Alternative and complementary medicine — what the evidence says

Reviewed by a board-certified geriatric medicine specialist

Some complementary approaches have solid evidence behind them, and some have none at all. Acupuncture, tai chi, and CBT-based therapies have earned NIH recognition for specific conditions in older adults. High-dose supplements, homeopathy, and unregulated herbal remedies carry real risks, from drug interactions to organ damage. The key is knowing which is which before your parent spends money or stops a proven medication.

Acupuncture, Tai Chi, and Certain Mind-Body Practices Have Real Evidence for Older Adults, but Supplements Are Unregulated and Can Interact Dangerously With Prescription Medications

Your mother has been taking turmeric for her arthritis. Your father is considering acupuncture for his back pain. A friend recommended their parent 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 distinction matters because the risks are very different.

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. The NIH's National Center for Complementary and Integrative Health (NCCIH) recognizes acupuncture as helpful for chronic pain, including low back pain, knee osteoarthritis, and headaches. Multiple randomized controlled trials support these findings. Insurance sometimes covers acupuncture. It's considered complementary medicine, used alongside other treatments.

Tai chi, a slow-moving meditation practice, has strong evidence for improving balance and reducing falls in older adults. A study published in the Journal of the American Geriatrics Society found that tai chi reduced fall risk by approximately 20 percent in community-dwelling older adults. The CDC includes tai chi in its recommended fall prevention strategies. It's accessible, has low risk, and many communities offer classes.

Massage therapy helps some people with muscle tension, stress, and pain. The evidence is mixed, but the NCCIH notes that massage may provide short-term relief for back pain and neck pain. 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, can help with flexibility, strength, and balance. Classes specifically designed for seniors are often safe and helpful. The NIH notes that yoga may benefit people with chronic pain conditions and anxiety.

Then there are approaches with minimal or no evidence. Homeopathic remedies are heavily diluted substances that, scientifically, contain no active ingredient. The NIH states clearly that there is little evidence to support homeopathy as an effective treatment for any specific health condition. Studies consistently show homeopathy is no better than placebo. If your parent wants to use it, it's not likely to be harmful, but spending significant money on it is hard to justify.

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 the NIH warns it interacts dangerously with many medications, including blood thinners, birth control, heart medications, and antidepressants. Ginkgo biloba has some evidence for memory support, though the research is modest and a large NIH-funded trial found no benefit for preventing dementia. Most herbal supplements have little to no research supporting their use, and some are genuinely dangerous.

The problem with supplements is that they're not regulated like medications. The FDA does not require supplement manufacturers to prove safety or effectiveness before selling their products. A bottle of herbal supplement might contain what it says, or it might contain something different. The dosage might vary between batches. The quality is not guaranteed. Some supplements contain ingredients not listed on the label. Some contain contaminants including heavy metals.

This is where talking to a doctor matters. Your parent should tell their doctor about any supplements they're taking. Supplements interact with medications. Ginkgo biloba increases bleeding risk, which matters if your parent is on blood thinners. St. John's Wort interferes with many medications including those for heart disease and depression. Supplements that lower blood sugar interact with diabetes medications. If your doctor doesn't know your parent 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 parent believes they help. The placebo effect is real and sometimes enough for subjective symptoms.

Some approaches are actually dangerous. High-dose supplements can cause organ damage. Certain herbal remedies have documented toxicity. Some have led to serious poisoning. Relying exclusively on alternative treatment for a serious condition instead of seeing a doctor can mean missing a diagnosis that matters.

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

But if your parent 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 to explore before turning to unproven approaches.

The financial aspect matters too. Some complementary therapies are expensive. Insurance doesn't always cover them. Your parent 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 parent 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 and a clear treatment plan. 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 parent to stop conventional treatment. Be cautious about anyone claiming to have secret knowledge not understood by regular doctors. These are red flags.

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 participatory and personal. This is valuable, and it's worth discussing these feelings with their doctor. Sometimes conventional doctors can address this by involving your parent more in decisions about their own care.

Your role is supporting informed decision-making. Help your parent understand what evidence exists. Help them talk to their doctor. Help them avoid practitioners who are making claims that sound too good to be true. Help them avoid spending limited resources on approaches that don't work. Help them understand that conventional and complementary medicine can coexist when done carefully.

Frequently Asked Questions

Should I tell my parent's doctor about the supplements they're taking?
Absolutely. The NIH and every major medical organization emphasizes that doctors need to know about all supplements because of drug interaction risks. St. John's Wort, ginkgo biloba, garlic supplements, and many others interact with common prescription medications including blood thinners, heart medications, and antidepressants. Make a list of everything your parent takes, including dose and frequency, and bring it to every appointment.

Is acupuncture safe for older adults?
Yes, when performed by a licensed acupuncturist. The NCCIH notes that acupuncture has a good safety profile when done by a trained practitioner using sterile needles. Side effects are uncommon and usually minor, like temporary soreness at needle sites. It is recognized as effective for several chronic pain conditions. Check whether your parent's insurance covers it, as many plans now do.

My parent wants to stop their blood pressure medication and use herbal remedies instead. What should I do?
This is dangerous. No herbal remedy has FDA approval or strong evidence as a replacement for proven blood pressure medications. Stopping blood pressure medication without medical supervision can cause a hypertensive crisis. Talk to your parent about why they want to stop, whether it's side effects, cost, or feeling overmedicated, and bring those concerns to their doctor. There are often adjustments that can be made within conventional medicine.

How do I know if a supplement is safe and actually contains what the label says?
Look for supplements that carry USP (United States Pharmacopeia) or NSF International certification, which means an independent lab has verified the contents match the label. The FDA does not test or approve supplements before they're sold, so third-party certification is the closest thing to quality assurance available.

Does Medicare cover any complementary therapies?
Medicare covers acupuncture for chronic low back pain (up to 12 sessions in 90 days, with the possibility of 8 additional sessions if improvement is demonstrated). Medicare also covers chiropractic services for spinal manipulation in limited circumstances. Most other complementary therapies, including massage, naturopathy, and supplements, are not covered.