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Health & science

Not so alternative anymore

Complementary medicine moves into the mainstream.

Sharon Crump and Carol Hitchcock compare herbal supplements.
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Published 6/30/1999

Sharon Crump picks up a bottle marked "E 400" from the drugstore shelf. "I just polished off a bottle of these," she tells Carol Hitchcock of Southfield, who is clutching a bottle marked "Mega-Energy," a concoction of more than a dozen herbs and other natural helpers in pill form.

"I take everything you can imagine," says Hitchcock, an energetic redhead who won’t reveal her age. She says consuming approximately 20 pills daily – including herbal and other nutritional supplements – helps keep her looking young.

The women, drawn by a common interest in alternatives to traditional medicine, met recently in Aisle 2 of the F&M drugstore in Royal Oak. They are just two of millions of consumers contributing to what is now a fast-growing, multibillion-dollar industry.

Measuring the growth of the alternative health industry is tricky. The field, more commonly known as Complementary and Alternative Medicine, or CAM, includes everything from herbal remedies and nutritional supplements to services such as acupuncture and massage therapy. Figures tend to vary, depending on what facet of CAM is being examined and what individual researchers believe constitutes alternative medicine.

America’s Pharmacist magazine, in November 1997, predicted that nutraceuticals – a catchall term the industry uses to encompass herbal and nutritional supplements and remedies – will be a $12 billion industry in the United States by the year 2000.

According to the Journal of the American Medical Association, CAM therapies were used by 83 million Americans in 1997, up from 61 million in 1990. The journal estimates that Americans spent approximately $33 billion on CAM-related products and services in 1997.

Scott Marber, spokesperson for the Emeryville, Calif.-based company Consensus Health, says that’s up from $17 billion in 1993. Marber says more recent estimates have been as high as $50 billion.

Whether you’re talking about services or products, supplements or remedies, there’s little doubt that alternative medicine is moving into the mainstream. Evidence of the industry’s growth abounds. Chiropractic care, not long ago on the periphery of American medicine, is now offered to some extent in most of the nation’s health plans. An expanding array of herbal and nutritional supplements are now available at many drug stores.

A few years ago, Hitchcock says, finding her favorite vitamin and herbal supplements wasn’t nearly as convenient as dropping by F&M. She still goes to health food stores for more obscure items, such as the olive leaf extract she says she uses to boost her immune system, but Hitchcock is now finding more of what she’s looking for at mainstream stores: products with increased potencies, and purer forms of her favorite supplements, such as Ester-C, a highly concentrated vitamin C.

Newer brands of supplements offered at F&M include ones made by pharmaceutical giants Bayer and Whitehall-Robins. A new line of One-A-Day vitamins, produced by Bayer, features combinations including B-complex and ginseng, and vitamin C with echinacea and zinc. Whitehall-Robins’ Centrum Herbals debuted late last year.

"Companies that are getting into this now wouldn’t be getting into it if it wasn’t making money," says William J. Keller, chair of the department of pharmaceutical sciences at Samford University in Birmingham, Ala.

Keller says adding herbs to vitamins is expensive because it involves buying equipment to process the roots and leaves of herbs, and adding quality assurance experts to oversee the process.

Quality control, Keller warns, is especially important when it comes to herbal and nutritional supplements because they aren’t regulated by the U.S. Food and Drug Administration. He recommends consumers stick with products from reputable companies and check product labels for the percentage of active ingredients, which indicates a standardized product. Patients are also commonly advised to inform their doctors of any supplements or remedies they are taking, and to beware of complications that could result from taking certain combinations of herbal supplements and drugs.

As the public continues to broaden its concept of what constitutes good medical care, alternative health-related terminology is evolving so rapidly that some have even ceased calling it alternative, preferring terms such as "complementary" or "integrative."

On the cutting edge of these concepts are Consensus Health and a handful of other companies that have recently begun to offer multispecialty networks of CAM providers to health plans around the nation.

Consensus Health, founded in San Francisco in 1996, boasts one of the more diverse packages available. Through Blue Shield of California, for example, the company offers everything from the more popular acupuncture and chiropractic services to homeopathy, yoga and even personal trainersall at up to a 25 percent discount. Consensus Health is slated to begin offering alternative health services through Blue Cross Blue Shield of North Carolina in August.

Studies suggest a growing number of managed care programs want in on the action.

A survey underwritten by the Sacramento-based company Landmark Healthcare shows more than half the nation’s HMOs already offer some form of alternative health care, and more plan to jump on the bandwagon. More than 100 senior executives at HMOs were interviewed by telephone for the study, according to Landmark’s Web site.

Marber, who is Consensus Health’s senior vice president of marketing, says people are turning to alternative health care partly because of the current trend toward thinking of health as part of a lifestyle, not just a way of fixing something that’s already broken.

The focus on prevention comes at a time when employees are increasingly being required to contribute more for their health premiums. Therefore, Marber says, "people are becoming less apt to abdicate responsibility for their health to their doctor and their health plan."

Then there are those who believe traditional doctors have failed them, particularly those who suffer from chronic fatigue or pain. However, Marber adds, many people who are looking for solutions outside of traditional medicine are doing so simply because they want to be healthier than ever.

"People are looking for a mix of alternative health care and traditional health care," he says. "They want to take the best of both worlds."

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