Alternative medicines are popular, but do any of them really work?

(ISTOCKPHOTO/ ) - Coconut oil is sometimes recommended for helping prevent Alzheimer’s disease.

(ISTOCKPHOTO/ ) – Coconut oil is sometimes recommended for helping prevent Alzheimer’s disease.

By Paul Offit

If people want to burn fat, detoxify livers, shrink prostates, avoid colds, stimulate brains, boost energy, reduce stress, enhance immunity, prevent cancer, extend lives, enliven sex or eliminate pain, all they have to do is walk in to a vitamin store and look around.

The shelves will be lined with ginkgo or rose and orange oils touted as aids for memory; guarana and cordyceps for energy; chicory root for constipation; lemon balm oil, ashwagandha, eleuthero, Siberian ginseng and holy basil for stress; sage and black cohosh for menstrual pain; coconut oil and curry powder for Alzheimer’s disease; saw palmetto for prostate health; sandalwood bark to prevent aging; garlic for high cholesterol; peppermint oil for allergies; artichoke extract and green papaya for digestion; echinacea for colds; chondroitin sulfate and glucosamine for joint pain; milk thistle for hepatitis; St. John’s wort for depression; and tongkat ali for sexual potency.

The question, however, is: Which products work? And how do we know they work? Fortunately, thanks to James Lind, we can figure it out.

When Lind climbed aboard the HMS Salisbury intent on testing whether citrus was a cure for scurvy in 1740, he moved medicine from a faith-based system to an evidence-based system. No longer do we believe in treatments. We can test them to see whether they work.

Although the size and cost of clinical studies have increased dramatically since the days of Lind, the claims made about alternative remedies are testable, eminently testable.

In that sense, there’s no such thing as alternative medicine. If clinical trials show that a therapy works, it’s good medicine. And if a therapy doesn’t work, then it’s not an alternative.

For example, Hippocrates used the leaves of the willow plant to treat headaches and muscle pains. By the early 1800s, scientists had isolated the active ingredient: aspirin. In the 1600s, a Spanish physician found that the bark of the cinchona tree treated malaria. Later, cinchona bark was shown to contain quinine, a medicine now proven to kill the parasite that causes malaria. In the late 1700s, William Withering used the foxglove plant to treat people with heart failure. Later, foxglove was found to contain digitalis, a drug that increases heart contractility. More recently, artemisia, an herb used by Chinese healers for more than a thousand years, was found to contain another anti-malaria drug, which was later called artemisinin.

“Herbal remedies are not really alternative,” writes Steven Novella, a Yale neurologist. “They have been part of scientific medicine for decades, if not centuries. Herbs are drugs, and they can be studied as drugs.”

Looking at the claims

In many case, though, when natural products have been put to the test, they’ve fallen short of their claims. For instance, although mainstream medicine hasn’t found a way to treat dementia or enhance memory, practitioners of alternative medicine claim that they have: ginkgo biloba. As a consequence, ginkgo is one of the 10 most commonly used natural products.

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