Conventional health care has come a long way and is arguably more effective than ever in diagnosing and treating disease. So why do so many people turn their backs on them and consult alternative practitioners like acupuncturists, osteopaths, iridologists, aromatherapists, etc. ?
This troubling question has not one, but multiple answers. One of the main ones is the popularity of the idea that alternative medicine is gentle, pleasant and harmless. Every time I talk to someone about this topic, I hear something like, “Okay, these therapies might not be perfect, but at least they don’t hurt.” It is precisely this postulate that attracts patients tired of the sometimes serious side effects of modern drugs. The practitioners of alternative medicine are of course doing everything possible so that we do not forget this seductive message. Unfortunately, it is not only wrong, but also dangerous. Certainly, an aromatherapy massage is pleasant and a reflexology session can be relaxing. But alternative medicine is not free of dangers either. And their risk of causing unwanted side effects is more complex than most of us imagine.
Dangers for the liver, arteries, lungs…
The most obvious risk is that of direct harm due to adverse effects of the applied treatment. Some alternative therapies, such as homeopathy or divine healing (or “faith healing”), are very unlikely to cause direct adverse effects. But unfortunately this is not the case for many others. Like some herbal remedies that can damage the liver.
For example, turmeric, which is particularly popular these days, is touted as a wonder drug capable of curing multiple disorders including serious illnesses. Yet a series of recent cases suggests that it can cause damage – sometimes severe in some cases – to the liver, as shown in this study published in 2023 in the scientific journal The American Journal of Medicine. As for the manipulations of the spine used by osteopaths and chiropractors, they have regularly been associated with serious damage to the arteries that supply the brain, which can lead to strokes and even death, indicates this study that I published in 2010 in theInternational journal of clinical practice. And during acupuncture sessions, a needle can also perforate the lung, which, in turn, leads to complications that can prove fatal, reveals this case series published in theInternational journal of emergency medicinein 2022.
Unreliable diagnoses
When we talk about alternative medicine, we almost automatically think of treatments and we forget that alternative practitioners also use a wide range of diagnostic techniques unknown to conventional health care: iridology, applied kinesiology, diagnosis by language, etc., which I mention in my book Alternative Medicine: A Critical Appraisal of 202 Modalities (ed. Springer International Publishing). Thus, a patient in perfect health can be diagnosed with this or that disease, wrongly. Then follows a series of useless treatments at the end of which the practitioner proudly announces the disappearance of a disease that never existed. As a result, part of his client’s wallet also disappears…
There are even more disturbing scenarios, such as when practitioners claim their patient is disease-free when they are actually affected by the early stages of a serious condition like cancer. Valuable time that could have been spent on treating the disease early with conventional care is then wasted and, in the worst case, the patient may even die prematurely due to the risk of an unnecessary alternative diagnostic method.
Endangerment of protected species and incompetence
In some forms of alternative health care, such as traditional Chinese medicine, practitioners like to prescribe products from endangered animal or plant species. “It is of great concern that China has reversed its 25-year-old ban on tiger bone and rhino horn, allowing a trade that will have devastating global consequences. The trade in tiger bone and rhino horn was banned in 1993. wild state”, says Margaret Kinnaird of the World Wide Fund for Nature (WWF).
But perhaps the most significant risk is the collateral damage caused by the advice given by particularly incompetent practitioners. An example that we have all had the opportunity to encounter during the Covid-19 pandemic is the recommendation of naturopaths, homeopaths, chiropractors and even doctors practicing alternative medicine not to vaccinate, a practice which has also been sanctioned by the courts, in the United Kingdom. This seems so obvious that it does not seem necessary to explain why advice discouraging the taking of prescribed drugs endangers the health of patients, but in the case of vaccinations, it must be remembered that the consequences can be serious, and that if the practice is too widespread, it can endanger the health of entire populations.
Undermining trust in conventional care
Finally, there are several other issues that may seem far-fetched at first glance, but which are unfortunately real and widespread. For example, the damage that practitioners of alternative medicine cause by medicalizing insignificant states of ill-being. How many times have we heard a totally minor problem become extremely popular because an alternative practitioner gave it an ominous name, or because he felt that someone on a bad day would be chronically ill? An upset stomach, for example, can become a “leaky gut” syndrome. Food aversion? It’s an allergy. A transient back pain? Probably chronic lumbago. A bad mood turns into depression and a conflict at work becomes a burnout.
Likewise, it should also be pointed out that alternative practices can cause damage, in particular because they undermine confidence in evidence-based medicine, in rational thought, as well as in medical progress and research. Proponents of alternative medicine tend to believe that their personal experience is more important than scientific evidence. And spiritual healers attack rationality by claiming that there are healing energies that can be channeled and transmitted from person to person. Homeopaths, on the other hand, fight to have research funds diverted from conventional research to confirm their implausible ideas. Because of these diverse mechanisms, even seemingly innocuous alternative therapies can cause untold damage.
“The value of a medical treatment is not determined solely by its absence of harm”
Despite all these arguments, consumers of alternative medicine convinced of its benefits advance an ultimate answer: “There may be risks, but at least they are much lower than those of conventional drugs”. It may be true. And if we want to give an extreme example, aromatherapy is undeniably much safer than chemotherapy! But the argument is no less absurd. Chemotherapy unquestionably saves lives, while aromatherapy provides little more than a pleasant experience.
What I am trying to say is simple: the value of medical treatment is not determined solely by its harmlessness. It depends above all on the benefits it brings. This is why experts talk about the paramount importance of balancing risk and reward. If therapy can save your life, you’re likely to endure even the most ominous side effects. On the other hand, if a treatment has no tangible health effects, even a relatively low risk will tip the risk/benefit balance towards the negative, making it undesirable.
* Edzard Ernst is Emeritus Professor at the University of Exeter, UK