Complementary and alternative medicine, also called CAM, is enjoying a surge of popularity in the United States. Integrative medicine is developing as a new form of medical practice.

The standard form of health and medical care practiced in the United States is conventional medicine, also called "Western" medicine (its practice began in the Western Hemisphere) or allopathic medicine. When you go to a doctor who is an M.D. or a D.O., she will likely diagnose you and treat you based on the medical knowledge and experience she has gained through conventional education or practice, using drugs, surgeries or standard physical therapies.

CAM therapies take a different approach. Most are founded in Chinese medicine, also called Eastern medicine (emanating from the Eastern hemisphere). They rely on herbs and other "natural" substances (we'll explore that word "natural" below), orienting the human mind or physical manipulation to achieve health and wellness.

Integrative medicine is a combination approach that takes complementary, alternative and conventional medicine into consideration. It's the point at which East meets West for wellness, and where the combination can allay the disagreement.

What is the Difference Between Complementary and Alternative Forms of Medicine?
Often, these two terms are used interchangeably. However, there is a difference.

Alternative therapies are used in place of a conventional medical approach. If you chose to do yoga instead of going to a physical therapist, it would be considered an alternative therapy.

Complementary therapies are used together with conventional therapies. For example, your doctor might suggest you take calcium for your bones, plus one of the drugs developed to stave off osteoporosis. Since you are using both approaches, it would be considered complementary.

What Medical Approaches are Considered to Be Complementary and Alternative?
You have probably used some forms of CAM without realizing it. If you put aloe on a cut, for example, or if you take zinc or ecinacea when a cold gets started, you are using alternative remedies. Men take saw palmetto for prostate health, and people with arthritis take glucosamine and chodroitin to help relieve pain. You may choose foods with antioxidants or omega-3 fatty acids to stay healthy.

The U.S. government, on its website devoted to Complementary and Alternative Medicine, breaks down these therapies into five categories:

• Biologically-Based, such as herbal supplements, botanicals, animal-derived products, vitamins, proteins, probiotics and other organic approaches.
• Energy Medicine, such as veritable energy like sound, electromagnetic forces, and light or putative energy fields (also called biofields) which work to identify a body's own energy field, also called "chi." Alternative medicine professionals believe that when these biofields are disturbed, it causes illness in the body.

Examples of energy medicine are acupuncture, reiki, Qi gong, homeopathy, healing touch and intercessory prayer in which the prayers of one person help improve the health of another. These particular therapies are among the most controversial of the CAM therapies.

• Manipulative and Body-Based, such as chiropractic, osteopathic, reflexology, and therapeutic massage. These therapies rely on the structures and systems of the body, making adjustments to them to heal symptoms and medical problems.
• Mind-Body Medicine, which focuses on the interactions among the brain, behavior and physical health, such as meditation, yoga, biofeedback, tai chi, even spirituality.

Even conventional medicine has long understood the relationship between the mind and the body. Mental health and physical health are intertwined, and this type of approach is being used more and more for pain control, cancer management, and is being explored to learn more about its immunity response.

• Whole Medical Systems that have evolved totally separately from what we consider to be conventional medicine in the United States. These systems have names like naturopathy, homeopathy, traditional Chinese medicine, Eastern medicine and Ayurvedic medicine. You will see some of these names already mentioned in the categories above. The distinction here is in the way they developed rather than the therapy itself.

What is Integrative Medicine?
For those practitioners and patients who want to consider both conventional and CAM medicine in their medical decision-making, the integrative model makes sense.

Integrative medicine is the combination of the two. It takes the best practices of both worlds, reviews the evidence for treating whatever the patient's medical problem is, and combines them to benefit the patient. An integrative doctor will choose from either conventional medicine, or CAM, or will choose them together.

For example, there is evidence that teaching breast cancer patients to meditate, a complementary treatment, in combination with chemotherapy, a conventional treatment, improves their outcomes. It helps reduce stress, improve mood, improve their quality of sleep and reduce their fatigue. This is both complementary and integrative.

Are CAM Remedies Really "Natural"?
Some are. Some are not. Sometimes herbs and other plant substances are combined with non-natural additives to make an alternative supplement.
 
You'll find many claims that supplements are "natural." You are supposed to draw the conclusion that "natural" equates to safe -- and that is not always true. Not all natural substances are safe (think arsenic or toxic plants), which also contributes to the controversy behind complementary and alternative therapies.

Thinking About CAM for Yourself?

If you are interested in pursuing complementary or alternative therapies, and just as you should for any therapy you and your doctor decide to choose, be sure to:

1. Understand the controversies, then...
2. Do your research, including...
3. Review of the evidence.
4. Then talk to your doctor. If your doctor is unwilling to help you integrate CAM treatment, then...
5. You may need to change doctors.