Alternative therapies: without evidence they do more harm than good

The efficacy of Ginko biloba has not been proved. Rebecca Anne

Alternative medicines and therapies are not only costly and largely ineffective, they may harm the individuals who use them and, indirectly, harm the institutions that promote and teach these very dubious therapies.

I’m particularly concerned that some of the smaller universities – around 17 of them – are giving degree courses in “quackery”. They’re giving the imprimatur of the university to non-evidence based medicine and non evidence-based courses.

Chiropractic is one of them but homeopathy, iridology, naturopathy and various non evidence-based medicines are being taught at universities, and degrees are being given for these courses.

This undermines the credibility of the universities, particularly if there are true scientists in these universities trying to get funding for their science and trying to say their science is credible.

The best source to find whether something is efficacious or not, or safe or not, is to go to the Cochrane Reviews. These are independent, peer reviews.

If you look up the basis of commonly used alternative medicines such as Gingko biloba or Valerian, you’ll see that the Cochrane Reviews do not show efficacy.

When alternative medicine people say, “we have evidence”, they usually can’t show the evidence or they refer to highly selected, poor quality trials as their evidence. They ignore the Cochrane systematic reviews of the evidence.

Most alternative medicines and therapies – whether it’s chiropractic or acupuncture – do no better than a properly controlled placebo group. So a lot of these therapies are placebos.

And why shouldn’t people with a chronic illness be left to to use a placebo? Because here are four potential harms to these so-called “harmless therapies”.

1) They are a terrible waste of the health dollar.

Alternative medicine industry (the medicines alone) is a $4 billion a year industry in Australia, and there is probably the same again spent on therapies, such as acupuncture and chiropractic. This is a huge waste of the health dollar.

When the health system needs so much money for proven medicine, it seems silly to waste it on the unproven.

I’m the very first to say that there are also unproven medicines used in conventional medicine, and all the time conventional medicine is trying to root out its unproven therapies and get rid of the things that do more harm than good.

Conventional medicine is not immune to this but there is a better reputation in conventional medicine for trying to minimise the problems and test the value of these therapies.

2) Side effects and drug interactions, which are hugely under reported.

There’s no great obligation to report side effects from alternative medicines. Most patients don’t tell their doctor that they’re on alternative medicines. The patients don’t think their side effects could be caused by the “natural” therapies they’re taking and the doctors don’t know they’re taking it.

3) The depression, disappointment and disillusionment that comes from going to the health food shop shelf, buying one medicine after the other that’s recommended by an unqualified person behind the counter. For example, to relieve the symptoms of premenstrual syndrome or menopause.

But the placebo effect soon wears off and they have to move onto another expensive product and another expensive product. This makes the consumer more and more disillusioned and they question whether they should they believe any health professional.

4) This is the most harmful: the delay of effective therapy.

If you take a herb for your appendicitis you could easily have the appendix rupture and have a much worse situation than if you had sought early appropriate treatment in the first place.

If you are using an inappropriate supplement for your osteoporosis you will lose 1% to 2% of your bone each year and become more and more osteoporotic. When you eventually find that the supplement was not effective and you could have been on something better, it’s too late to restore your bone.

So there are many risks to these therapies. Universities need to look hard at themselves and stop trying to make money out of courses that are lowering their reputation and credibility. They should not be endorsing courses of quackery.

Finally, as an obstetrician I am concerned that pregnant mothers and babies are targeted by chiropractors and naturopaths.

The use of alternative medicines on children is a form of child abuse albeit well-intentioned. But it’s a form of child abuse and it shouldn’t be encouraged by alternative practitioners who try to make money out of gullible parents.

The four harms of the harmless therapies should be remembered.