Complementary & Alternative Medicines

Complementary and alternative medicine (CAM) includes a wide variety of interventions — from diets and supplements to meditation and T’ai Chi — which come from many different disciplines and traditions. Most are considered to be outside the realm of conventional medicine, although others, including vitamin D, exercise, acupuncture and cooling strategies, for example, are establishing their role in comprehensive care through scientific study and clinical trials.When used in combination with conventional medicine, these interventions are referred to as “complementary”; when used instead of conventional medicine, they are referred to as “alternative.” In the United States today, the vast majority of people incorporate one form or another of CAM as part of their MS management, most often in combination with their prescribed MS treatments. 

Many people use CAM because they believe that anything sold online or over-the-counter at a pharmacy or health food store is healthy and harmless. But many products that claim to be safe and beneficial may not be. Unlike conventional medical treatments that are thoroughly tested and carefully regulated by the U.S. Food and Drug Administration (FDA), most CAM therapies have undergone very little — if any — scientific study to evaluate their safety and effectiveness. So some forms of CAM may be completely safe for a person with MS while others may actually pose significant risks — by producing significant side effects, over-stimulating the person’s immune system or interacting negatively with other medications a person is taking. Some may provide benefit for a person with MS while others offer no benefit at all.The American Academy of Neurology released a guideline on the use of complementary and alternative medicine (CAM) in MS. The guideline was developed to address the following questions:

1. Do CAM therapies reduce specific symptoms and prevent relapses or disability?
2. Can CAM use worsen MS or cause serious adverse effects?
3. Can CAM use interfere with MS disease-modifying therapies?

Although these are all very important questions, the authors found very few published studies of sufficient quality to provide helpful answers about most of the CAM therapies that are being used by people with MS.

Carefully-designed clinical trials are the best way to determine the safety and effectiveness of a particular treatment. Here’s why:

• Because the course of MS is variable, and each person’s symptoms tend to come and go in an unpredictable way, the only way to determine if a treatment is effective is to test it against a placebo or an already established treatment, in a large number of people.
• Because every treatment carries with it the risk of anticipated and unanticipated side effects, the only way to evaluate a treatment’s safety is to evaluate it in a large number of people over a sufficient period of time.

Questions to ask when considering CAM:

• What does the treatment involve?
• How and why is it supposed to work?
• How effective is it?
• What are the risks associated with its use?
• How much does it cost or is it covered by your insurance plan?
• Will it interact with my other therapies?