Recently, the interest in the use of complementary and alternative medicine (CAM) by patients in the U.S. has incre

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Recently, the interest in the use of complementary and alternative medicine (CAM) by patients in the U.S. has increased tremendously (Arcangelo et al., 2017).  With the rising costs of traditional health care as well as the increased dissatisfaction of medical care, patients are turning to alternative means as a way to gain more control over their treatment process and incorporate seemingly “natural” alternatives into their life (Arcangelo et al., 2017).  If done correctly and under the supervision of qualified healthcare providers this route can help enhance treatment regimes, but great caution must be taken to avoid harm caused be unproven claims.

According to Borse et al. (2019), 52% of cancer patients at the MD Anderson Cancer Centre reported the use of CAM therapies in combination with their treatments.  They article also stated that many patients being treated for chronic diseases like diabetes and cancer use alternative treatments like herbal supplements with or without the knowledge of their physicians, placing the patient at increased risk for adverse drug reactions (Borse et al., 2019).

In order to preserve safety in care with patients choosing these types of alternatives in-depth patient teaching is required.  One safety issue to discuss is that over the counter (OTC) supplements used by patients are not considered medicine and do not have to abide by the strict regulations set forth by the FDA (Arcangelo et al., 2017).  This means that health claims made by the company are not approved by the FDA.  Certain claims like fighting cancer, diabetes and hypertension do not need to be backed by the same rigorous studies and testing done with prescription drugs (Arcangelo et al., 2017). 

As a prescriber I would have concerns about my patients’ taking supplements in conjunction with the prescribed treatment.  It is more likely that a patient forgets to report supplement type and dosage to the provider than OTC and prescribed medications (Arcangelo et al., 2017).  This can be problematic when adverse actions arise without a known cause to the prescriber.

Supplements like Coenzyme Q10 has been used for ailments like cancer and diabetes but can interfere with prescribed drugs like reducing the effectiveness of warfarin, increase the effects of blood lowering medications and alter the effects of thyroid hormone medications (Arcangelo et al., 2017).  Having clear communication about its use with the provider is one of the only ways they can ensure that it does not interfere with regular treatment with the patient.  

Another herbal supplement that is commonly used to prevent the growth of cancer cells flaxseed.  It is reported to be able to do this by disrupting malignant cells from attaching to other cells with its high omega-3 fatty acid content (Arcangelo et al., 2017).  Caution should be taken with this medication as it can lower blood sugar and decrease blood clotting.  Diabetics need to be encouraged to closely monitor their blood sugar levels while taking this supplement (Arcangelo et al., 2017). 

Ginkgo Biloba is another supplement commonly used for its properties to promote increased tissue perfusion and blood flow (Arcangelo et al., 2017).  This supplement, considered an antioxidant has minimal studies showing its efficacy at lowering cholesterol in patients (Arcangelo et al., 2017).  Adverse drug interactions noted are hypoglycemia in patients using it with diabetic medications as well as increased blood pressure when taken with thiazide diuretics (Arcangelo et al., 2017).          

In order for prescribers to maintain safety in their treatment regime, they must have open communication directed at the current and additional use of supplements throughout therapy.  According to Asher et al. (2017), 17% of patients use dietary supplements with less than on-third of them reporting this use to their provider.  The article suggests that the best way to prevent adverse reactions is knowledge about the additional use of these substances as well as the provider keeping up to date on literature about the interactions these substances have with prescribed drugs (Asher et al, 2017).  With so many people using alternative medications it is not enough for prescribers to just condemn their use, they must have open discussions with their patients and up to date knowledge in order to work with their patients in a safe, effective treatment plan.