Alternative and complementary medicine — what the evidence says

This article provides information about alternative and complementary medicine approaches. Always discuss any alternative or complementary treatments with your elder's doctor to ensure they're safe and don't interact with other medications.

Your mother has been taking turmeric for her arthritis. Your father is considering acupuncture for his back pain. A friend recommended their elder try traditional herbal medicine rather than the medications the doctor prescribed. How do you sort through this? What actually works? What's safe? What's a waste of money?

Alternative medicine and complementary medicine are often used interchangeably, but they're different. Complementary medicine is used alongside conventional treatment. Alternative medicine is used instead of conventional treatment. When your mother takes turmeric supplements while continuing her arthritis medication, that's complementary. If she were to stop the arthritis medication and use only turmeric, that would be alternative.

The evidence for different approaches varies tremendously. Some have solid research. Some have no research. Some have been studied and shown not to work. The challenge is figuring out which category something falls into.

Acupuncture has actual evidence behind it. Multiple studies show that acupuncture helps some people with chronic pain, including back pain and arthritis. The evidence isn't perfect, but it's real. Insurance sometimes covers acupuncture. It's considered complementary medicine, used alongside other treatments.

Tai chi, a slow moving meditation practice, has evidence for improving balance and reducing falls in older adults. Studies show it helps. It's accessible, has low risk, and many communities offer classes. This is another approach with genuine evidence.

Massage therapy helps some people with muscle tension, stress, and pain. The evidence is mixed, but some conditions seem to benefit. Some insurance covers massage with a referral. Like tai chi, it's low risk if done by a trained therapist.

Yoga, when adapted for older adults, might help with flexibility, strength, and balance. Classes specifically designed for seniors are often safe and helpful.

Then there are approaches with minimal or no evidence. Homeopathic remedies are heavily diluted substances that, scientifically, contain no active ingredient. Studies consistently show homeopathy is no better than placebo. Yet people report feeling better after using it. This might be the placebo effect, which is real, or might reflect the time and attention paid to the person. If your elder wants to use it, it's probably harmless, though expensive.

Herbal supplements vary wildly in evidence. Some have been studied and shown to help. St. John's Wort, for example, has evidence supporting its use for mild depression, though it interacts with many medications. Ginkgo biloba has some evidence for memory support, though the research is modest. Most herbal supplements have little to no research supporting their use, and some are actually dangerous.

The problem with supplements is that they're not regulated like medications. A bottle of herbal supplement might contain what it says, or it might contain something different. The dosage might vary. The quality is not guaranteed. Some supplements contain ingredients not listed on the label. Some contain contaminants.

This is where talking to a doctor matters. Your elder should tell their doctor about any supplements they're taking. Why? Because supplements interact with medications. Ginkgo biloba increases bleeding risk, which matters if your elder is on blood thinners. St. John's Wort interferes with many medications including birth control and blood pressure medications. Supplements that lower blood sugar interact with diabetes medications. If your doctor doesn't know your elder is taking a supplement, they can't adjust other medications appropriately.

Some complementary approaches are harmless but ineffective. They don't help but don't hurt either. This is fine if the cost is low and your elder believes they help. The placebo effect is real and sometimes enough.

Some approaches are actually dangerous. High-dose supplements can cause organ damage. Certain herbal remedies have no research and genuine toxicity. Some have led to serious poisoning. Relying exclusively on alternative treatment for a serious condition instead of seeing a doctor can mean missing critical diagnosis.

The question of whether to use complementary approaches alongside conventional treatment deserves thoughtful consideration. If your elder wants to try acupuncture for back pain while continuing physical therapy and pain medication, that's probably fine if done by a licensed acupuncturist. If your elder wants to try meditation and tai chi while taking heart medications, that's good. These things work together.

But if your elder wants to stop their medications and use only supplements, that's a conversation that needs to happen with their doctor. Sometimes there are legitimate reasons to try something different. Sometimes the medications aren't working or side effects are intolerable. But stopping medications without medical guidance is dangerous. There are always alternative treatments within conventional medicine before turning to unproven approaches.

The financial aspect matters too. Some complementary therapies are expensive. Insurance doesn't always cover them. Your elder might be spending money on approaches that don't actually help. This is particularly concerning when someone is on a fixed income and struggling to pay for proven medications.

Finding quality practitioners is important. If your elder wants acupuncture, see someone licensed by their state. If they want massage, see a licensed massage therapist. If they want a chiropractor, find one with good credentials. Not all practitioners in complementary fields are equally trained.

Be especially cautious about anyone promising to cure diseases with complementary medicine. Be cautious about anyone telling your elder to stop conventional treatment. Be cautious about anyone claiming to have secret knowledge not understood by regular doctors.

Some older adults use complementary medicine because they feel a loss of control over their health. Conventional medicine sometimes feels like things being done to them rather than with them. Complementary approaches can feel more giving you the tools. This is valuable, and it's worth discussing these feelings with their doctor. Sometimes conventional doctors can address this by involving your elder more in decisions.

Your role is supporting informed decision-making. Help your elder understand what evidence exists. Help them talk to their doctor. Help them avoid practitioners who are frankly fraudulent. Help them avoid spending limited resources on approaches that don't work. Help them understand that conventional and complementary medicine can coexist.

Before your elder starts any new supplement or complementary treatment, discuss it with their doctor. Tell their doctor about everything they're taking, including supplements and herbal remedies. Don't replace proven medications with unproven alternatives without talking to their doctor. If complementary approaches make your elder feel better and don't interfere with other treatment, that's fine, but discuss it with their medical team.