You Use That Stuff, Too?

You're Not the Only One Sold on Alternative Approaches. Here Are Ten of America's Favorites -- and What the Science Shows

It's not exactly a secret that Americans have leapt ahead of the science on alternative medicine, trying supplements and therapies -- such as echinacea for colds and yoga for back pain -- without waiting for proof of their efficacy. But just how far ahead they've gotten became clear earlier this month when the National Center for Complementary and Alternative Medicine (NCCAM) released a survey showing that more than one-third of American adults used some kind of complementary and alternative medicine in the past year. Broadening the definition of alternative health to include prayer raised the figure to nearly two-thirds.

The willingness of Americans to experiment on themselves generated $49.6 billion in supplement sales and payments to alternative health care providers in 2002, according to the Nutritional Business Journal, an industry publication.

Some researchers say it's time for the science to catch up with this hefty market -- especially since not all of these treatments can be presumed to be harmless. Experts caution that people should be sure to tell their doctors when they try herbs or other therapies, and people should not use alternative medicines or treatments in lieu of safe and effective conventional care.

But do the most frequently used alternative treatments really work? In many cases, it's hard to say. Because most mainstream medical researchers have shown little interest in studying alternative healing methods and because funding for large-scale research has been scarce, controlled, randomized studies are rare. The NCCAM is trying to change that. The center, which was established by Congress in 1998 and is part of the National Institutes of Health, will spend an estimated $103.5 million in 2005 to fund scientific studies into alternative and complementary medicines and treatments. Government funding for the center has risen from $50 million in 1999 to $117 million this year.

Meanwhile, we examined 10 therapies that placed high on NCCAM's survey to see what the best science currently shows about their efficacy.

Echinacea

After prayer -- a special case that we'll return to later -- herbs and other "nonvitamin, nonmineral, natural products" are the alternative therapies Americans turn to most, used by a quarter of the more than 31,000 adults interviewed for the NCCAM survey. And among such products, echinacea is the hands-down favorite, used by 40 percent of this smaller group. That places it in the top 10 therapies used in the survey.

Native Americans used echinacea, made from the root and other parts of the coneflower, for various ailments, and some German studies have shown that doses of echinacea can stimulate parts of the immune system. Today, users mostly take the herb in pill or liquid form in hopes of warding off or reducing the severity of the common cold.

Bruce Barrett, a researcher with the University of Wisconsin-Madison Department of Family Medicine, said evidence for the use of the herb as a natural cold medicine is mixed. While some small, older studies suggested that echinacea reduces the symptoms and duration of the common cold, several larger, more recent studies found no effect. (This includes one of Barrett's own studies, published in December 2002 in the Annals of Internal Medicine.) A study published this month in the Archives of Internal Medicine (and described in Quick Study, Page F8) also found that taking echinacea did not lessen the severity of colds or speed recovery. Another study, published in the December 2003 Journal of the American Medical Association (JAMA), found the herb didn't help children get over their colds faster or improve their symptoms.

According to the Mayo Clinic Web site, most forms of echinacea are unlikely to cause serious side effects if dosing instructions are followed. (Echinacea injections, which are not recommended by Mayo, can cause severe allergic reactions.) Some studies are examining whether echinacea may interfere with birth control medications.

Ginseng

The Chinese have used Panax ginseng, the root of Asian ginseng, for 2,000 years. In the United States, users generally take it in pill form, hoping to improve mental performance and concentration. Ginseng was the second most popular natural product in the NCCAM survey -- 24 percent of those who used herbal products had used it in the past year.

Some studies have shown that ginseng can improve reaction time and learning ability, but they haven't been well designed or reported, according to the Mayo Clinic Web site. Other studies have suggested that taking ginseng together with ginkgo biloba may boost brain power, but again the studies are small and not randomized or controlled.