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Natural doesn't mean safe. And CAM is neither.

It's surprising how easily people fall for the argument that complementary or alternative therapies are safe, because they are natural. Yet on both counts, this argument is false.

It's surprising how easily people fall for the argument that complementary or alternative therapies are safe, because they are natural. Yet on both counts, this argument is false.

One of the strongest selling points for complementary or alternative therapies is the notion that they are natural – and anything natural is, of course, safe isn't it?

It is surprising how easily people fall for this nonsense – even GPs. And who can blame them? If we hear something a hundred times, we tend to believe it. This is called brainwashing! I can think of a lot of things that are natural and outright dangerous: an earthquake, a flash of lightning, a landslide, a tsunami, etc, etc, etc.

41223903But seriously, most complementary or alternative treatments are neither natural nor totally safe. What is natural about sticking needles into people's skin? What is natural about serial dilution as in homeopathy? What is natural about cracking bones as in chiropractic? The answer is, not a lot!

But these treatments could still be safe. The trouble is, however, that this notion is not true either. Sure, most of these treatments probably have less adverse effects than the powerful drugs of mainstream medicine, but risk-free? No.

One problem with assessing therapeutic risks reliably is that you need to actively look for adverse effect. The information rarely falls into your lap. So who is looking?

The answer is nobody.

Apart from the yellow card scheme which does cover adverse effects of herbal treatments, there is no mechanism in complementary or alternative medicine that would record adverse effects, not even serious ones.

Some years ago, I wrote to all UK professional organisations of complementary medicine asking them how they monitor adverse effects in their area of healthcare. The answers were almost entirely uniform: we don't need post marketing surveillance because we do not cause harm; this is only an issue in mainstream medicine.

So, is it fair then to say that we know of no risks because, so far, nobody has looked out for them? Not quite. We do know a little bit about risks of complementary or alternative medicine because, like sailing past the tip of an iceberg during bright daylight, we could not help noticing. But systematic knowledge akin to the one in conventional healthcare is usually not available.

For instance, we know of approximately 700 patients who suffered severe injuries, mostly vascular accidents, after spinal manipulation. Despite this impressive figure – a drug with this track record would probably have been banned long ago – most chiropractors insist that a causal link has not been established.

The website of the General Chiropractic Council has a question and answer section where we find the following:

"Q. Is chiropractic safe?

A. Yes, all the evidence is that chiropractic is a safe and effective form of care when provided by registered chiropractors…"

Really? All the evidence? You must be kidding! But the general public tends to believe such promotional misinformation: after all, natural must be safe.

Professor Edzard Ernst Recent posts

So-called 'integrated medicine' is disturbing nonsense 30 March 09
Why 'belief' in complementary medicine is misguided 23 March 09

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