Risks Associated With Undisclosed Complementary and Alternative Medicine in Clinical Practice.

Abstract

Complementary and alternative medicine (CAM) use is widespread among American adults, with the National Health Interview Survey reporting use in 36.7% of patients in 2022. Most patients using CAM do not disclose this to their physicians. Physicians often have limited familiarity and may therefore underestimate the biologic potency and potential toxicity of many CAM treatments. They might miss that such therapies can exert real clinical effects. Although herbs and supplements are often regarded as harmless because they are "natural," evidence finds they can cause adverse effects, contamination-related harms, and drug interactions. Some CAM practitioners administer chelation therapy for nonconventional indications, such as Lyme disease, which can cause significant adverse effects. Physicians may misdiagnose the cause of these adverse effects. There is a great need for physician education about the different CAM treatments, the indications or rationale for which CAM providers may recommend these treatments, and the effects and interactions of each intervention.