HARVARD GAZETTE ARCHIVES

Alternative Medicine is Booming, Study Shows

Americans Spend $27 Billion a Year on Herbs, Massages, and Other Elective Treatments

By William J. Cromie
Gazette Staff

An estimated 4 out of every 10 Americans have tried relaxation techniques, herbs, massages, megavitamins, spinal manipulation, homeopathy, hypnotism, biofeedback, acupuncture, or other things you generally won't find in a physician's office or in a hospital. They spent $21.2 billion for the services of alternative therapists in 1997 - $12.2 billion of it not covered by insurance, according to a Harvard study.

In 1997, the study found, people in the United States made more visits to alternative medicine practitioners than to primary care doctors. The score was 629 million to 386 million.

"The market for alternative medicine is vast and growing, [despite] the low rates of insurance coverage for these services," notes David Eisenberg of the Harvard-affiliated Beth Israel Deaconess Medical Center in Boston. He and colleagues at the Harvard Medical School surveyed 2,055 adults by telephone and compared use of alternative therapies with 1,539 adults surveyed in 1990. They found that visits to alternative-medicine practitioners jumped 47 percent and money spent rose 45 percent in just seven years.

In both 1990 and 1997, people turned to alternative help most frequently for such chronic conditions as back and neck pain, anxiety, arthritis, and headaches. Therapies that saw the greatest increase in usage include herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. The latter involves administration of minute doses of substances that would produce symptoms similar to that disease in healthy people, for example treating diarrhea with a tiny amount of laxative.

The study recorded a 380 percent increase in the use of herbal remedies and a 130 percent rise in the use of high-dose vitamins from 1990 to 1997. Women availed themselves of these and 14 other alternative therapies more than men (49 percent compared with 38 percent). Those aged 35 to 49 took more advantage of alternative services and products than younger or older people. Use was higher among the college-educated and people with incomes exceeding $50,000 a year than among those with less education and lower incomes.

Less than half of these people tell their medical doctors about their use of alternative therapies. That worries the researchers because they estimate that one in every five Americans who took prescription drugs in 1997 also took herbs, megavitamins, or both. This suggests that 15 million adults could be at risk for adverse effects from such combinations. These effects include reducing or eliminating the benefits of the prescription drugs, or worsening liver or kidney problems.

"This figure includes nearly 3 million people 65 years or older," according to the Harvard scientists.

Spines, Fetuses, and Bowels

Eisenberg, who directs the Center for Alternative Medicine Research and Education at Beth Israel Deaconess, Medical Center, reported on this study at an American Medical Association briefing in Washington, D.C., on Tuesday, Nov. 10. Other presentations at the meeting covered successful and unsuccessful applications of alternative treatments such as spinal manipulation, various herbal remedies, and an ancient Chinese medical practice.

Geoffrey Bove of Harvard Medical School described research that led him and Niels Nilsson of Odense University in Denmark to conclude that spinal manipulation does not relieve tension headaches. Such headaches affect more than one-third of all Americans and involve mild to moderate pain on both sides of the head. Most people treat them with nonprescription drugs such as aspirin or Tylenol, but others look for relief with hands-on manipulation, usually done by a chiropractor.

The researchers divided 75 people into two headachy groups. One group received spinal massage, the other did not. No significant differences were found between the two groups.

Other meeting participants described using a traditional Chinese system called moxibustion to move a fetus into the correct position for birth. Moxibustion involves burning herbs to stimulate acupuncture points, but it also increases the likelihood that unborn babies will move into a "headfirst" position in the womb, researchers found. In China, burning herbal preparations containing moxa (Artemisia vulgaris) is sometimes used in place of needles to stimulate acupuncture sites. It also is a popular treatment in China for provoking a fetus to move from the hind-first to the headfirst position.

Chinese herbal medicine may also help those with irritable bowel syndrome, according to a group of scientists in Australia. Between 10 and 20 percent of Americans suffer from this problem, which causes stomach pain and disturbed bowel function. Sufferers use a variety of treatments to handle the pain and discomfort, including drugs, changes in diet, and counseling. Now, they can try Chinese herbs for relief, say the researchers.

More and more people in the United States take an herbal compound known as Garcinia cambogia to lose weight. But a scientific test done at St. Luke's-Roosevelt Hospital in New York City shows that it works no better than a placebo. There was little difference in weight and fat loss among 135 overweight people who took one or the other.