What Things Should I Know When Selecting a Complementary Health Practitioner?

03.06.04  What Things Should I  Know When Selecting a Complementary Health Practitioner — GARD

If you’re looking for a complementary health practitioner to help treat a medical problem, it is important to be as careful and thorough in your search as you are when looking for conventional care.

Here are some tips to help you in your search:

1If you need names of practitioners in your area, first check with your doctor or other health care provider. A nearby hospital or medical school, professional organizations, state regulatory agencies or licensing boards, or even your health insurance provider may be helpful. Unfortunately, the National Center for Complementary and Integrative Health (NCCIH) cannot refer you to practitioners.

2Find out as much as you can about any potential practitioner, including education, training, licensing, and certifications. The credentials required for complementary health practitioners vary tremendously from state to state and from discipline to discipline.

Once you have found a possible practitioner, here are some tips about deciding whether he or she is right for you:

3Find out whether the practitioner is willing to work together with your conventional health care providers. For safe, coordinated care, it’s important for all of the professionals involved in your health to communicate and cooperate.

4Explain all of your health conditions to the practitioner, and find out about the practitioner’s training and experience in working with people who have your conditions. Choose a practitioner who understands how to work with people with your specific needs, even if general well-being is your goal. And, remember that health conditions can affect the safety of complementary approaches; for example, if you have glaucoma, some yoga poses may not be safe for you.

5Don’t assume that your health insurance will cover the practitioner’s services. Contact your health insurance provider and ask. Insurance plans differ greatly in what complementary health approaches they cover, and even if they cover a particular approach, restrictions may apply.

6Tell all your health care providers about the complementary approaches you use and about all practitioners who are treating you. Keeping your health care providers fully informed helps you to stay in control and effectively manage your health.

What are the issues related to a Complementary Health Approach?

03.06.03  What are the issues related to a Complementary Health Approach? — GARD

https://nccih.nih.gov/health/decisions/consideringcam.htm

Millions of Americans use complementary health approaches. Like any decision concerning your health, decisions about whether to use complementary approaches are important. The National Center for Complementary and Integrative Health (NCCIH) has developed a fact sheet to assist you in your decisionmaking about complementary health products and practices.

Take Charge of Your Health

▪ Be an informed consumer. Find out and consider what scientific studies have been done on the safety and effectiveness of any health approach that is recommended to or interests you.

▪ Discuss the information and your interests with your health care providers before making a decision.

▪ Choose a complementary health practitioner, such as an acupuncturist, as carefully as you would choose a conventional health care provider.

▪ Before using any dietary supplement or herbal product, make sure you find out about potential side effects or interactions with medications you may be taking.

▪ Only use treatments for your condition that have been proven safe. Do not use a product or practice that has not been proven to be effective to postpone seeing your health care provider for your condition.

▪ Tell all your health care providers—complementary and conventional—about all the health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

What do “complementary,” alternative,” and “integrative” mean?

“Complementary and alternative medicine,” “complementary medicine,” “alternative medicine,” “integrative medicine”—you may have seen these terms on the Internet and in marketing, but what do they really mean? While the terms are often used to mean the array of health care approaches with a history of use or origins outside of mainstream medicine, they are actually hard to define and may mean different things to different people.

The terms complementary and integrative refer to the use of non-mainstream approaches together with conventional medical approaches.

Alternative health approaches refer to the use of non-mainstream products or practices in place of conventional medicine. NCCIH advises against using any product or practice that has not been proven safe and effective as a substitute for conventional medical treatment or as a reason to postpone seeing your health care provider about any health problem. In some instances, stopping—or not starting—conventional treatment can have serious consequences. Before making a decision not to use a proven conventional treatment, talk to your health care providers.

How can I get reliable information about a complementary health approach?

It’s important to learn what scientific studies have discovered about the complementary health approach you’re considering. Evidence from research studies is stronger and more reliable than something you’ve seen in an advertisement or on a Web site, or something someone told you about that worked for them. (For tips on how to evaluate Web site information, see the NCCIH fact sheet Finding and Evaluating Online Resources on Complementary Health Approaches.)

https://nccih.nih.gov/health/webresources

Understanding a product’s or practice’s potential benefits, risks, and scientific evidence is critical to your health and safety. Scientific research on many complementary health approaches is relatively new, so this kind of information may not be available for each one. However, many studies are under way, including those that NCCIH supports, and knowledge and understanding of complementary approaches are increasing all the time. Here are some ways to find reliable information:

▪ Talk with your health care providers. Tell them about the complementary health approach you’re considering and ask any questions you may have about safety, effectiveness, or interactions with medications (prescription or nonprescription) or dietary supplements.

▪ Visit the NCCIH Web site (nccih.nih.gov). The “Health Information” page has an A-Z list of complementary health products and practices, which describes what the science says about them, and links to other objective sources of online information. The Web site also has contact information for the NCCIH Clearinghouse, where information specialists are available to assist you in searching the scientific literature and to suggest useful NCCIH publications. You can also find information from NCCIH on Facebook (www.facebook.com/nih.nccih (link is external)
>  Twitter (www.twitter.com/nih_nccih (link is external)
>  YouTube (www.youtube.com/c/nih_nccih (link is external)
>  and Pinterest (www.pinterest.com/nccih (link is external)

▪ Visit your local library or a medical library. Ask the reference librarian to help you find scientific journals and trustworthy books with information on the product or practice that interests you.

Are complementary health approaches safe?

As with any medical product or treatment, there can be risks with complementary approaches. These risks depend on the specific product or practice. Each needs to be considered on its own. However, if you’re considering a specific product or practice, the following general suggestions can help you think about safety and minimize risks.

▪ Be aware that individuals respond differently to health products and practices, whether conventional or complementary. How you might respond to one depends on many things, including your state of health, how you use it, or your belief in it.

▪ Keep in mind that “natural” does not necessarily mean “safe.” (Think of mushrooms that grow in the wild: some are safe to eat, while others are not.)

▪ Learn about factors that affect safety. For a practice that is administered by a practitioner, such as chiropractic, these factors include the training, skill, and experience of the practitioner. For a product such as a dietary supplement, the specific ingredients and the quality of the manufacturing process are important factors.

▪ If you decide to use a practice provided by a complementary health practitioner, choose the practitioner as carefully as you would your primary health care provider. (To learn more, see NCCIH’s 6 Things To Know When Selecting a Complementary Health Practitioner.)

▪ If you decide to use a dietary supplement, such as an herbal product, be aware that some products may interact in harmful ways with medications (prescription or over-the-counter) or other dietary supplements, and some may have side effects on their own. (To learn more, see the NCCIH fact sheet Using Dietary Supplements Wisely.)

▪ Tell all your health care providers about any complementary or integrative health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

How can I determine whether statements made about the effectiveness of a complementary health approach are true?

Before you begin using a complementary health approach, it’s a good idea to ask the following questions:

▪ Is there scientific evidence (not just personal stories) to back up the statements?

▪ What is the source? Statements that manufacturers or other promoters of some complementary health approaches may make about effectiveness and benefits can sound reasonable and promising. However, the statements may be based on a biased view of the available scientific evidence.

▪ Does the Federal Government have anything to report about the product or practice?

▪ Visit the NCCIH Web site or contact the NCCIH Clearinghouse to see if NCCIH has information about the product or practice.

▪ Visit the U.S. Food and Drug Administration (FDA) online at www.fda.gov/ to see if there is any information available about the product or practice.

▪ Information specifically about dietary supplements can be found on the FDA’s Web site at www.fda.gov/Food/DietarySupplements/ and on the Web site of the National Institutes of Health (NIH) Office of Dietary Supplements at ods.od.nih.gov/.

▪ Visit the FDA’s Web page on recalls and safety alerts at www.fda.gov/Safety/Recalls/. The FDA has a rapid public notification system to provide information about tainted dietary supplements. See www.fda.gov/AboutFDA/ContactFDA/StayInformed/RSSFeeds/TDS/rss.xml.

▪ Check with the Federal Trade Commission at www.ftc.gov to see if there are any enforcement actions for deceptive advertising regarding the therapy. Also, visit the site’s Consumer Information section at www.consumer.ftc.gov.

▪ How does the provider or manufacturer describe the approach?

▪ Beware of terms like “scientific breakthrough,” “miracle cure,” “secret ingredient,” or “ancient remedy.”

▪ If you encounter claims of a “quick fix” that depart from previous research, keep in mind that science usually advances over time by small steps, slowly building an evidence base.

▪ Remember: if it sounds too good to be true—for example, claims that a product or practice can cure a disease or works for a variety of ailments—it usually is.

Is That Health Web Site Trustworthy?

If you’re visiting a health Web site for the first time, these five quick questions can help you decide whether the site is a helpful resource.

Who? Who runs the Web site? Can you trust them?

What? What does the site say? Do its claims seem too good to be true?

When? When was the information posted or reviewed? Is it up-to-date?

Where? Where did the information come from? Is it based on scientific research?

Why? Why does the site exist? Is it selling something? Are You Reading Real Online News or Just Advertising?

Are complementary health approaches tested to see if they work?

While scientific evidence now exists regarding the effectiveness and safety of some complementary health approaches, there remain many yet-to-be-answered questions about whether others are safe, whether they work for the diseases or medical conditions for which they are promoted, and how those approaches with health benefits may work. As the Federal Government’s lead agency for scientific research on health interventions, practices, products, and disciplines that originate from outside mainstream medicine, NCCIH supports scientific research to answer these questions and determine who might benefit most from the use of specific approaches.

I’m interested in an approach that involves seeing a complementary health practitioner. How do I go about selecting a practitioner?

▪ Your primary health care provider or local hospital may be able to recommend a complementary health practitioner.

▪ The professional organization for the type of practitioner you’re seeking may have helpful information, such as licensing and training requirements. Many states have regulatory agencies or licensing boards for certain types of complementary health practitioners; they may be able to help you locate practitioners in your area.

▪ Make sure any practitioner you’re considering is willing to work in collaboration with your other health care providers.

▪ For more suggestions, see NCCIH’s 6 Things To Know When Selecting a Complementary Health Practitioner and Credentialing, Licensing, and Education.

Can I receive treatment or a referral to a complementary health practitioner from NCCIH?

NCCIH does not provide treatment or referrals to complementary health practitioners. NCCIH’s mission is to define, through rigorous scientific investigation, the usefulness and safety of complementary health approaches and their roles in improving health and health care.

Can I participate in a clinical trial of a complementary health approach?

NCCIH supports clinical trials on complementary health approaches. These trials are taking place in many locations, and study participants are needed. To learn more or to find trials that are recruiting participants, visit NIH Clinical Research Trials and You. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials.gov, and other resources and stories about the personal experiences of clinical trial participants.

For More Information

NCCIH Clearinghouse

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.:

1-888-644-6226

TTY (for deaf and hard-of-hearing callers):

1-866-464-3615

Web site:

nccih.nih.gov

E-mail:

info@nccih.nih.gov

(link sends e-mail)

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Office of Dietary Supplements (ODS), National Institutes of Health (NIH)

ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public. Its resources include publications (such as Dietary Supplements: What You Need to Know), fact sheets on a variety of specific supplement ingredients and products (such as vitamin D and multivitamin/mineral supplements), and the PubMed Dietary Supplement Subset.

Web site:

ods.od.nih.gov

E-mail:

ods@nih.gov

(link sends e-mail)

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MedlinePlus

To provide resources that help answer health questions, MedlinePlus (a service of the National Library of Medicine) brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations.

Information on health approaches

Web site:

www.medlineplus.gov

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NIH Clinical Research Trials and You

The National Institutes of Health (NIH) has created a Web site, NIH Clinical Research Trials and You, to help people learn about clinical trials, why they matter, and how to participate. The site includes questions and answers about clinical trials, guidance on how to find clinical trials through ClinicalTrials.gov and other resources, and stories about the personal experiences of clinical trial participants. Clinical trials are necessary to find better ways to prevent, diagnose, and treat diseases.

Web site:

www.nih.gov/health/clinicaltrials/

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PubMed®

A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed.

Web site:

www.ncbi.nlm.nih.gov/pubmed

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U.S. Food and Drug Administration (FDA)

The FDA oversees the safety of many products, such as foods, medicines, dietary supplements, medical devices, and cosmetics. See its Web page on Dietary Supplements.

Toll-free in the U.S.:

1-888-463-6332

Web site:

www.fda.gov

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Federal Trade Commission (FTC)

The FTC is the Federal agency charged with protecting the public against unfair and deceptive business practices. A key area of its work is the regulation of advertising (except for prescription drugs and medical devices).

Toll-free in the U.S.:

1-877-382-4357

Web site:

www.ftc.gov

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This publication is not copyrighted and is in the public domain. Duplication is encouraged.

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NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

NCCIH Pub No.: D339

Last Updated:

September 2016

How to find a disease specialist — GARD

Many individuals want to know about healthcare professionals or researchers who have knowledge of their conditions. When a condition is rare, it can be difficult to find someone who has seen many cases. Although there is no list of experts in rare diseases, the guidelines below include several ways to identify healthcare professionals who have experience with a particular condition. Potential resources include patient advocacy groups, researchers who have conducted or are conducting clinical trials, and authors of articles published in the medical literature.

We are providing these resources to assist you in your search; however, sometimes it will not be possible to find a healthcare professional who has extensive experience in a particular rare condition. At the bottom of this fact sheet, we have provided some suggestions to help you when you are still unable to locate an expert after researching these resources.

The GARD Information Center provides these resources for informational purposes only and not as an endorsement of services. You should use your own judgment when evaluating a healthcare professional. You can find helpful information on choosing quality health care from the Agency for Healthcare Research and Quality (AHRQ).

How can I find a:

✽    Healthcare professional with experience in a specific condition?
✽    Specialty treatment center?
✽    Genetics clinic?
✽    Researcher who is studying my condition?
✽    What if I can’t find an expert?
✽    How can I find a healthcare professional with experience in a specific condition?

Several resources may be able to assist in your search for a healthcare professional with experience in a particular condition:

✽    Many disease advocacy organizations have medical advisory boards, physician locator services, or patient networks, all of which may help you find a healthcare professional who is familiar with a particular condition. You can search for a condition on this website to find related disease advocacy organizations. These would be located in the “Organizations” section. If you don’t find a specific group, search the Genetic Alliance and the National Organization for Rare Disorders (NORD) websites.

✽    Published resources provide another way to find a specialist for a particular condition. Experts are often called upon to contribute to online publications such as GeneReviews, NORD, and Medscape Reference. Many of these resources list the author’s name and institution and may provide an e-mail address or phone number.

✽    You can also search the medical literature to find healthcare professionals or researchers who have published recent articles or case reports on a particular condition. You can find relevant articles through PubMed, a searchable database of biomedical journal articles. Although not all of the articles are available online for free, most articles listed in PubMed have a summary/abstract available. In addition, contact information for one of the authors may be listed. On the Results page, select “Abstract” under Display Settings to view information about the authors.

Source: https://rarediseases.info.nih.gov/guides/pages/25/how-to-find-a-disease-

SG 03.06.01

What do I need to know about apremilast/Otezla?

Why is apremilast prescribed?

Apremilast is used to treat psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin). Apremilast is in a class of medications called phosphodiesterase inhibitors. It works by blocking the action of certain natural substances in the body that cause inflammation. Brand name: Otezla®

Click HERE to learn more about apremilast at MedlinePlus (U.S. Library of Medicine)

Editor’s Note
What works for one doesn’t work for all.  What has been your experience with apremilast/Otezla? Please use Leave a Reply below to share your insights.

SG Acitretin / Soriatane

What do I need to know about adalimumab/Humira?

Why is adalimumab prescribed?

Adalimumab injection is used alone or with other medications to relieve the symptoms of certain autoimmune disorders (conditions in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage) including the following:

✽    rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function),

✽    juvenile idiopathic arthritis (JIA; a condition that affects children in which the body attacks its own joints, causing pain, swelling, loss of function, and delays in growth and development),

✽    Crohn’s disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever) that has not improved when treated with other medications,

✽    ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum) when other medications and treatments did not help or could not be tolerated.

✽    ankylosing spondylitis (a condition in which the body attacks the joints of the spine and other areas causing pain and joint damage),

✽    psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin),

✽    chronic plaque psoriasis (a skin disease in which red, scaly patches form on some areas of the body).

Adalimumab injection is in a class of medications called tumor necrosis factor (TNF) inhibitors. It works by blocking the action of TNF, a substance in the body that causes inflammation. Brand name: Humira® Injection

Click HERE to learn more about adalimumab at MedlinePlus (U.S. Library of Medicine)

Editor’s Note
What works for one doesn’t work for all.  What has been your experience with adalimumab? Please use Leave a Reply below to share your insights.

SG Adalimumab

What do I need to know about secukinumab/Cosentyx?

Why is this secukinumab prescribed?

Secukinumab injection is used to treat moderate to severe plaque psoriasis (a skin disease in which red, scaly patches form on some areas of the body) in people whose psoriasis is too severe to be treated by topical medications alone. Secukinumab injection is in a class of medications called monoclonal antibodies. It works by stopping the action of certain cells in the body that cause the symptoms of psoriasis. Brand name: Cosentyx®

Click HERE to learn more about secukinumab at MedlinePlus (U.S. Library of Medicine)

Editor’s Note
What works for one doesn’t work for all.  What has been your experience with secukinumab? Please use Leave a Reply below to share your insights.

SG Secukinumab

What do I need to know about certolizumab/Cimzia?

Why is certolizumab prescribed?

Certolizumab injection is used to relieve the symptoms of certain autoimmune disorders (conditions in which the immune system attacks healthy parts of the body and causes pain, swelling, and damage) including the following: Certolizumab injection is in a class of medications called tumor necrosis factor (TNF) inhibitors. It works by blocking the activity of TNF, a substance in the body that causes inflammation.

✽     Crohn’s disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever) that has not improved when treated with other medications,

✽    rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function),

✽    psoriatic arthritis (a condition that causes joint pain and swelling and scales on the skin),

✽    active ankylosing spondylitis (a condition in which the body attacks the joints of the spine and other areas causing pain and joint damage).

Brand name: Cimzia®

Click HERE to learn more about certolizumab at MedlinePlus (U.S. Library of Medicine)

Editor’s Note
What works for one doesn’t work for all.  What has been your experience with certolizumab/Cimzia? Please use “Leave a Reply” below to share your insights.

SG Certolizumab

What do I need to know about ixekizumab/Taltz?

Why is ixekizumab prescribed?

Ixekizumab injection is used to treat moderate to severe plaque psoriasis (a skin disease in which red, scaly patches form on some areas of the body) in people whose psoriasis is too severe to be treated by topical medications alone. Ixekizumab injection is in a class of medications called monoclonal antibodies. It works by blocking the action of a certain natural substance in the body that causes the symptoms of psoriasis. Brand name: Taltz®

Click HERE to learn more about ixekizumab at MedlinePlus (U.S. Library of Medicine)

Editor’s Note
What works for one doesn’t work for all.  What has been your experience with ixekizumab/Taltz? Please use”Leave a Reply” below to share your insights.

SG Ixekizumab