Introduction to Integrative Medicine
Basic Information About Integrative Medicine
According to a 2012 national survey, many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches that are not typically part of conventional medical care or that may have origins outside of usual Western practice. When describing these approaches, people often use “alternative” and “complementary” interchangeably, but the two terms refer to different concepts:
- If a non-mainstream practice is used in addition to conventional/orthodox medicine, it’s considered “complementary.”
- If a non-mainstream practice is used in place of conventional/orthodox medicine, it’s considered “alternative.”
- If a non-mainstream practice is used in strategic coordination with conventional/orthodox medicine, it's considered "integrative."
Integrative health care often brings conventional and complementary approaches together to supplement each other. It emphasizes a holistic, patient-focused approach to health care and wellness—often including mental, emotional, functional, spiritual, social, and community aspects—and treating the whole person rather than, for example, one organ system.
In additional to complementary and alternative is the term “functional medicine.” This term sometimes refers to a concept similar to integrative health, but it may also refer to an approach that more closely resembles naturopathy A term that can apply to any of these approaches is "evidence-based," which is often used to describe a practice that evidence shows to be effective, even if the exact mechanism is disputed.1
Integrative approaches generally include traditional practices, mind-body techniques, and natural products for medical use (materia medica). These categories often overlap and many approaches include multiple aspects that can be separated or combined depending on the patient and the therapy.
A more exhaustive map of ISHAR's integrative topics can be found here, but below is an example of some of the more well-known integrative approaches. Please note that popularity does not always connote effectiveness.
Traditional Vedic medical system dating to 3000 BCE. Widely accepted in Indian medical institutions. Involves yoga, herbal medicines, mineral or metal supplementation (rasa shastra), surgical techniques, meditation and application of oil by massages in order to balance doshas and encourage healthy behavior/self-awareness.
A wide variety of practices utilize biofield approaches, includes Qigong, Reiki, Therapeutic Touch, and more. The principle is that healing energy is channeled into patients through hands-on, hands-off, or distant practitioners. The nature of this energy is controversial, ranging from bioelectromagnetism to spiritual power.
Traditional Chinese medicine ("TCM"; simplified Chinese: 中医; traditional Chinese: 中醫; pinyin: zhōng yī) is a broad range of medicine practices sharing common concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage (Tui na), exercise (qigong), and dietary therapy. TCM is widely used in China.
Includes ingesting nutritional supplements, restricting diet to certain types of foods, long-term limitations on caloric intake or temporary cessation of eating (fasting).
Created by Samuel Hahnemann, based on the idea that materials which cause symptoms in healthy people would cure them in sick people. Another key belief in homeopathy is the “law of minimum dose” which is the notion that the lower the dose of the medication, if agitated, the greater the effectiveness.
Meditation has been practiced since antiquity as a component of numerous religious traditions and health techniques. Meditation often involves an internal effort to self-regulate the mind in some way.
As with any approach to health care, the answer depends on many circumstances. If a patient were given antibiotics to treat their cancer, the results would be worse than useless. That does not mean that antibiotics are ineffective, nor that cancer is untreatable. It means that matching ailments with treatments is a complex, strategic, and individualized process, whether in orthodox or integrative healthcare.
In general, integrative medicine is most effective at treating issues involving:
- chronic pain
- systemic inflammation
- unhealthy lifestyle
- dietary ailments
- mental health
- quality of life
Conversely, orthodox medicine usually excels at treating problems like:
- acute conditions
- immediately life threatening conditions
Neither of these lists are authoritative and should not be used in place of a professional medical opinion.
Some advocates of integrative health have described the difference as "conventional medicine keeps you alive, integrative medicine keeps you living."
There are many integrative practices from many backgrounds. There are some approaches that have consistently positive results, some that are effective only under certain circumstances, and some that are no more effective than placebo. It is difficult to rate the reliability of techniques that are still being actively researched, but that is one of the issues that ISHAR is attempting to address.
ISHAR is currently developing a reliability rating system for the various topics housed on the database.
Below is a small selection of various findings on integrative reliability. More information is available throughout ISHAR on both topics and individual research papers.
- Studies have shown that spinal manipulation can provide mild-to-moderate relief from low-back pain and appears to be as effective as conventional medical treatments. Results from one trial that examined long-term effects in more than 600 people with low-back pain suggest that chiropractic care involving spinal manipulation is at least as effective as conventional medical care for up to 18 months.
- Using state-of-the-art imaging technology, NIH documented the power of the mind to activate certain parts of the brain to block pain signals, providing important information on how the mind-body connection works.
- In a study with over 3,000 participants, researchers supported in part by NCCAM found that the dietary supplement Ginkgo biloba was ineffective in reducing the development of dementia and Alzheimer's disease in older people. The trial, known as the Ginkgo Evaluation of Memory (GEM) study (http://nccam.nih.gov/research/results/gems/), is the largest clinical trial ever to evaluate ginkgo's effect on the occurrence of dementia.
- In one of the largest clinical trials to date to test the safety and efficacy of acupuncture, NIH-supported researchers found that acupuncture significantly reduced pain associated with osteoarthritis of the knee when used as a complement to conventional therapy. Other studies and reviews demonstrated that acupuncture provides relief for vomiting and nausea from chemotherapy, shows possible effect for tension headaches, and that acupuncture and simulated acupuncture can both provide relief for those suffering from low-back pain.
- Results from a long-term NIH-supported study revealed that people who took the dietary supplements glucosamine and chondroitin (alone or in combination) for osteoarthritis of the knee had outcomes similar to those experienced by people who took the drug celecoxib or placebo. This study, part of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) (http://nccam.nih.gov/research/results/gait/) assessed the safety and effectiveness of the supplements over two years.
- People with fibromyalgia may benefit from practicing tai chi according to a study in 66 people. Study participants who practiced tai chi had a significantly greater decrease in total score on the Fibromyalgia Impact Questionnaire. In addition, the tai chi group demonstrated greater improvement in sleep quality, mood, and quality of life.2
Any integrative medical approach relies on patients being actively involved, rather than passive recipients.
ISHAR encourages users to compare the perspectives on other informational sites to what they find on ISHAR, then come to their own conclusions regarding what the evidence supports.
Many topics on this site include links to articles offering alternative perspectives by different information sites, usually including Wikipedia, WebMD, a site advocating integrative practices, and a site condemning integrative practices. Every source of information has its biases and ISHAR encourages critical analysis of all its content.
Some steps for coming to an informed conclusion involve:
- Who is making a claim and do they have a stake in convincing you?
- Look for evidence to support claims
- Is the evidence peer-reviewed or just an opinion?
- Is there evidence that refutes the claim?
- Are there obvious flaws in either type of reasoning?
- If you compare the evidence for and against, which is more convincing?
- Be prepared to change your mind if the evidence leads that way
There are numerous organizations working to advance the understanding and application of integrative medicine, several of whom ISHAR is privileged to work with.
A few of the leading organizations in this field include
- The Chopra Institute
- Osher Centers for Integrative Medicine
- The federal NCCIH program
- Sweden's renowned Karolinska Institute
- The Mayo Clinic's Integrative Medicine Research Program
- UCSD's Center for Integrative Medicine
1 “Complementary, Alternative, or Integrative Health: What’s In a Name?,” NCCIH, November 11, 2011, https://nccih.nih.gov/health/integrative-health.
2 “NIH Fact Sheets - Complementary and Alternative Medicine,” updated June 30, 2018, https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=85.
“Brent A. Bauer - Complementary and Integrative Medicine Program,” Mayo Clinic, http://www.mayo.edu/research/centers-programs/integrative-medicine-healt...
"Complementary and Integrative Medicine,” Text, https://medlineplus.gov/complementaryandintegrativemedicine.html
"Home Page,” Osher Center For Integrative Medicine, https://oshercenter.org/.
“Welcome to a Workshop in Bioelectronic Medicine at KI,” https://ki.se/en/staff/calendar/welcome-to-a-workshop-in-bioelectronic-m....