sufficient
doses would produce a set of illness symptoms in healthy individuals,
are given in microdoses to produce a "cure" of those same symptoms. The
symptom is not thought to be part of the illness but part of a curative
process.

**Hyperbaric Oxygen**  A therapy in which 100% oxygen is given at or
above atmospheric pressure. An increase in oxygen in the tissue is
proposed to increase blood circulation and improve healing and health
and influence the course of disease.

**Hyperthermia**  The use of various heating methods (such as
electromagnetic therapy) to produce temperature elevations of a few
degrees in cells and tissues, leading to a proposed antitumor effect.
This is often used in conjunction with radiotherapy or chemotherapy for
cancer treatment.

**Immunoaugmentative Therapy**  A cancer treatment that proposes that
cancer cells can be arrested by the use of four different blood
proteins; this approach is also proposed to restore the immune system.
Can be used as an adjunctive therapy.

**Jin Shin Jyutsu**  A bodywork technique that uses specific "healing
points" at the body surface, which are proposed to overlie energy
flowing (Qi). The therapist's fingers are used to "redirect, balance,
and provide a more efficient energy flow" to and throughout the body.

**Laetrile**  A pharmacologic treatment using apricot pits that has been
proposed to treat certain cancers.

**Light Therapy**  Natural light or light of specified wavelengths is
used to treat disease. This may include ultraviolet light, colored
light, or low-intensity laser light. The eye generally is the initial
entry point for the light because of its direct connection to the brain.

**Magnetic Therapy**  Magnets are placed directly on the skin,
stimulating living cells and increasing blood flow by ionic currents
that are created from polarities on the magnets. Both acute and chronic
health conditions are suggested to be treatable by this procedure.

**Manual Manipulation**  A group of therapies with different assumptions
and, in part, different areas of treatment. The major focus includes
both stimulation and body manipulation, which are proposed to improve
health or arrest disease, or both. Includes soft-tissue manipulation
through stroking, kneading, friction, and vibration. Types include
massage, adjustment of the spinal column (chiropractic), and tissue and
musculoskeletal (osteopathic) manipulation.

** Mediterranean Diet**  A diet that is thought to provide optimal
distribution of daily caloric intake of different nutrients and includes
50% to 60% carbohydrates, 30% fats, and 10% proteins. The diet is
derived from the eating habits of people in the Mediterranean area, who
were shown to have reduced rates of cardiovascular disease.

 **Mind-Body Therapies**  A group of therapies that emphasize using the
mind or brain in conjunction with the body to assist healing. Mind-body
therapies can involve varying degrees of levels of consciousness,
including hypnosis, in which selective attention is used to induce a
specific altered state (trance) for memory retrieval, relaxation, or
suggestion; visual imagery, in which the focus is on a target visual
stimulus; yoga, which involves integration of posture and controlled
breathing, relaxation, and/or meditation; relaxation, which includes
lighter levels of altered states of consciousness through indirect or
direct focus; and meditation, in which there is an intentional use of
posture, concentration, contemplation, and visualization.

**Muscle Energy Technique**  A manual therapy with components of both
passive mobilization and muscle reducation. Diagnosis of somatic
dysfunction is performed by the practitioner after which the patient is
guided to provide corrective muscle contraction. This is followed by
further testing and correction.

**Music Therapy**  The use of music either in an active or passive mode.
Proposed to help allow for the expression of feelings, which helps to
reduce stress. Other types of "vibratory" sounds can be used mainly to
reduce stress, anxiety, and pain.

**Native American Therapies**  Therapies used by many Native American
Indian tribes, including their own healing herbs and ceremonies that use
components with a spiritual emphasis.

**Naturopathy ** A major health system that includes practices that
emphasize diet, nutrition, homeopathy, acupuncture, herbal medicine,
manipulation, and various mind-body therapies. Focal points include
self-healing and treatment through changes in lifestyle and emphasis on
health prevention.

**Neuroelectric Therapy**  Transcranial or cranial neuroelectric
stimulation (TENS), once called "electrosleep"; originally used in the
1950s to treat insomnia. In a typical TENS session, surface electrodes
are placed in the mastoid region (behind the ear) and, similar to
electroacupuncture, stimulated using a low-amperage, low-frequency
alternating current. It has been suggested that TENS stimulates
endogenous neurotransmitters such as endorphins that produce symptomatic
relief.

**Ornish Diet**  A life-choice program based on eating a vegetarian diet
containing less than 10% fat. The diet is high in complex carbohydrates
and fiber. Animal products and oils are avoided.

**Orthomolecular Therapy**  A therapeutic approach that uses naturally
occurring substances within the body, such as proteins, fat, and water,
that promote restoration or balance (or both) by using vitamins,
minerals, or other forms of nutrition to subsequently treat disease or
promote healing, or both.

**Oslo Diet**  An eating plan that emphasizes increased intake of fish
and reduced total fat intake. Diet is combined with regular endurance
exercise.

**Piracetam**  A pharmacologic treatment proposed to be useful in the
treatment of dementia. Uses a cyclic relative of the transmitter
gamma-aminobutyric acid (GABA).

**Prayer ** The use of prayer(s) that are offered to "some higher being"
or authority to heal and/or arrest disease. May be practiced by the
individual patient, by groups, or by other(s) with or without the
patient's knowledge (e.g., intercessory).

**Pritkin Diet**  A weight management plan that is based on a vegetarian
framework. Meals are low in fat, high in fiber, and high in complex
carbohydrates.

**Qi Gong**  A form of Chinese exercise-stimulation therapy that
proposes to improve health by redirecting mental focus, breathing,
coordination, and relaxation. The goal is to "rebalance" the body's own
healing capacities by activating proposed electrical or energetic
currents that flow along meridians located throughout the body. These
meridians, however, do not follow conventional nerve or muscle pathways.
In Chinese medical training and practice this therapy includes "external
Qi," which is energy transmitted from one person to another so as to
heal.

**Raja Yoga**  Yoga practice that includes all of the other forms of
yoga practice. The practitioner is instructed to follow moral
directives, physical exercises, breathing exercises, meditation,
devotion, and service to others to facilitate religious awakening.

**Reconstructive Therapy**  A nonsurgical therapy for arthritis that
involves the injection of nutritional substances into the supporting
tissues around an injured joint. The intent is to cause the dilation of
blood vessels, which will allow fibroblasts to form around the injury
and begin the healing process.

 **Reflexology**  A bodywork technique that uses reflex points on the
hands and feet. Pressure is applied at points that correspond to various
body parts, to eliminate blockages thought to produce pain or disease.
The goal is to bring the body into balance.

**Reiki ** Comes from the Japanese word meaning "universal life force
energy." The practitioner serves as a conduit for healing energy
directed into the body or energy field of the recipient without physical
contact with the body.

**Restricted Environmental Stimulation Therapy (REST**)  A procedure
that uses a completely sensory-deprived environment to increase physical
or mental healing through a nonreactive state.

**Rolfing ** A bodywork technique that involves the myofascia. The body
is realigned by using the hands to apply a deep pressure and friction
that allows more sufficient posture, movement, and the "release" of
emotions from the body.

**Shiatsu ** A bodywork technique involving finger pressure at specific
points on the body mainly to balance "energy" in the body. The major
focus is on prevention by keeping the body healthy. The therapy uses
more than 600 points on the skin that are proposed to be connected to
pathways through which energy flows. A Japanese form of acupressure.

**Tai Chi**  A technique that uses slow, purposeful motor-physical
movements of the body to control and achieve a more balanced physiologic
and psychologic state.

 **Therapeutic Touch**  A body energy field technique in which hands are
passed over the body without actually touching to recreate and change
proposed "energy imbalances" for restoring innate healing forces. Verbal
interaction between patient and therapist helps to maximize effects.

**Traditional Chinese Medicine**  An ancient form of medicine that
focuses on prevention and secondarily treats disease with an emphasis on
maintaining balance through the body by stimulating a constant,
smooth-flowing Qi energy. Herbs, acupuncture, massage, diet, and
exercise are also used.

**Transcranial Electrostimulation**  Pulsed electrical stimulation of 50
microamperes or less is applied between two electrodes attached to the
ear. The stimulation is proposed to activate endogenous opioid activity,
which may assist in the treatment of certain health problems such as
substance abuse and physical pain.

**Twelve-Step Program**  A program such as Alcoholics Anonymous that is
based on a series of 12 steps, or tasks, that participants are asked to
complete. As members progress through the 12 steps, they are expected to
gain courage to attempt personal change and develop a greater acceptance
of themselves. Programs emphasize the group process through the sharing
of stories and experiences and through social interactions with other
group members. Most 12-step programs incorporate a spiritual component
and ask members to turn their lives over to a higher power.

**DESCRIPTION OF THE MOST COMMON HERBAL REMEDIES, THEIR 'EFFECTS' AND
THE SIGNS AND SYMPTOMS RELATED TO THE USE OF THESE NON-DRUG
SELF-ADMINISTERED REMEDIES**

+---------+------------------+--------------+-------------------------+
| NAME    | USES             | **FORM**     | **CONSIDERATIONS**      |
+---------+------------------+--------------+-------------------------+
| Aloe    | External burns,  | Gels,        | Internal: Painful       |
|         | sunburn, cuts,   | creams,      | intestinal              |
|         | wounds Internal: | lotions      | contractions, bloody    |
|         | constipation     |              | diarrhea, kidney damage |
|         |                  | Internal:    |                         |
|         |                  | **Not**      |                         |
|         |                  | recommended  |                         |
+---------+------------------+--------------+-------------------------+
| A       | GYN disorders,   | Tablets,     | Avoid during Pregnancy  |
| ngelica | menstrual        | capsules,    | and breast feeding due  |
|         | discomfort       | injection    | to uterine stimulation, |
|         |                  |              | avoid anticoagulants    |
+---------+------------------+--------------+-------------------------+
| C       | External pain,   | External     | Counterirritant,        |
| apsicum | shingles         | creams,      | repeated application    |
|         | diabetic         | gels,        | produces neuronal       |
|         | neuropathy,      | ointment,    | depletion analgesia.    |
|         | headache,        | lotion.      | Burning, itching        |
|         | arthritis,       | Internal:    | diminish with continued |
|         | stimulate        | diet as      | use                     |
|         | stomach          | tolerated,   |                         |
|         | secretions       | supplements  |                         |
|         |                  | NOT          |                         |
|         |                  | recommended  |                         |
+---------+------------------+--------------+-------------------------+
| Ch      | Rx of stomach    | Teas,        | Decreased absorption of |
| amomile | maladies, GI     | capsules,    | other meds from         |
|         | spasm,           | liquid.      | antispasmodic activity, |
|         | inflammation.    | Dried        | excess coag with other  |
|         | Sedation         | flowers      | anticoagulants          |
+---------+------------------+--------------+-------------------------+
| Cr      | Prevention of    | Capsules,    | May enhance elimination |
| anberry | UTI              | juices,      | of drugs via urine.     |
|         |                  | powders      | With excessive,         |
|         |                  |              | diarrhea                |
+---------+------------------+--------------+-------------------------+
| Ec      | Wound healing,   | Tablets,     | Prolonged use may over  |
| hinacea | URI, UTI         | capsules,    | stimulate the immune    |
|         | immunostimulant, | tincture     | system, with possible   |
|         |                  |              | immune suppression      |
+---------+------------------+--------------+-------------------------+
| F       | Migraine         | Tablets,     | Allergic reactions,     |
| everfew | prophylaxis,     | capsules,    | mouth ulcers,           |
|         | antipyretic,     | liquids,     | withdrawal: aches,      |
|         | menstrual        |              | pains, joints and       |
|         | problems,        | No consensus | muscle stiffness. Avoid |
|         | toothache,       | on dose      | during Pregnancy or     |
|         | psoriasis,       |              | breast feeding          |
|         | asthma,          |              |                         |
|         | rheumatism,      |              |                         |
+---------+------------------+--------------+-------------------------+
| Flax    | External:        | External:    | Allergic reactions,     |
|         | External:        | meal for     | nausea, flatulence. May |
|         | Inflammation,    | poultice,    | diminish absorption of  |
|         | Internal:        | Internal:    | other meds.             |
|         | constipation,    | seeds, oil   | **CONTRAINDICATED**     |
|         | IBS, colon       |              | Pregnancy, breast       |
|         | dysfunction,     |              | feeding, ileus and      |
|         | diverticulitis,  |              | prostate CA             |
|         | h                |              |                         |
|         | ypercholesterol, |              |                         |
+---------+------------------+--------------+-------------------------+
| Garlic  | Antimicrobial,   | Tablets,     | Contact dermatitis,     |
|         | lowers           | capsules     | dizziness, garlic odor, |
|         | cholesterol and  |              | GI irritation, nausea,  |
|         | BP, antiplatelet |              | vomiting. Drug          |
|         | agent            |              | interactions (anticoag) |
|         |                  |              | Avoid Pregnancy and GI  |
|         |                  |              | disorders               |
+---------+------------------+--------------+-------------------------+
| Ginger  | Antiemetic for   | Tablets      | Overdoes may produce    |
|         | morning, motion  |              | CNS depression and      |
|         | sickness,        |              | arrhythmias. Ginger may |
|         | an               |              | enhance anticoagulant   |
|         | ti-inflammatory, |              | effects                 |
|         | antitumor,       |              |                         |
|         | antimicrobial,   |              |                         |
|         | antioxidant      |              |                         |
+---------+------------------+--------------+-------------------------+
| Ginkgo  | CV disease,      | Tablets,     | Though uncommon,        |
|         | peripheral       | capsules     | reactions have included |
|         | vascular         |              | seizures in children,   |
|         | insufficiency,   |              | bleeding complications, |
|         | resulting in     |              | Drug interactions with  |
|         | short-term       |              | antiplatelets meds or   |
|         | memory loss,     |              | anticoagulants          |
|         | vertigo,         |              |                         |
|         | tinnitus,        |              |                         |
|         | dementia         |              |                         |
+---------+------------------+--------------+-------------------------+
| Ginseng | Improved         | Tablets,     | Avoid in Pregnancy and  |
|         | stamina,         | capsules,    | breast feeding Patients |
|         | concentration,   | Extract      | with CV disease,        |
|         | healing,         |              | hypertension,           |
|         | efficiency,      |              | hypotension or steroid  |
|         | aphrodisiac,     |              | Rx should avoid. Drug   |
|         | sleep aid,       |              | interactions may exist  |
|         | antidepressant,  |              | with agents that        |
|         | antistress       |              | inhibit MAO (e.g.       |
|         |                  |              | phenylzine)             |
+---------+------------------+--------------+-------------------------+
| Green   | CA prevention,   | Tea          | Concomitant with milk   |
| tea     | dental caries,   |              | may inhibit antioxidant |
|         | h                |              | effect                  |
|         | ypercholesterol, |              |                         |
|         | stimulant        |              |                         |
|         | atherosclerosis, |              |                         |
|         | astringent,      |              |                         |
|         | antibacterial    |              |                         |
+---------+------------------+--------------+-------------------------+
| Kava    | Anxiety, stress, | Dried        | Enhanced CNS sedation   |
|         | restlessness     | extract,     | if used with other      |
|         |                  | tablets,     | depressants (e.g.       |
|         |                  | capsules     | alcohol,                |
|         |                  |              | benzodiazepines,        |
|         |                  |              | opioids                 |
+---------+------------------+--------------+-------------------------+
| Ma      | CNS stimulant,   | Tablets, tea | Dose related: anxiety,  |
| Huang   | appetite         |              | cardiac arrhythmia,     |
|         | suppressant,     |              | infarction, insomnia,   |
|         | asthma, colds,   |              | psychosis, stroke,      |
|         | flu, nasal       |              | urine retention,        |
|         | congestion       |              | uterine contractions    |
|         |                  |              | Avoid if hypertensive,  |
|         |                  |              | Pregnancy, diabetic,    |
|         |                  |              | BPH, CVA or cardiac     |
|         |                  |              | disease                 |
+---------+------------------+--------------+-------------------------+
| Milk    | Liver disease,   | Tablets,     | Low adverse reaction    |
| thistle | including        | capsules     | incidents               |
|         | cirrhosis,       |              |                         |
|         | chronic          |              |                         |
|         | hepatitis,       |              |                         |
|         | gallstones,      |              |                         |
|         | protect from     |              |                         |
|         | liver toxins     |              |                         |
|         | (halothane,      |              |                         |
|         | psychotropics)   |              |                         |
+---------+------------------+--------------+-------------------------+
| Nettle  | Diuretic, BPH,   | Capsules,    | Though rare, edema,     |
|         | allergic         | tincture     | oliguria, stomach       |
|         | rhinitis,        |              | irritation. Avoid if    |
|         | bladder          |              | Pregnant, breast        |
|         | irritation,      |              | feeding,                |
|         |                  |              |                         |
|         | Gout             |              |                         |
+---------+------------------+--------------+-------------------------+
| Passion | Sedative         | Tea          | Avoid if PG/breast      |
| flower  |                  |              | feeding. Drug           |
|         |                  |              | interactions, adverse   |
|         |                  |              | effects unknown         |
+---------+------------------+--------------+-------------------------+
| Pep     | External: common | Creams,      | Gastroesophageal Reflux |
| permint | cold, arthritis, | rubs, tea    | could be exacerbated.   |
|         | musculoskeletal  |              | Menthol can cause       |
|         | problems,        |              | sensitization and       |
|         | Internal: IBS,   |              | allergic reactions.     |
|         | dyspepsia,       |              | Avoid in                |
|         |                  |              | infants/children        |
+---------+------------------+--------------+-------------------------+
| Saw     | BPH              | Tablets,     | GI reactions,           |
| p       |                  | capsules     | hypertension, decreased |
| almetto |                  |              | libido, back pain,      |
|         |                  |              | dysuria, headache,      |
+---------+------------------+--------------+-------------------------+
| St.     | Depression,      | Tablets,     | Photosensitivity,       |
| John's  | anxiety, viral   | capsules     | constipation,           |
| wort    | infection        |              | dizziness, dry mouth,   |
|         |                  |              | restless.sleep          |
|         |                  |              | disturbances            |
+---------+------------------+--------------+-------------------------+
| Tea     | Local            | Topical      | If ingested, CNS        |
| tree    | antiseptic,      |              | depression. Contact     |
| oil     | burns, athlete's |              | dermatitis if patient   |
|         | foot,            |              | susceptible             |
+---------+------------------+--------------+-------------------------+

**PERFORMANCE EFFECTS OF THE COMMONLY USED ALTERNATE/COMPLEMENTARY AND
HERBAL REMEDIES**

Many physicians, though they may be aware of different forms of
alternative medicines, often do not treat herbs in the same manner as
other types of medication. It is apparent that the effects of various
agents, such as those outlined in the table above, can be very
significant in producing various physiologic reactions that could be
dangerous when experienced by a pilot particularly in a flight
environment. The doses as well as the quality of the agent can be
variable. If a little helps, a lot would be even better!

The AME must also consider the reason the individual is taking the
agent. Is it as a preventative? Is it treating a condition, and, if so,
would the condition itself have a deleterious effect on the pilot's
ability to safely fly an aircraft? Is the pilot taking other
prescription or non-prescription medicines? There is very little
evidence from systematic studies regarding the potential for drug-drug
or herb-drug interactions with over-the-counter agents.

There is often a significant risk of interaction between herbal products
and conventional medications.

Fortunately, medical references are becoming more available to the
physician relating to alternative medicine such as the newer Physician's
Desk Reference that cover non-prescription/dietary, nutritional
supplements and herbal medicines.

More recently, many pilots are getting "on board" the herbal bandwagon.
Since it is not a drug the pilot may feel that there's no question as to
its use with reference to flying. Though, a pilot may not ask if an
herbal agent is safe to take, they will sometimes ask the AME if the
taking of a substance such as ***ephedra*** may alter the random
employee drug screen. (*The answer: Yes, on the initial screen but the
more definitive test would be needed to confirm the initial screen).*

A few comments on performance effects of alternative medicine therapies.
The herbal table above relates to the use of those products and their
potential biochemical and physiologic effects on an individual. The
specific therapies would vary considerably with the techniques of the
therapy itself. Also, if an individual with signs and symptoms elects to
seek out alternative treatment and the condition happens to be more
serious, significant time may be lost in the process thus making the
later diagnosis of the patient's condition far more difficult to treat
due to the time elapsed.

In summary, the pilot's mission is usually to get from point A to point
B in an aircraft in a safe and timely manner. The AME, though primarily
an evaluator of the pilot's health and its potential effect on flying,
also has the secondary responsibility as an advocate to teach the pilot.
Those factors that could have an effect on his/her ability to safely
fly.