Our latest guest blogger is Ruth Kendon, the Regulatory & Technical Manager for Complementary Medicines, for the Australian Self-Medication Industry (ASMI). Ruth is a practising naturopath and herbalist with more than 24 years of experience. She has degrees in Naturopathy and Botanical Medicine and has served on the Board of Directors of the National Herbalists’ Association of Australia.

In this blog, Ruth talks about the role of complementary medicines in the health system, and shares some tips for using complementary medicines effectively.


Does complementary medicine deserve its place beside conventional medicine?

Complementary medicines are a legitimate and valid part of modern healthcare, despite recent allegations that they lack evidence, or that their popularity is no more than a passing fad.

Traditional complementary medicines have been used all over the world for centuries, and there is a large body of evidence, not only traditional but increasingly scientific, supporting their benefits. Much of this evidence has been scrutinised by respected expert bodies such as the European Commission and the World Health Organization (WHO). Both organisations have produced detailed and authoritative publications on the subject.[1] [2]

In the 20th Century the science of nutrition and of food components expanded dramatically and the importance of essential nutrients such as vitamins, minerals, and essential fatty acids, is now well established. These play an important role in the prevention, management and treatment of health conditions. Many governments as well as WHO have published information, recommendations and guidelines on specific nutrients, as well as on nutrition generally.[3] [4] [5] [6]

There are many examples of complementary medicines which are supported by good scientific evidence.

A Cochrane review of 28 randomised, double-blind controlled trials of the herb St. John’s Wort found that this herb is superior to placebo and equivalent to standard anti-depressants in the treatment of clinical depression. The reviewers also found that subjects treated with St. John’s Wort experienced fewer adverse reactions.[7]

More than 120 clinical trials have been published on the herb Ginkgo biloba. The great majority, including double-blind placebo-controlled trials, showed benefit in several conditions: intermittent claudication, tinnitus and mild dementia due to cerebral insufficiency or early Alzheimers disease. Once again, use of the herb was found to be similar in effect to standard drug treatment, with fewer adverse effects.[8] [9]

Vitamin D is essential in calcium metabolism, bone health, and other metabolic roles including immune function. It is produced in the body as a result of sunlight falling on the skin. Although the vitamin is found in small quantities in some foods, with current patterns of eating it is almost impossible to obtain sufficient vitamin D from the diet alone.[10] In recent years the risk of melanoma has led to national campaigns to use sunscreens and to avoid direct sun exposure. As a result, vitamin D deficiency is a growing problem and supplementation is frequently recommended, for example an article by a group of Sydney medical professionals says:

Australia is well known for its abundance of sunshine. Hence, it is perhaps surprising that vitamin D deficiency is a common condition affecting a large proportion of Australians. A recognised consequence of low vitamin D is osteomalacia in adults. It also contributes to osteoporosis, that is fragility fractures, in part through increased risk of falls. Vitamin D deficiency has also been implicated in other conditions including cardiovascular disease, increased cancer risk and mortality, falls, diabetes, multiple sclerosis, osteoarthritis, epilepsy and cognitive dysfunction.[11]

It is worth bearing in mind that substances like digitalis, codeine, quinine and aspirin were developed from traditional herbal medicines, based on traditional knowledge, and subsequently demonstrated by modern science to be highly effective.

Much progress has been made to develop the evidence base for complementary medicines but those who wish to invest in research face major challenges. The lack of appropriate IP protection provisions is a major disincentive. The vast majority of complementary medicines are based on well known ingredients, which make it very difficult to patent them. High-quality research is extremely costly and without patents companies cannot protect the investment required to run large trials. Despite this unfavourable regulatory environment many companies invest millions of dollars each year in the development of products and the evidence to prove their efficacy.

The growth in our understanding and acceptance of health and wellness, and of complementary medicines of all kinds, complements the body of medical knowledge. The important contribution of complementary medicines to the wider health system should be acknowledged and appreciated.

Consumers have made it very clear that they see a definite role for complementary medicines as part of an integrated approach to personal health and self care. Today’s consumers seek information, and have the tenacity to weigh up their options before making choices. All the evidence suggests that the majority of complementary medicine users in Australia are well educated, and use these products and services in combination with existing orthodox treatments; and they want GPs, pharmacists and other healthcare professionals to assist them in making the right choices.

Many GPs have embraced evidence-based complementary medicines as an important aid to wellness and recovery, and hold dual qualifications in both conventional and complementary medicine. These GPs should be commended, and there should be an enhanced role for the medical professions in helping consumers to make informed choices evidence-based alternative medicine.

So, in answer to the question I posed at the outset of this blog: Yes, evidence-based complementary medicines fully deserve their place alongside conventional medicines in the health system. With the industry moving in leaps and bounds to develop and innovate, consumers will only continue to benefit from quality health outcomes.

To get the best results with complementary medicines there are a few rules to follow:

  • Consult a qualified natural health practitioner, doctor or pharmacist to ensure that the complementary medicine is safe and effective, and to identify any possible reactions with other medications.
  • Read the label instructions carefully and know the active ingredients of the product so you can make informed choices.
  • Always check the use-by dates on the labels.

For more information about using complementary medicines wisely visit NPS

For more information about complementary medicines generally, visit Healthinsite and EBSCO Health Library .

[1] WHO, 2003. Monographs on Selected Medicinal Plants. World Health Organisation.

[2] The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council.1999.

[3] Australian Government Dept. of Health and Aging. 2006. Nutrient Reference Values for Australia and New Zealand including Recommended Dietary Intakes.

[4] WHO and FAO. 2004. Vitamin and Mineral Requirements in Human Nutrition. Second Edition.

[5] Food and Nutrition Board (USA). Dietary Reference Intakes for Energy, Carbohydrate, Fibre,  Fat, Fatty Acids,  Cholesterol,  Protein, and Amino Acids (Macronutrients) (2005). The National Academies Press.

[6] U.S. Department of Health and Human Services. U.S. Department of Agriculture. 2005. Dietary Guidelines for Americans. 2005.

[7] Linde K, Berner MM, Kriston L. St John’s Wort for major depression. Cochrane Database Syst Rev. 2008.

[8] Blumenthal M. 2003. The ABC Clinical Guide to Herbs. American Botanical Council/ Thieme.

[9] WHO,2003. Monographs on Selected Medicinal Plants. World Health Organisation.

[10] Australian Government Dept. of Health and Aging. 2006. Nutrient Reference Values for Australia and New Zealand including Recommended Dietary Intakes.

[11] Joshi D, Center J, Eisman J. Vitamin D deficiency in adults. Aust Prescriber 2010;33:103–6)